Permit /iiJio ok.d -4 Chi by-6,A'G(4 cer, J Vol 17 �. 1
1 F CITY OF TIGARD ELECTRICAL PERMIT
•
COMMUNITY DEVELOPMENT
Permit #: ELC2010 -00407
Date Issued: 08/05/2010
l,f f G,1 It 0; 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102AA03000
Jurisdiction: Tigard
Site address: 8732 SW SCOFFINS ST, STE# 140
Subdivision: Lot: 0
Project: Spec Space
Project Description: (2) branch circuits for TI. 8/11/10 added (4) branch circuits and (1) low voltage system for
telecommunications B.T.
Owner: FEES
HARRIS - MCMONAGLE ASSOCIATES INC Quantity Description Date Amount
8740 SW SCOFFINS ST
TIGARD, OR 97223 2 crt Branch Circuits 08/05/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/05/2010 $7.63
Electrical
Contractor: 105 da Electrical Permit 08/11/2010 $104.68
D & L ELECTRIC INC 13 da 12% State Surcharge - 08/11/2010 $12.56
PO BOX 367 Electrical
WEST LINN, OR 97068
PHONE: 503 - 656 -5623
FAX: 503 -650 -1918
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $188.47
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 Ce er. Those rules are set forth in OAR
952 - 001 -0010 through • R 952- 001 -0100. You m- • - - y z le r - •r direct questions to OUNC by calling 503.2 699 or 1 :11.332.
Issued B. % Permittee Signature:
AllProa."'
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.
CaII 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.
• 4 CITY OF TIGARD ELECTRICAL PERMIT
II
111 COMMUNITY DEVELOPMENT Permit #: ELC2010 00407
T i G R b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2010
Parcel: 2S102AA03000
Jurisdiction: Tigard
Site address: 8732 SW SCOFFINS ST, STE# 140
Subdivision: Lot: 0
Project: Spec Space
Project Description: (2) branch circuits for TI
Owner: FEES
HARRIS - MCMONAGLE ASSOCIATES INC Quantity Description Date Amount
8740 SW SCOFFINS ST
TIGARD, OR 97223 2 crt Branch Circuits 08/05/2010 $63.60
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 08/05/2010 $7.63
Electrical
Contractor:
D & L ELECTRIC INC
PO BOX 367
WEST LINN, OR 97068
PHONE: 503 - 656 -5623
FAX: 503 - 650 -1918
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $71.23
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 - • : s: pproved 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 la requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 1010 through OAR 952 -00 0 to.' o =y obtain a copy of the rules or direct questions to OUNC by calling 503.246.699 or 1. 0.3 .2344.
Iss ed By: ' ! Al Q 1 � . Permittee Signature: K 7
__
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' � ` 4 _ / ` _ Date: g' S /
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.
• FOR OFFICE USE ONLY
Electrical Permit Application Received a Electrical
Date/By: 0 5 10 09 Permit No.: Cke,016 ' 7
City of Ti and Planning Approval Sign
g Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503 - 639 -4171 Fax: 503 - 598 1960 Post - Review Land Use
DateBy: Case No. :
Internet: www.ci.tigard.or.us cal ( Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 " Name/Method: Supplemental Information.
TYPE OF WORK PLAN REVIEW (Please check all that apply)
❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
® Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
CATEGORY OF CONSTRUCTION 1 & 2 family dwellings four or more residential units in
1 & 2- Family dwelling ❑ Commercial/Industrial 0 System over 600 volts nominal one structure
DII
❑ Building over three stories ❑ Feeders, 400 amps or more
Accessory Building 111 Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
JOB SITE INFORMATION and LOCATION Submit _ sets of plans with any of the above.
a The above are not applicable to temporary construction service.
Job site address: 54/ ,SGo T7)Nr S� FEE* SCHEDULE
Suite #: �? 3 7- Bldg. /Apt. #: „5.71.01 4 1 1 6 Number of inspections per permit allowed
Project Name: Description Qty Fee (ea.) Total
New residential - single or multi - family per 1
Cross street/Directions to job site: Sh.t... � dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #: Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
DESCRIPTION OF WORK service and/or feeder 90.90 2
P�H� G N 474S
Services or feeders - installation,
alteration on or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
sia PROPERTY OWNER 1 ❑ TENANT 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
Name: MA, /D /Pi 0 /-e— Reconnect only 66.85 2
Address: f 7 ye 57r/ S GO 4 1' jt0 I / Temporary services or feeders - installation,
,/ alteration, or relocation:
City /State /Zip: i'/ .,' o!2 i 7Z Z- y 200 amps or less 66.85 1
Phone: Fax: 201 amps to 400 amps 100.30 2
❑ APPLICANT ❑ CONTACT PERSON Branch n c h amps 133.75 2
Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 6.65 2
City /State /Zip: B. Fee for branch circuits without purchase of j 5(4%
service or feeder fee, first branch circuit 5 2
Phone: 1 Fax: Each additional branch circuit / "A'{ .G& 2
E -mail: Misc.(Service or feeder not included):
CONTRACTOR Each pump or irrigation circle 53.40 2
Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
alteration, or extension Page 2 2
Business Name: 0 eZ e. L., . L Description:
Address: ilo' 36 V-
Each additional inspection over the allowable in any of the above:
City /State /Zip: /tie gs 1.- G; .4-4c./ Cie i Per inspection per hour (min. 1 hour) 6 2. 50
Phone,' 23— 4,5*6 �•lcy Fax 3 --467 " // /6 Investigation fee:
CCB Lic. #: n94 Lic. #: 3 /G /c.„ Other:
Electrical Permit Fees*
Supervising electrician II/ �tC ' �� Subtotal $ e, 5.66
signature required: id�� /�!j[' LO p �i A„,,,ya..�•% Plan Re view (25% of Permit Fee) $ 'f7�
Print Name Lic. #: a2t2 5 S tat e Surcharge (8% of Permit Fee) $ 7 , s.5
/b , i / a
~� /� �/ ~�"` 1 TOTAL PERMIT FEE $ ? ( o 3
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set by Tri- County Building Industry Service Board.
(Please print name)
i:\Dsts\Permit Forms \ElcPermitApp.doc 01/03
Electrical Permit Application ���1 1 c)1it 1 Ic I:•Ls OiNi • City of Tigard �� cdta A,` ateB "'Received g // id 6 PermitNo.:�/C ' #/ G - co'1o7
° 13125 SW Hall Blvd., Tigard, OR 97223 1� ,� at
g ,A0A, . Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 a 4 Date/By: Ins Line: 503.639.4175 lD ;\ `, ' Date Ready/By: Juris: El See Page 2 for
I I t i \ - - - - . A 4
Notified/Method: Supplemental Information
Internet: www.tigard-or.gov c N '
TYPE OF WORK �rAr3Ta PLAN REVIEW
�� • P lease check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction IN Addition/alteration/replac tt
v ❑ 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 J] 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: ` ( 7.01' I00HP or more. occupancy.
!J 7V Q SL./ S. , /✓j ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 7 7 ma a2 7 7 Z 7_J ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE .
Cross street/directions to job site: Description 1 Oty. 1 Fee. i Total 1 *
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 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
• ADD Port' L, "-es residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
to 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: '' 7 y ,!J 5c, /j4,s 7 L Over 1,000 amps or volts 552.26 2
.449 042 5' 22.-3 Temporary services or feeders installation, alteration, and/or
City/State /ZIP:
relocation
Phone: ,, (c ) —iris. -1 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
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 1 • ❑ CONTACT .PERSON above service or feeder fee, 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'l branch circuit 4 7.42 a q , Cor22
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: /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 a �
Business name: 7 �� � Z�L panel, alteration, or extension. � Page 2 � T 2
!r Each additional inspection over allowable in any of the above
Address: p..,. ,J 3 4 2 Additional inspection (I hr min) 66.25/ hr
City/State /ZIP: r 4_ , A.4..., ` g.- 7701 g Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: r,3 ) e r-L $` Ls Fax: (fay ) j ,r-O —/ 9 / 9 Inspections for which no fee is 90.00 / hr
specifically listed (%2 hr min)
CCB Lic.: b b G e'7 Electrical Lic.:5...4` /G Suprv. Lic. , SJ 'ELECTRICAL PERMIT ,FEES .
Suprv. Electrician signature, required: Subtotal: 1V`‘, (� -
0V/4o Plan review (25% of permit fee):
Print name:� /�( II Z / ,.. ^ . Date: State surcharge (12% of permit fee): (�... TOTAL PERMIT FEE: i 1 — ) r
Authorized Signature: This permit application expires if a permit is not obtained within 18
Print name: Date: days after it has been accepted as complete.
Num of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 07/01 /10 440- 4615T(11/05 /COM/WEB
r ,
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
• Audio and Stereo Systems
0 Burglar Alarm
H Garage Door Opener
• Heating, Ventilation and Air Conditioning System
• Vacuum Systems
El Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
0 Boiler Controls
0 Clock Systems
n Data Telecommunication Installation
D Fire Alarm Installation .
n HVAC
D Instrumentation
0 Intercom and Paging Systems
n Landscape Irrigation Control
0 Medical
0 Nurse Calls
n Outdoor Landscape Lighting
n Protective Signaling •
n Other •
Number of Systems
* No licenses are required. Licenses are required for all
other installations •
i:\Dsts\Permit Forms\ElcPermitAppPg2.doc 01/03
Electrical Permit Application - City of Tigard
'Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
• _
n Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other: -
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system . . . •
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls •
❑ Clock ems •
ata Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n 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 all other installations
1:\Building\Permits\ELC- PermitApp.doc 07/01/10