Permit CITY OF TIGARD ELECTRICAL PERMIT
.74
COMMUNITY DEVELOPMENT Permit #: ELC2010 00507
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/16/2010
Parcel: 2S113AB01201
Jurisdiction: TIGARD
Site address: 16505 SW 72ND AVE
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: Liberty Mutual
Project Description: Electrical for interior TI.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 4 crt Branch Circuits 09/16/2010 $78.44
wo /Purchase Service or
PHONE: 503 - 624 -6300 Feeder
1 ea 12% State Surcharge - 09/16/2010 $9.41
Electrical
Contractor:
TIMBERLINE ELECTRICAL CONTRACTORS
PO BOX 918
LAKE OSWEGO, OR 97034
PHONE: 503 - 459 -4089
FAX: 503 -254 -4227
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $87.85
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 OA 52- 001 -0100. You may obtain a e rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
VIP
Issued Permittee Signature: �ii1 Iii
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 503.638.4175 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.
09/15/2010 02:03 FAX f1001 /002 r
City of T ���,��� ll� is a a . No:.. - .... .
i ' • ' SW HallBlvd., Tigard, OR 97223 Date/8 . �. ) P e . 0 : •-' .- ".• . •
. . Phone: 503.639.4171 Fax:' 503.598.1960 Plan aim .. Permit .
Inspection Line: 503.639.4175. 5 2 O 1 O Other
ff;
Internet: www.tigafd-or.gov c � i� 14otiSed/Me�odt
• ❑ New - construction O�eronialterahon/mplacement ther4� w
Ple c heck sll lrrema o R ).
. .0 Demol
CI Sotvioe or'febder Dialing ovei'lhiee itorin • where the available fault current • O Marinas md boatyards
."k, exceeds 10,000 a
` : ': ; • nrps�330.vvite or•: (r1.37oafiag .--
`i less to ground, or exceeds 14,000 D Commerrciel -use agricultural
.. Eat, and 2- family dwelling ► . . mmercial/industrial ❑ Accessory building amps for all ether. stallaaons. • kiddinga, .
. D Multi-family Master builder
•
Y ❑Other
❑ Fire pump. ' D Iuatellation of 75 KVA m
Fraergemcy syeoem• huge aeateb. derived system
D Addition of oew motor load of D "A ", "E". "1 -2 "1 -3 "..
Job•no:: Job Sete address: + '1-4 100HP or mom. occupancy. •
❑Six or more reiriruma.1 units. D Reamaponal vehicle perks.
City/StatC/ZIP:. • ,� D Health -care facilities. d sripply'velm8e formore than
.a ,
n D Hazardous locations. 600 who nominal
• Suite/bldg./apt. o:: . Project name: L, D Service or feeder 600 amp; or more:
Cross street/directions to job site: •im. Total `
.,_. : ;"77 :- ,7.`... - _____. ..,.....w._. _ ._ . . -..- . - . • . .. New - a_ y - or.- aw►0faud1ydtpe milli t. ..
n
. Includes atfaehed
. Subdivision: Lot no.: 1,000 sq. ft or less 168.54 _ .
Tax map/ l no,: Ea. add'l 500 sq. R. or portion 33.92 •1
Limited energy, residential
(witti abovesQ tt.�
lasaoal 0nergy. iamb- imatly , 75 00 2
tssidential (with above a9 ft.)
- - -- Services or feeders nstaltation,_alterattoa retocstla
200 am ps or less . . •.
1 00 70 . 2.
.
_ amp; to 400 amps 133.56 2
r
Ne1nC. 401 amps to 600 amps t '�Z0094 2
601 amps to 1,000 amps 301.04 2
Address: Over I,000 amps or volts : . 552.26 • ' ' • 2.
• Temporary anises or feeders installation, alteration, and/or
City/State/ZJP: "
relocation
Phone: ( ) • Fax: ( ) 200 amps or lees 59.36 I
• (Owner installation: This installation is being made on property that I own which is not tot amps to 400 amps 125:08 2
intended forsale,lease, rent, or exchange,.according to ORS 447, 449, 670, and 701. aUt.ampa to 599 amps 168.54 2
Br'anc ititeuits : sew', etteretioa :oreateoetoniner panel
.7 ' Owner signature: Date: A. Fee for branch circuits with •
c branch cucwt fee.. •
•..'.. < . each
7:42` � 2,
Business.name: .. B. Fee for branch circuits without • service or feeder loo, first 1 56.18 Ili' 2
• Contact. name: • broach circuit S(.
- .Bach add' Ibiacit . EigiMallirMijitil
_ MMIIIIII circi I • - tenons (servlse.or feeder not itidaded) . . -
Each manufacpmad or modular .. - `
. City/State/ZIP: • dwelling, service and/or feeder : -• .. 67.84 ; 2
Phone: ( ) Fax: : ( ) Remotest only 67.84 • 2
g mail. -
Pump or irrigation cirdle ( : • 67.84 • - 2
• Sign or outline lighting 67.84 2
. _ sigaaleircttft(s ) orhmrtad- energy .,.: . ,. _ • $nsiness ump . i r ..„.:4--
" 8 • o (r L rt,1 panel, alteration, or extension. Page 2 . 2
Each additional inspection over allowahle in sift of the abov
• Address. ! tt . 6 D • �� Additional inspection (1 hr min) • • 66.25/ hr , • .
CRy/Stetifae:. ;.....,,2.. ' a r3 r 0 R, tit 6 a lovestt pain) ..46.25/ hr
Industrial plant (11ir min) 78.181 hr
Phone: 4 ) a ,` :. - �, e. Fax .(56 ) i Inspections for which no fee'is .
�:b/� b s - listed hr mm 90 00/ hr
.CCB Lie:: 4 'D • :Electrical t s � � _
Spprv• Ble cbician• signatuue, te4vired: ' rav'1��� Plan review 25 °k of Si x : • ( p )
Print name:. . . i�� Date: q �� S tate.surchar ► 96 rr off � p nn • q. *1
Aathonzed signature' L / . • !a S '�►LTA R r1!t ,1L FEE.: , . 91. r l
^ 7 Th e permiteFFfteet WPM_ . 4ftew7ott b eoj, wi!6irt 180
days af i tha a been e ceep fed as complete; ' .
• Print name: • • - .. ` . •_. a . Date: ' � ° • dumber of ias pactio m all •
per p •
L .doe 07f0UIO 440.4615T(111O5/COMIWEB • .