Permit r CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
ENT Permit #: ELC2010 00045
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: "01/27/2010
Parcel: 2S102BD01600
• Jurisdiction: Tigard
Site address: 9845 SW°WALNUT PL
Subdivision: Lot: 0
Project: Tigard United Methodist Church
Project Description: Add /alter (1) branch circuit for drinking fountain.
•
Owner: _ • FEES
TIGARD COMMUNITY METHODIST Quantity Description " Date Amount
CHURCH, 9845 SW WALNUT _
1 crt Branch Circuits 01/27/2010 $56.18
TIGARD, OR 97223
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 01/27/2010 $6.74
Electrical
Contractor:
A & M ELECTRIC CONTRACTING INC
20922 NE 83RD ST
VANCOUVER, WA 98682
PHONE: 360- 883 -1281
FAX: 360 -883 -1051
Type of Use: COM
Type Class of Work: ALT Type of Const:
Occupancy Grp:
Total $62.92
Required,items and'Repoits (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 wit
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 N. .tion" Center. Those rules are set forth in OAR
952 - 001 -0010 through 'R'952- 001 -0100. You may 'obtain a copy of the rules or direct questions to OUNC by c- ing 51 ;.246.6699 or 1.800.332. ,4.
Issued By: `o 1 11)lkiVY 3 P ermittee Signature: </0�•-_: �_ '
px
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.
Cali 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall tie 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.
{ N` CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
q
11 . ;' 11 _ COMMUNITY DEVELOPMENT Permit #: ELR2010 -00045
TI GA b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/24/2010
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7228 SW DURHAM RD, STE# 100
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Style Shock
Project Description: Low voltage for HVAC wiring.
FEES
Owner:
PACIFIC REALTY ASSOCIATES Description Date Amount
15350 SW SEQUOIA PKWY #300 Restricted Energy Permit 03/24/2010 $67.84
PORTLAND, OR 97224 12% State Surcharge - Electrical 03/24/2010 $8.14
PHONE: 503 - 624 -6300
Contractor: •
PROTEMP ASSOCIATES INC
9788 SE 17TH AVE
PORTLAND, OR 97222
PHONE: 503 - 233 -6911
FAX: 503 - 238 -9767
Type of Use: COM
Class of Work: ALT
Total Number of Systems: 1
Audio & Stereo: N Boiler Controls: N
CCTV: N Clock Systems: N
Data & Telecommunications: N Fire Alarm: N
HVAC: Y Instrumentation: N Total $75.98
Intercom /Paging: N Landscape /Irrigation: N Required Items and Reports (Conditions)
Landscape Lighting: N Medical: N
Nurse Calls: N Protective Signal: N
Security Alarm: N Other: N
Other Desc:
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 accord- . - , ith 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. ATTE •N: Oregon law re res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0' 0 thro gh OAR 95 001- 00. Y ,may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issue. = : ✓�/�'� `�/ Permittee Signature: k'
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.
kk -)Aoto - coo 4//
Electrical Permit Application RECJVED FOR OFFICE USE ONLY
CI of Ti and Received 2 Permit No.: p
`J g Date /B : 01 / 7 149 E �--e, dole) -- ys
q 13125 SW Hall Blvd., Tigard, OR 97223 MAR 1 1 t . Plan Review � BOO
' 0 Phone: 503.639.4171 Fax: 503.598.1960 Date /B : Other Permit:
TIGARD
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: lus� ® See Page 2 for
Internet: www.tigard - or.gov Notified /Method: e.-- s;.---
lc� Supplemental Information
RUP DING DIV :SION
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ® Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ". "E' . "1 -2 ", "1 -3 ",
Job no.: 9757 Job site address: 7228 sw DURHAM RD IOOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: TIGARD OREGON 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
�� ❑ Hazardous locations. 600 volts nominal.
0V (
Suite /bldg. /apt. no.: 60 Project name: STYLESHOCK CHEER & DANCE ❑ Service or feeder 600 amps or snore.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Otv. I Fee. 1 Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 67.84 2
DESCRIPTION OF WORK (with above sq. ft)
Limited energy, multi - family
67.84
THERMOSTATS & WIRE residential (with above sq. 0.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
Branch circuits – new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT above service or feeder fee,
0 CONTACT PERSON each branch circuit 7.42 2
Business name: PROTEMP ASSOCIATES B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: BRUCE BUTNER branch circuit
Each add'I branch circuit 7.42 2
Address: 9788 SE 17 AVE Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZIP: PORTLAND OREGON 97222 dwelling, service and/or feeder 67.84 2
Phone: (503) 519 -6199 Fax: : (503) 238 -9767 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: bruce @protmp
Sign or outline lighting 67.84
CONTRACTOR Signal circuit(s) or limited- energy
Business name: SAME AS ABOVE panel, alteration, or extension. Page 2 �7 $�
2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is
specifically listed (Y3 hr min) 90.00/ hr
CCB Lic.: 38868 Electrical Lic.: 261036 Suprv. Lic.: 2613LEB ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: M Q _ Subtotal: (p 7 0 ` mast Plan review (25% of permit fee): ">9
Print name: MONTY SCHROEDER Date: 3/17/10 State surcharge (12% of permit fee): g • /y
TOTAL PERMIT FEE: 75 . 9 '
Authorized signature: L J This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: BRUCE BUTNER Date: 3/17/10
* Number of inspections allowed per pennit.
I: \Building \Permits\ELC - PermitApp.doc 10 /09 440- 4615T(1I /05 /COM/WEB
,
Electrical Permit Application n L.
s '' ; '' bk FoR on I US { ON L \ -s' r t 1 44 ,, , , x.
JAN 2 7 2010
Received
II q City Of Tigard Date /B : , Permit No. OA 0. oOC S
13125 SW Hall Blvd., Tigard, OR 97223 'ITY OF TIGARD Plan Revie
G ' • Phone: 503.639.4171 Fax: '503.598.1960 Date /B : Other Permit:
I' I C. A R D Inspection Line: '503.639
BUILDING DIVISIO ' Date Ready/By: El See Page 2 for
Internet: www.tigarckir.gov Notified/Method: Supplemental Information
;PYPE,OF 11ORK PLAN REV
❑ New construction Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
'❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
.
' CATEGORY OF 'CONSTRUCTION ' < . t ` exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
• "` less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling - , Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
- . -, •. ❑ Emergency system. larger separately derived system.
• JOB'SITE INFORMATION :AND ;LOATION C ❑ Addition of new motor load of ❑ "A ", "E "I -2 ", "I -3 ",
Job no.: Job site address: °Dr— C + ,' L Q 100HP or more. occupancy.
a 7 7 . , (4 14 A. /N Nv`/ 174 ce , ❑ Six or more residential units. ❑Recreational vehicle parks.
City /State /ZIP: - {) R 0/1 z a 3 ❑ He
facilities. ['Supply voltage for more than
✓ ID locations: 600 volts nominal.
Suite /bldg. /apt. no.: Project name: II /' n. 1 ` ❑ Service or feeder 600 amps or more.
r— ri J -�• ` ; FEE S CH E DU L E •
,Cross street/directions to job site: r /1 9 a ,-- Description
� �, r t r / Qty. l Fee.. 1 Total
y ✓ New residential single- or multi - family dwelling unit.
b e 1,4,/ j r T ,fj L- i4jz rr C w a r X ed Includes attached garage.
Subdivision: �. y/ / /Lot no.: 1,000 sq. ft. or less 168.54 4
l t z �lr,J /Me /h 0!'it�NK �� t+ Ea. add] 500 sq. ft. orportion 33.92 1
map /parcel no.: mited energy, residential
. r 67 84
ax Li
2
. • DESCRIPTION OF WORK -,_ , ' (with above sq. ft.)
ip Limited energy, multi - family
A d; c j. • -e. r - (l, .�k C , r W c) a R( residential (with above sq. ft.) 67.84 2
-e( Services or feeders installation, alteration, and/or relocation
(, \ 1.1 n 200 amps or less 100.70 2
❑ ;PROPERT- OWNER, ❑ TENANT... 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 '2 .
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
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, lease, 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. Fee for branch circuits with
❑: APPLICANT , - ' CONTACT [ PERSON fee,
7.42 2
above service or feeder ee
` each branch circuit
Business name: B Fee for branch circuits
�� / without service or feeder fee,
Contact name: 56.18 2
61 ./. #, + — C.1t_'C4h-C�1 first branch circuit
Address: U 4 -Z /Lie �3 / j Each add'I branch'circuit 7.42 2
Miscellaneous (service or feeder not included)
City /State /ZIP: /qA/64 t )J /; ,t' [A Lot . 4,2_., Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Q
Phone: (3 40 ) U g3' / Z T Fax : LL .' ( ) 81s-4 Reconnect only 67.84 2
^ e>dl C ! �Y►'rPJGG r:c
E-mail: I : CONTRA I dz. fP.SI�"nezf'i � , 4e-14-- Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
Signal circuit(s) or limited
Business name:
A y rh / L, L 7 r , c e r --4.0 , energy panel, alteration, or
extension. Describe: Page 2 2
Address: (72642 Z fi r3 r � s
City /State /ZIP: i 4.) ( O v 17 ,, y e 409 9/4 g' --- Each additional inspection over allowable in any of the above
Per inspection 66.25
Phone: (3w) fg „_ ` $'/ Fax: (60 t1 - /6S/ Investigation per hour (1 hr min) 66.25
CCB Lic.: /392,81 Electrical Lic.: 37- skz Suprv. Lic.:'Y`S3 Industrial plant per hour 7818
ELECTRICAL'TERMIT.;FEES ".'• .. A'"" ' " '
Suprv. Electrician signature, required: / r Subtotal:
Print name: / v! / D ate: Plan review (25% of permit fee):
44e1 rn P �Z2 � �� �� Or6 State surcharge (12% of permit fee):
Authorized signature: ,- ,' . / TOTAL PERMIT FEE: ' n 9 ,q `-
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
C\Building\Permits\ELC- PermitApp.doc 1 /01/09 440 -4615T(1 I /05 /COM/WEB
A s\C- +n — fi r e � �bou. -� �rn l abet.
A
Electrical Permit Application City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
i`-`RESIDENTIAL WORK ONLY:'• •
Fee for all residential systems combined ... $67.84
. Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
•
❑ Vacuum Systems*
❑ Other:
COMMERCIAL. WORK ONLY
Fee for each. commercial $67.84
•
•
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio.and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation_ Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other •
Total number of commercial systems:
*No licenses are required. Licenses are required
for alr'other installations
1: \ Building \Permits\ELC- PermitApp.doc 10/01/09