Permit . . CITY OF TlGARD
a ELECTRICAL PERMIT
a v >... COMMUNITY DEVELOPMENT Permit #: ELC2010 -00312
T 1 G ARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/24/2010
Parcel: 2S102AA00600
Jurisdiction: Tigard
Site address: 11940 SW PACIFIC HWY A
Subdivision: Lot: 0
Project: Pacific Plaza
Project Description: (5) branch circuits.
Owner: FEES
ALPROP CO Quantity Description Date Amount
6149 SW SHATTUCK RD
PORTLAND, OR 97221 5 crt Branch Circuits 06/24/2010 $85.86
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/24/2010 $10.30
Electrical
Contractor:
JARMER ELECTRIC INC
5105 SW 45TH AVE #200
PORTLAND, OR 97221
PHONE: 503 - 246 -5381
FAX: 503- 244 -8037
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $96.16
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 ther 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 rk is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. hose rules are set forth in OAR
952- 001 -0010 through OA' - -a01 -0100. You may obtain a co. o .e rules or direct questions to OUNC by calling 503.246.6699 or 0.332.2344.
Issued By: ` �� �-��......-- - Permittee Signature: --'`�
`i'
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' 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.
Electrical Permit Application ,�€ryrt, ,' w ' lrtr�r �{r�' f , ' „ ,L '' , , ,
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nhnr X` � ' t a C Of Tigard IV Permit Ir�j i Received n 11
'' 13125 SW FIall Blvd., Tigard, OR 97223 1 L/➢J Plan Re ' n ((1 `(-- Eta-M.— �JU 3
Plan Renew
,a Phone: 503.639.4171 Pax; 503 >aae/I3 ; OtherPermiq �,P io -emus/
Inspection Line; 503.639.4175 ? ®1�
I .', '' ` sa U N 2 4 Dato ReadyBy; 6d Sea Page 2 for
. -`+ • " Internet; Www.tiga rd- Or.gov Notified&Method: MN Supplemental information
Twit O WORK [T Ur TIG�� s . PI,AN•.REyIEW
' 17t. ' Ple a ch eek all that apply • p (submit 0 New construction ► • ddttion /alteration, . ( bait 3 acts of plans w /items checked below);
El Demolition Other" ❑ Service or feeder 400 amps or more 13 Building over thnr c stories.
where the available ihult current ❑ Marinas and boatyards.
• ' CATEGORY 1f V TION cxa cds 10,000 amps at 150 v0113 or ❑ bloating buildings.
Iris M ground. Or =zeds 14 000 a Commercial -use agricultural
❑ 1 - and 2-family dwelling Comm ❑ Accessory building amps for ail other installations. budidinge.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KvA or
• .3013 SITE INFORMATION 'Mil LOCATION L] Emergency system, larger separately derived system.
❑ Addition anew motor load of 1:1"A", "E" "1 -2 ", "1.3"
Job no.; D Job site address: / / 7 0 S 64) P . G f i ! 14 7 u1 100HP or more, occupancy.
❑
❑ Six or more residential unite. Recreational vehicle parks,
CityIStatc/ZIP: 1 D - 3 - 13 Health -care facilities. ❑Supply voltage fi r mare thou
� 0 Hazardous locations. Supply
vets nominal.
./ Suite/bldg. /apt no.: - , Project name: —TT -W r1 — U Service or tbeder600 Amps or more.
Cross street/directions to job site; [ .. c ]E �
P/ .t ( 1 PI / cceA Aaettaao A rea T0ts1 *
New resideutial single- or multi - family dwelling unit.
_ includes attached garage.
Subdivision: l Lot no." 1,000 R. fl or less 168.54 4
Tax map/parccl no,: Ea, add'l 500 sq. ft or portion I 33.92 1
Limited energy, residential 67.84 2
. ' • AESCR11l'll: os-oF 'LORI (with above sq. ft.)
•
l S C.- Limited energy, multi - family 67,84 2
eA e,-h e l td C/y k residential (with above sq. (1.)
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
0 ' PROPIERTY.0VoliER . f ❑ TENANT. 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 4 200.34 2
Address: 601 amps to 1,000 strips 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) Pax: ( ) 200 amps or less _ 1 59.36 1 l
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, base. rent, or exchange. according to ORS 447. 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits new, alteration, or extension, per panel
Owner signature: Date: A. Fen for branch circuits with
' • AP I AN r •[7 CONTACT PPSON above service or feeder fee.
• Business name:
each branch circuit 7.42 2
B. Fcc for branch circuits
Contact name: without service or feeder fee. /
first branch circuit 56.18 5 --b . j y 2
Address: Each add'I branch circuit 1 7.42 2 /.(' 2
City/State/ZIP:
3411tellailems or modular included)
rt6t
J T dwelling stavice and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
• _ CONTRACTOR _ Sign mainline lighting 67.84 2
Business name; �Q(Zfyf+F FEC,-� 0... NC— Signal circuit(s) a r limited -
energy panel, alteration. or
Address: 5I of u 4 , , aeop extension. Describe: Page 2 2
City /State/ZiP: ?Of A ND 0 9q c?..---1 Each additional Inspection over allowable in anv of the above
Pcr inspection 66,25
Phonee:,603) . 1( - 5,....( Fax: (55-13) - .039' Investigation per hour p hr min) 66.25
v 6CB Lic.: a� lcotr ical Lic. :2• t{5 Gtsu . Lic.:40 Industrial plant per hour 78.18 • • •. 1l;ECIVICAL 'PERM' FEES Suprv. Electrician signature, required: r ...4.......- ' t,..._... __ Subtotal; ��e8dv
Print name: ( Plan review 25% of
�vA2`T' SAekiltg_. Date: b 3 - Q ( pamitfee):
Strisurcharge
Authorized signature:
(12% ofpermit fee): p 0
TOTAL PERMIT FEE: y 6,, /
Print name: Tbla permit application expires if a permit h ant obtainer within t
l Date: days after it Mast bete accepted as complete.
' Number of inspections allowed per perm(1.
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