Permit Bd fv Z_049
` CITY OF T GAR® ELECTRICAL PERMIT
e
a b: COMMUNITY DEVELOPMENT Permit #: ELC2010 -00335
�r t < Date Issued: 07/06/2010
TI G/{RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102BD00701
Jurisdiction: Tigard
Site address: 12785 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Spec Space
Project Description: (1) 601 amp service and (2) branch circuits for TI.
7/20/10: Add (2) 201 -400 amp feeders and (2) branch circuits, plus plan review fees for entire
project.
Owner: FEES
THE HOLLAND INC Quantity Description Date Amount
109 WEST 17TH STREET
VANCOUVER, WA 98660 1 ea Services or Feeders - 601 to 07/06/2010 $301.04
1000 amps
PHONE: 2 crt Branch Circuits w /Purchase 07/06/2010 $14.84
Service or Feeder
1 ea 12% State Surcharge - 07/06/2010 $37.91
Contractor: Electrical
• ACCURATE ELECTRIC, INC. 267 da Electrical Permit 08/03/2010 $267.12
P.O. BOX 871866 149 da Plan Review - Electrical 08/03/2010 $149.46
VANCOUVER, WA 98687 32 da 12% State Surcharge - 08/03/2010 $32.05
PHONE: 360 - 567 -3330 Electrical
FAX: 360 - 567 -3320 15 da Electrical Permit 08/03/2010 $14.84
2 da 12% State Surcharge - 08/03/2010 $1.78
Electrical
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $819.04
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 a • • - -_ • 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. A "TION: Oregon aw, requir- u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 •010 through OAR 952-00'41 • . You 'ma • tain a copy of the rules or direct questions to OUNC by calling • •-•• or 1.800.332.234.
Is. ued By: / 4 Permitte- : • �' — r�
OWNER INSTALLATION ^ .
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.
� '. •CITY OF TIGARD ELECTRICAL PERMIT
' 7. "" COMMUNITY DEVELOPMENT Permit #: ELC2010 00335
13125'SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/06/2010
II CrARDs g Parcel: 2S 102 BD00701
Jurisdiction: Tigard
Site address: 12785 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Spec Space
Project Description: (1) 601 amp service and (2) branch circuits for TI
Owner: FEES
THE HOLLAND INC Quantity Description Date Amount
109 WEST 17TH STREET
VANCOUVER, WA 98660 1 ea Services or Feeders - 601 to 07/06/2010 $301.04
1000 amps
PHONE: 2 crt Branch Circuits w /Purchase 07/06/2010 $14.84
Service or Feeder
1 ea 12% State Surcharge - 07/06/2010 $37.91
Contractor: Electrical
ACCURATE ELECTRIC, INC.
P.O. BOX 871866
VANCOUVER, WA 98687
PHONE: 360 - 567 -3330
FAX: 360 - 567 -3320
Type of Use: COM
Class of Work: ALT Type of Const: ,
Occupancy Grp:
Total $353.79
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 a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. `
Issued By: Permittee Signature: o� "9 7°,6 / C�%7 ()N
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 FOR OFFICE USE ONLY
City of Tigard Date
Date/B ed
111111 2?c5 11 ermu o.: • Id • • _6•
° 13125 SW Hall Blvd., Tigard, OR 97223 + o Plan Review
Q 1 20 Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 ` 2 Date /B : •� • t
T I G A R D Inspection Line: 503.639.4175 <1v Date Ready /By: ® See Page 2 for
Internet: www.tigard- or.gov , ' ,,,. ,;�*,.7i Notified /Method: Supplemental Information
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TYPE OF WORK �� 1 � ��� )
��1, � ' PLAN REVIEW
❑ New construction ® Addition /alterationNepfa 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 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
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ","I - 13
Job no.: 10 - 1070 Job site address: 12785 SW Pacific Hwy 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: Burgerville Shell Reconst ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qtv. 1 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'l 500 sq. 0. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
Limited energy, multi - family 67.84 2
Reconstruct shell to original condition residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
CC)-1 F e S �(Y/1�11� 200 amps or less 100.70 2
❑ PROPERTY O ER / ❑ TENANT 201 amps to 400 amps /`M ' 133.56 2
�
401 amps to 600 amps / � 200.34
Name: 601 amps to 1,000 amps mow 301.04 PPM 04 2 4
Address: Over 1,000 amps or volts ��' 552.26 P -
Temporary services or f< •ders installation, alteration, and /or
City/State/ZIP: relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 I
Owner installation: This installation is being made on property that 1 own which is not '201 amps to 400 amps 125.08 55
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteratio - ension, per panel
Owner signature: Date: A. Fee for branch circuits with ( 1 - :_4 above service or feeder tee, ❑ APPLICANT ❑ CONTACT PERSON each branch circuit 7.42 J
B. Fee for branch circuits withou`
Business name: service or feeder fee, first
Contact name: branch circuit 56.18
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84
Y dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Accurate Electric, Inc. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: P.O. Box 871866 Additional inspection (1 hr min) 6625/ hr
City/State /ZIP: Vancouver, WA 98687 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: 360 (360) 567 - 3320 Inspections for which no fee is
Phone: ( 360) 567 - 3330 F ax: ( 90.00/ hr
specifically listed ('h hr min)
CCB Lic.: 158875 Electrical L'..: 37 -1 P29C Suprv. Lic.: 5094S ELECTRICAL PERMIT FEES _c!
Suprv. Electrician signature, required: .4.. ` Subtotal:
1
•
Su
p g �f� ��' , , ; Plan review (25% of permit fee .. PL-41 -UV,e
Print name: Ken Sweo , Date: 7 -01 -10 %S tiL State surcharge (12% of permit fern 1 r
1 \ 1) I^„ + ' ^ �� h i tap TOTAL PERMIT FE �
Authorized signature: I � 1� 1 1`/A\ Tbi t application expires if a permit is not oblam al within ISO
N days after it has been accepted as complete.
Print name: Debi Watts Date: 7 - - * Number of ins e 4 ions al owed er ennit.
p it1i`sC, 700 .
1: Building Permits ELC- PermitApp.doc 100109 440 -46 UT(II O5 COM -WEB I � PGi --- � ^ / ;.,_ '.
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JUL -01 -2010 16:10 Accurate Electric, Inc. 3609947013 P.001
Electrical rermlt Appllcat.Ion I OR OFFICE USE ONLY 1 t•
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''` ' ' ''?:'i . '. City of Tigard Received Permit CA „�
g J” 71 — ��Y •
° 13125 SW Hall Blvd., Ti Tigard, ORS!�. Date /B i O�0 ' dos
Plan Review
Phone: 503.639.4171 Fax: 503 e DateB : O the rPerrtty�,/�O� /Q N) /0 6
Inspection Line: 503 11 �°
TIGA "RD g g Date Ready /By: lens: i El See Page 2:for
Internet: www.tl and -or. ov �UL Notified/Method: S lemental Information
- 111 /� � �O�O (j % � 1Y PP
, TYPE. OF.a'Y RK ;, .' .: P LAN REVIEW
r-.-ni nt „ -; re z P lease check all that a ] submit 2 sets of lans w /items checked below
El New construction � Addition /alte'r /r,�placement�� pP y ( P )
` 'I( �p ' y y� �` ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: R�1At tJjlxl�� ��l V ��1 V ` where the available fault current ❑ Marinas and boatyards.
CATEGORY :OF .CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, nr exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- faintly dwelling Eg Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB ;S1TE INFORN AND LOCATION A mergen o r.ew m larger separately
derived system.
"' Addition of new motor load of
Job no.: 10 -1070 Job site address: 12785 SW Pacific Hwy loo( or more. oceapancy.
- ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Burgerville Shell Reconst ❑ Service or feeder 600 amps or more.
Cross street/directions to ob site: FEE ;SCHEDULE `
J Desn,ption I Qtv. I Fee I Total l
'New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map /parcel n0 m nergy tial
' ' DESCRIPTION OF WORK L1 (w t h above sq sid ft-) n 67.84 2
Limited energy, multi - family 67.84 2
Reconstruct shell to original condition residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑:PROPERTY:OWNER fiENANT.' 201 amps to 40D amps 133.56 2 • 401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps I 301.04 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/ S[ate/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) F ( ) 200 amps or less 59.36 1
201amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 ainps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits —new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT': above service or feeder fee, 2 14.84
:
`❑. CONTACT PERSON' 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'( branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Ci /State /ZIP: Each manufactured or modular 67.84 2
ty dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2 '
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
CONTRACTOR ': Signal circuit(s) or limited- energy
Business name: Accurate Electric, Inc. panel, alteration, or extension. Page 2 2
, , I Each inspection over allowable in any of the above
Address: P.O. Box 871866 � w Additional inspection (I hr min) 66.25/ hr
City/State/ZIP: Vancouver, WA 98687 Investigation (1 hr min) 66.25 / hr
Industrial plant (I hr min) 78.18/ hr
Phone: (360) 567 -3330 Fax: (360) 567 - 3320 Inspections for which no fee is 90.00/ hr
/Y /' specifically listed(' /z hr min) i • ,,/VCCB Lic.: 158875 o Electrical L .: 37 - 1 29C _/rSuprv. Lic.: 5094S l/ . . . .'..:ELECTRICAL.PERMIT,FEES. ..
Subtotal: 315.88
Suprv. Electrician signature, required: ` / /J
If Plan review (25% of permit fee):
Print name: Ken Sweo Date: 7 - - State surcharge (12% of permit fee): 37.91 DI u
k V e TOTAt PERMIT FEE: 353.79 ✓
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Debi Watts Date: 7 -01 -10 * Number of inspections allowed per permit.
I:. Building .Permia.ELC- PermitApp doc 10.0109 440- 4615T(1105•COi4WEB