Permit CITY OF T I G A R D ELECTRICAL PERMIT
/+ PERMIT #: ELC2001 -00060
�,
�- DEVE H B .SO RV 2`iES 639 -4171 DATE ISSUED: 1/26/01
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 510 -
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE •
BLOCK: LOT : 002 JURISDICTION: TIG
Proiect Description: Installation of 5 branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH-ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS
ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 4 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp/volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TIGARD TRIANGLE I LLC PHOENIX ELECTRIC CO
4650 SW MACADAM AVE STE 220 DBA/ENCOMPASS ELECTRICAL TECH
PORTLAND, OR 97201 7379 SW TECH CENTER DRIVE
TIGARD, OR 97223
Phone: Phone: 684 -3600
Reg #: LIC 00052288
SUP 4140S
ELE 34 -247C
FEES Required Inspections
Type By Date Amount Receipt
Ceiling Cover
PRMT CTR 1/26/01 $73.45 2720010000( Wall Cover
5PCT CTR 1/26/01 $5.88 2720010000( Elect'l Final
Total $79.33
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Speaalty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -1987.
PERMITTEE'S SIGNATURE k/ ISSUED BY: A eg,
OWNER INSTALLATION ONLY
The installation is being made on property 1 own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
Electrical Permit Application pp lication
Date received: / Zro D/ Permit no.: Eli 200/ -di. 6, a
. A . � City of Tigard Project/appl. no.: - Expire date:
City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: ' Bya), „ Receipt no.:
Phone: (503) 639 -4171
Fax: (503) 598 -1960 Case file no.: - Payment type:
Land use approval:
TYPE OF PERMIT
0 1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi- family nant improvement .
0 New construction „ : 0 Addition/alteration /replacement 0 Other: 0 Partial - ,
JOB SITE INFORMATION �r •
Job address: 13 1 Sc) 68 f q, / - Bldg. no.: Suite. o.:: v T; map /tax lot/account no.:
Lot: IBlock: ISubdivision: - 50 a
Project name: Tr, c 1 . I Description aid location of work on premises: ..
Estimated date of completion/inspection: ,-
• CONTRACTOR APPLICATION • FEE SCHEDULE .. ,
Fee Max
Job no: 8/ 3 Description Qty. (ea.) Total no. insp
Business name: F,,, ,,, le,,,1 Tei. t c., New residential -single or multi-family per
Address: 7A ? 4 -LtA 'r C-4^ A, dwelling unit. Includes attached garage.
City: 7 r H 5 �l 49,2_
\ I State: I ZIP: 97 Service Included:
i
Phone: (6 8 y- 670 I Fax: 6,9Y // I E -mail: 1000 sq. ft. or less 4
Each additional 500 sq. ft. or portion thereof
CCB no.: 2 V..? y? L - . 'Elec. bus. lic. no: Sa 2 8 e Limited energy, residential • 2
City /metro iC. no.: l _ Limited energy, non - residential _ 2
Each manufactured home or modular dwelling
Signature of supervising electrician (required) Date Service and/or feeder -2
` ` r vn Services or feeders — Installation,
Sup. elect name (print): }'1 t ` c c.•c�t. F License no: 3 il G 0 S. alteration or relocation:
._. PROPERTY OWNER . 200 amps or less 2
• - 201 amps to 400 amps 2
Name (print): 401 amps to 600 amps ” 2
Mailing address: 601 amps to 1000 amps 2
City: I State: I ZIP: Over 1000 amps or volts 2
Phone: I Fax: I E -mail: Reconnect only i
Owner installation: The installation is being made on property I own Temporary services or feeders -
which is not intended for sale, lease, rent, or exchange according to pa}iog alteration, orrelocation: Insta
200 amps or less 2
ORS 447, 455, 479, 670, 701. 201 amps to 400 amps 2
Owner's signature: • Date: 401 to 600 am s 2
Branch circuits - new, alteration,
or extension per panel:
Name: A. Fee for branch circuits with purchase of
Address: service or feeder fee, each branch circuit 2
City: I State: I ZIP: B. Fee for branch circuits without purchase
of service or feeder fee, first branch circuit: 2
Phone: Fax: E-mail: Each additional branch circuit:
PLAN REVIEW (Please check all that apply) • Misc. (Service or feeder not included):
O Service over 225 amps - commercial - O Health -care facility Each pump or irrigation circle 2
O Service over 320 amps - rating of 1&2 0 Hazardous location Each sign or outline lighting 2
family dwellings 0 Building over 10,000 square feet four or Signal circuit(s) or a limited energy panel,
O System over 600 volts nominal more residential units in one structure alteration, or extension* 2
O Building over three stories 0 Feeders, 400 amps or more *Description:
O Occupant load over 99 persons 0 Manufactured structures or RV park Each additional inspection over the allowable in any of the above:
O Egress/lightingplan 0 Other. Per inspection 1 1 `" 1 ` " l •
. .. -- Submit _ sets of plans with any of the above. • ; Investigation fee
The above are not applicable to temporary construction service. Other . . , • - "" - - "- - • S ,
L Notice: This permit application Permit fee $ 7. '
O tsar "MasterC . - expires if a permit is not obtained an review (at _ %) $
Credit card number. '' 1 / a 16 - 4 r 1 a. a /0 Ho Z within 180 days after it has been State surcharge (8 %) .... $ (P?
Pticr;.a"A Eli• r,,, Cc. Ss nc- i2.r , Expires accepted as complete. TOTAL $ 77, .3
Name of cardholder as shown on credit card $ CvrN ro )
Card der signature Amount py OEit/0 / 772(�(g eee 4444615 (tuW/COM)
. i. "En- .TBO / -
Electrical Permit Fees - Limited Energy Fees: M: -
Complete Fee Schedule Below: TYPE OF WORK INVOLVED - RESIDENTIAL ONLY
Restricted Energy Fee $75.00
Number of Inspections per permit allowed (FOR ALL SYSTEMS)
Service included: Items Cost Total y Check Type of Work Involved:
Residential - per unit
1000 sq. ft or less $145.15 4 ❑ Audio and Stereo Systems
Each additional 500 sq. ft. or
portion thereof . $33.40 1 ❑ Burglar Alarm
Limited Energy $75.00
Each Manufd Home or Modular ❑ Garage Door Opener
Dwelling Service or Feeder $90.90 2
Services or Feeders " " ❑ Heating, Ventilation and Air Conditioning System*
Installation, alteration, or relocation •
200 amps or less _ $80.30 2 Ell $80.30 Systems*
201 amps to 400 amps _ $106.85 2
401 amps to 600 amps $160.60 2 —' Other 601 amps to 1000 amps $240.60 2
Over 1000 amps or volts $454.65 2 —
Reconnect only $66.85 2
Temporary Services or Feeders .. = TYPE OF WORK INVOLVED - COMMERCIAL ONLY
Installation, alteration, or relocation
.200 amps or less $66.85 2 Fee for each system $75.00
201 arnps to 400 amps _ $100.30 2 (SEE OAR 918 -260 -260)
401 amps to 600 amps _ $133.75 2
Over 600 amps to 1000 volts, Check Type of Work Involved: .
see "b" above. ❑
Audio and Stereo Systems
Branch Circuits
New, alteration or extension per panel ❑ Boiler Controls
a) The fee for branch circuits
with purchase of service or ❑
feeder fee. Clock Systems
Each branch circuit $6.65 2
b) The fee for branch circuits ❑ Data Telecommunication Installation
without purchase of service .
_ _ or feeder fee. th �� El Fire Alarm Installation
First branch circuit 1 - $46.85
Each additional branch circuit y $6.65 3 6" b o ❑ HVAC
Miscellaneous
(Service or feeder not included) ❑ Instrumentation
Each pump or irrigation circle $53.40
Each sign or outline lighting $53.40 ❑ Intercom and Paging Systems
Signal circuit(s) or a limited energy
panel, alteration or extension $75.00
Minor Labels (10) $125.00 n Landscape Irrigation Control*
Each additional inspection over ❑ Medical
the allowable in any of the above "
Per inspection $62.50
Per hour $62.50 ❑ Nurse Calls
In Plant $73.75 ❑
Outdoor Landscape Lighting'
Fees:
Enter total of above fees $ 7
y ❑ Protective Signaling
8% State Surcharge $ `�
n Other
Number of Systems
25% Plan Review Fee
See 'Plan Review" section on $
front of application. - * No licenses are required. Licenses are required for all other installations
Total Balance Due $ 71. 33 Fees: -
0 Trust Account # Enter total of above fees . • $
8% State Surcharge
Total Balance Due .. $
•
i:\dsts \forms\elc- fees.doc 10 /09/00 •