Permit q� o� r
/ EL R CAL PERMIT 7
j _ , f / F IGARD
," \ PERMIT #: ELC2007 -00574
-. . ° COMMUNITY DEVELOPMENT
DATE ISSUED: 8/15/2007
T1GAKD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 AA -09100
SITE ADDRESS: 12259 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT : 030 JURISDICTION: TIG
PROJECT: HONGKONG SHANGHAI BANK CARD
Project Description: 4 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 3 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TIGARD CORPORATE CENTER BROADWAY ELECTRIC - COCHRAN INC
LTD PARTNERSHIP 626 SE MAIN
ATTN: GREG SPECHT PORTLAND, OR 97214
BEAVERTON, OR 97006
Phone: Contact #: PRI 503 - 234 -6564
FAX 503 - 238 -2098
FEES
Description Date Amount Reg #: ELE 37 -546C
[ELPRMT] ELC Permit 8/15/2007 $66.80 LIC 72942
[TAX] 8% State Surcharge 8/15/2007 $5.34 SUP 3447S
Total $72.14 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. AD
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 than 180 days. ATTENTION: Oregon law requires you to follow 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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: & 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'N: 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.
t.
Electrical Perm' FOR OFFICE USE ONLY
CI of Tigard I y Received ♦ n 0,6,9,4221.... /'
`J g C aoeo �� & Date/By: " r7 a 1 Pemrit No.: 0657 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie /
Phone: 503.639.4171 Fax: 503.598.1940 /+ y � +h Date/By: Other Permit:
Inspection Line: 503.639.4175 AUG 1 J 2001 e' ' Date Ready/By: Jura 0 See Page 2 for
Internet: www.ci.tigard.or.us ((��� Notified/Method: Supplemental Information
` i 4YP'E'5 - P L A N " REVIEW
�
.I(� T
❑ New construction Y Ur4hlEilt tt / l ttit Please check all that apply:
['Service over 225 amps, comm'l ['Hazardous location
❑ Demolition CI Other:
Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
- , - •CATEGORY: OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other:
['Building over three stones ['Feeders, 400 amps or more
❑Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND :LOCATION - ❑Egress/lighting plan RV park
J ob no.: 60g 70 Job site address: /2_25' SW tP Cf tti `e-, ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: — 77 The above are not applicable to temporary construction service"
Suite/bldg. /apt. no.: () Project name: fiSB� FEE* SCHEDULE > --
Description I Qty. Fee. Total
Cross street/directions to job site: ` /4,4 / . - / New residential single- or multi- family dwelling unit. • / - / Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: • Limited energy, non - residential 75.00 2
• DESCRIPTION. O W Each manufactured or modular
b � i( &fY-at.e, dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or Tess 80.30 2
. . . a
PROPERTY OWNER - , ,❑ TENANT. - ; " 201 amps to 400 amps 10 5
❑ ROPERT 401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
.PLICANT - - CONTACT: PERSON •. A. Fee for branch circuits with
- service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: c k j � � L/ 6'1,1k, "��ie>�-+'j ( without service or feeder fee, / 46.85 2
" each branch circuit
Address: /
Each add'i branch circuit L3 6.65 [ TAS 2
City/State /ZIP: 931'tmbit Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (���j) Ti I -2_05-4242- Fax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
.- CONTRACTOR •: .
energy panel, alteration, or
` extension. Describe: Page 2 2
Business name: ')moo 6 W a.\ \ e.. 4 `�
1 Each additional inspection over allowable in any of the above
Address: C 2 Co S L M cs.v.s. Per inspection 62.50
City/State /ZIP: Tn 4-k ex. ,,,_ (2 c\-7 2■L-4 Investigation per hour (1 hr min) 62.50
Phone: (so3) 2,3(k —( ( y Fax: (9 3) Z32 2 ct s Industrial plant per hour 73.75
` .PERMIT `FEESt •.`
CCB Lic.: 7 2542..., Electrical Lic.: 31-5 6c,_ Suprv. Lic.: 3 .44 Subtotal 6(e; 1M(/
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: \G ev.v,e .-\c1 V.. c,....0: Date: State surcharge (8% of permit fee) � 53y
TOTAL PERMIT FEE /a . /
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: 0 Fee methodology set by Tri County Building Industry Service Board
•` Number of inspections per permit allowed.
is \Ruildino \ Permits \ELC- PcrmitAoo.doc 12/03 440- 4615T(10 /021COM/WEB