Permit CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC201000104
T I GAKD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/04/2010
Parcel: 2S 113AB01201
Jurisdiction: TIGARD
Site address: 16505 SW 72ND AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Liberty Mutual
Project Description: 2nd floor remodel, (15) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 15 crt Branch Circuits 03/04/2010 $160.06
wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 03/04/2010 $19.21
Electrical
Contractor:
TIMBERLINE ELECTRICAL CONTRACTORS
PO BOX 918
LAKE OSWEGO, OR 97034
•
PHONE: 503- 459 -4089
FAX: 503 - 254 -4227
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $179.27
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTI • ••. • - • •n law - ; uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -001 • + rough OAR 9 -%•1-01 . ' • �may�4obtt�ain �a�copy of the rules or direct questions to OUNC by calling % . 46.6699 or 1.800.332.2344.
Issued B / "`-� `� Permittee Signature: =
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Mir r?° Date:
LICENSE NO.
CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
03/03/2010 04:06 FAX Z002/002
pectrical lP,it Application -- " '.
,. .. ,;,- , ,, - i t,l - ,,,!-
s " t t ° .� 1 , City of Tigard - . °7 s a 3 CO .. Puma No. ^ e�G o O _In /O5f
13125 SW Hell Blvd, Tigard, OR 97 Plan Review
+=ar Or
• Ph one: 503.639.4171 Fax 503.598.1960 Datc/By: o Pamir:
Inspection Line: 503.639.4175 MAR 0 .3 2010 Date 1 eady'y: lu & el See Page 2 for
.t :s ,,._. Internet: www.tigard- or.gov Notifcd/Method: Supplanental Information
: ,,.< ? '.. f t ; Iy' it r r `k'7-: -� r... , ' '�➢'k r. i ie '' Z 'ta -'.�; ,, ,. { : jf¢ r. cr. 5. '45 i ,;> - a
t c 1 X'`t { '- 1t I :7,11' , �'4 y` t ' ro u �.
. 40 New construction ._< �� : f. '.�. � �.... . -i - v.,... ' � r i�� r -f �., f'� ��f`c?.c e�k, _.k�.. { t�� .�...� �.1.�-: � *F �!. r.�'.. .x�� e .... � `� f� ..
Addition/altera :VO" R i► ", ' • Please check ell that apply (submit a sets of plans wfrtems checked below):
❑ Service or feeder 400 amps Of mov D Building over tune stories.
❑.Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
_, } f t ti r 4 ,, y .. -Vz t 1 7 3,1• ,�,:'� ^ i s^t ^v. age t i ,!. - i t 4Ittri . 7�
exceeds rod9 10,000 amps 150 volts or Ftoatittg buildings
a � w..�ra w �.. : ..,_. : rY ...- ; � , ���c+ F. :: x...-.. r ,:. " t;e� ?:t�.'`n+a levstogrouad,orexceeds14,000 ❑Gommercial�useagrieulrurel
1- and 2-family dwelling ►.i Commercial/industrial ❑ Accessory building amps for all other installations. buildings -
❑ Multi-mil 0 Masted builder ❑ Other. ❑ Fire pump. 0 Installation of 75 KVA or
`'' y y i . ' s •cgs ??I',, „ , k+ is.c.F �3, • t i F ) ' t „ a ir: :4 � �.,., e ,:;.--14 ,,,t l In Ernm6Wcy system. larger separately derived ardent.
n .., s 4 , 4, N l r. a. . ,..:.:» . - _4; f _...e..._ .
t.....l..le. 1. > r ,s ai ar,,�X ...1 " ❑ Addition of new motor load of El 2"
"A ". "E ", "1 -, "I -3 ",
Job no.: Job site address: i a c-' '1 no A 10011P or mare. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/Sta iZ1P: 11 ► ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 609 voles nominal.
3tlitelbldg.7api no.: Project name: 4 6 . ' S erene w feeder 600 amps i" or more
u v
x A ;K rr- "l'(r.rM, - l t v a z N F
Cross street/directions to iob site: Ie:) 3f s&. fi . , __ r... r F ds ?. Taut ., 1 -x.;
n4iprMw Qty. •
New residential single- or mdti- family dwelling tmtt.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or less 168.54 4
Tax map /parcel Ile.: 3 Ea. add'I 500 sq. !Z or p ortion 33.92 1 •
" ' r } .:F; -z• _ i , WT 1 ry }i ° ' x , �i/. art. `��' iF. r Limited energy, residential 67.84 2
s 5, 4 : : .'.0 ._ �_. ... .t,.. . *:: :1 :�G,.. ar",� A `Ali .f^a;.n; i+ >f- is ";5`s%'J!�..I. (with above aq. 11J
M IIM Limned end' multi -may 67.84 2
reaideldial (with above sq. ft.)
Services or feeders alteration, and/or relocation
1` P' t' r ' 4 y ,, k , ytie. . fi yr / -T `+' yrf „' ce sn •� ,J�r�..�' 7 . Z ..W 2 200 amps or less 100.70 2
y l• .,Y,, , y c }' 20l amps to 400 amps 133.56 2
.4 :'� ?'. ?. .. a 5 ..a. a s"i. �!;n �t t.` -<_7 sr:W err y�� s�psl.:i
Name: % f k r. ` � ,� 401 atmps to 600 amps 200.34 2
+ 0 ° ��� ‘LID 601 amps to 1,000 amps 301.04 2
Address:
l 0 0 as G tX 1 t, P Over 1,000 amps or wits 552.26 2
City/State/ZIP: * tlr ' ,.. , a CI, q 1 1 Tesnporary services or feeders Installation alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I 1
Owner installation: This installation is being made on property that I own which is not 201 trips to 400 amps 125.08 2
1 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 earns to 599 amps 168.54 2
Branch drains - new, alteration, or extension, r panel
OWAec signature: Date: A. Fee for branch circuits with
t t S 5. i :i k ro
:d; a j n" ?C� i s 4 "r a
F =i r � u r , 's ' s'= 1 fq d �i"P z v : _ j . s above service or feeder feu, 7A2 2
...[c' ...r .,,.,_.,, .. .. .,r „Y ..�r.. .. .t ., • tr3:.- ?. rMt:4+; i_m. �__,,:71..r �`
_.� � . ... each branch circuit
Business name: 4. r • 4 B. Fee for branch circuits ,
without service or feeder fee,
Contact name: * fv i� �-6tw� first btanoh circuit 56.18 J r� , g 2
Address Each addl branch circuit 1 7.42 (D3, 6 2
Mi+cellaneons (service or feeder not hseluded)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone ( ) Fax: : ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
112:f' . ` " "' ' 4 , h . .P " s s � ;:
" ;,2 L 1V r - 3,, . s ;x. rr-. d Sign ar outline lighting 67.84 2
.
Signal circuit(e) or limited-
Business name: t 2
6� , , ( . ,, energy panel, alteration, or
Address: • 0 Q , l t� ■ ! R extension Describe: Page 2 2
City( ThP: !- tY 5jie 6o QQ, q-10 Each additional inspection over allowable to • . of the above
Per inspection
Phone: )�-�p f a Fax: (0) -� Investigation per hour (1 hr min) 66.25
CCB Lic.: IC, o 6 � / Electrical II :8 (p - l p r v. Lic.: 4 e Industrial plate per hour 7818
■' a s * r ,„ 4??:4 f '. r * tit y , . T . M t
Suprv. Electrician signature, required: Fill'��� � �-` s , _. u t k , # «r
Subtotal. • .
Print Warne: + .; - , . Plan review (25% of permit fee):
State surcharge
dr..t.L (12% of permit fee): 14', D
Authorized signature. , ,i I / . TOTAL PERMIT FEE: j 7 ,
a.
Print name: i / Date: / b This permit application expires Ira permit b not obtained within I80
t✓A t days after it has been accepted m complete
• Number of inspections allowed per permit
L18m1ditplPemrhs1FLC.P itapp.doa I04)1/09 440.4615r(11/051COM / w®