Permit `- . CITY OF TIGARD ELECTRICAL PERMIT
fi Permit #: ELC2009 -00595
x a r . C OMMUNIT Y DEVELOPMENT
(l 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/03/2009
t 1 v.ia+t w: Parcel: 2S101 DC04000
Jurisdiction: Tigard
Site address: 7550 SW TECH CENTER DR 220
Subdivision: Lot: 0
Project: Prosource
Project Description: Install 200 amp service.
Owner: FEES
WALTON CWOR SOUTHRIDGE 12 LLC Quantity Description Date Amount
BY TTA/EPROPERTYTAX DEPT 325, PO BOX
4900 1 ea Services or Feeders - 200 11/03/2009 $100.70
amps or less
PHONE: 1 ea 12% State Surcharge - 11/03/2009 $12.08
Electrical
Contractor:
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503 - 257 -7121
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952-001-0100. You may obtain
X/ iin a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 4n / IA�J� ((12,11.1 1 X .3 Permittee Signature: Q.S . i7P •
OWNER INSTALLATION ONLY
The installation is being made on properly I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
I lk /02/2009 10:09 5032577121 CAPITOL ELECTRIC PAGE 02
Electrical Permit A DPIiCati0nRECEIVED �i- ,, - :.44 . a l r + fr ?4
Received
£ F " ` City of Tigard Date/ y: e�^' � Permit no.: Y , ' /���C�C��
UI.AJ '5
' ._ ' n _ ■ 13125 SW Hall Blvd., Tigarfl, OR 97223A! 2,' Plan Review ei^'
t$• ' 2 Phone: 503.639.4171 Fax: 503.598.18 ��! 20 9 Datc/By: OtherPcrmit: jii
e ow.1114 Inspection Lute: 503.639.4175 Dale Ready/By: Jur . ear race 2 for
' .� ,•. ' -'� Internet: wwW.tigard- or -gov CITY OF TIGARD Notified/Method: lf'C1 Supplcmcn$.J tufrrmnuinn
BUILDING DIVISION
TYPE OF WORK PLAN REVIEW
I_I New construction LLJ Addition /alteration /replacement Please chock as that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other ❑ Service or feeder 400 amps or morn ❑ Building over three stones
CATEGORY OF CONSTRUCTION where the aveilablo fault current n Marinas and boatyards
❑ I. and 2-family dwelling 14 I Commercial /industrial LJ Accessory building exceeds 10.000 amps 31150 volts or Floating buildings
Multi•Parttil ❑I Master Builder LJ Other less to ground, or exceeds 14,000 Commorclal -use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other Installations. ❑ buadIngs
Job no.: 291066 Job site address; 7550 SW Tech Center Drive ❑ Fire Pomp 1.7.1 Installation of 75 KVA or
❑ Emorge ncy system _ larger separately derived system.
C.ily /Stale /ZIP; Tigard Oregon
❑ Addition of new motor load of L I "A ". "E", '1-2". "1 -3 ",
100HP or more. El occupancy
Suite/bldg./apt, no.: 7550 Pmjcct name: CA e t ❑ six Or more resIdnntlal units ❑ Recreational vehicle parks.
a.) ❑ Health-care facilities LJ Supply voltage for more than
Cross Street/Directions to jab site: ❑ 1- lazardous locations LJ 600 volts nominal.
❑ Service or fbcdcr 600 snips or mare
Subdivision: 1_nt no.: TEE SCHEDULE
Description I Qty. I Fee. I Tor.!
T
Tax map /parcel no.: New residential - single or multi- family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
Replace meter socket 1000 sq. ft. or less $ 145.15 el
Ea. Add) 500 sq. ft or portion $ 33.40 I
LJ PROPERTY OWNER 1 LJ TENANT - Limited energy residential
(with above ft.) $ 75,00 2
Namc:
Limited energy, multi - family
residential (with above sq. ft.) S 75.00 _ 2
Address: Service or feeders Installation. alteration, and /or relocation
200 amps or less 1 5 80.30 80.30 2
City /State /ZIP; 201 amps to 400 amps 5 106.85 2
Phone: Fax:
401 amps to 600 amps $ 160.60 2
601 amps to 1000 amps 5 240.64 2
Owner Installation: This installation is being made on property that I own which is not Over 1000 amps or volts S 45465 2
intended for sale, lease, rent or exchange, according to ORS 447, 449. 670. and 701 temporary services or feeders installation, niterntinn, and /nr
Owner signature: Date: relocation
200 amps or less 5 66,85 I
LI APPLICANT 1 CONTACT PERSON 20] amps to 400 amps S 100.30 2
Business Namc 401 amps to 600 amps S 133.75 2
Branch circuits • new, alteration, or extension, per pane(
Contact name: A. Fee for bmnch circuits will,
service or feeder fee, each
Address: branch circuit 5 6.65 2
13. Fee for branch circuits
without service or feeder Inc.
Oily /Sintc/'LIP: first branch circuit $ 46.55 2
Phone: pax; Each additional branch circuit: 5 6.65 2
Mlscellnnenus (service nr feeder not Included
E -mail; Each mamuPacturecl or modular
CONTRACTOR dwelling, service and or feeder $ 90.90 2
Business Namc: CAPITOL ELECTRIC CO., INC. Reconnect only $ 66.55 2
Pump or irrigation circle $ 53.40 2
Contact name' John McNeal Sign or outline lighting 5 53.40 2
Signal circuit(s) or limited-
energy panel. alterations. or
Address: 11401 NE MARX 3T,
extension. Describe: Page 2 2
City /Stoic /ZIP: PORTLAND, OR 97220 -1041
Each additional inspection over allowable in any of the nbovc
norm; 503. 255.9488 Fax: 503. 257.7121 Per ins S 62
Investigation per hour (1 hr min) 5 62.50
CCB Lic.; 48748 (Electrical Lic.: 26-496C I Suprv. Lic,: 3132 -S Industrial plant per hour 5 73.75
Suprv. P,Iccrrician niRnaturc, required: ie4� A^ a ELEC1 RICAL PERMIT FEES ji �, / /��(f Sub $ 80.30
M
Print Namc: DARRELL G LErae Datc: 11/02/09 Plan review (25% of permit fcc)
IF
Authorized signature: State surcharge ( 12% of permit fcc) $ 9.64
J 1 -, ./.., ` TOTAL PERMIT FEE $ 89.94
Print Name: DARRELL MCNEEL Tota pnrmlr appllmrtnn mplrrr ire prrmIt 1. not onramrn retririn 1311
days aver la San been accepted as complete.
- Number of inspections per permit allowed.
} I 2 r 78