Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1 4 a COMMUNITY DEVELOPMENT Permit #: ELC2010 -00601
Date Issued: 10/27/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S 27/201 0400
Jurisdiction: Tigard
Site address: 7632 SW DURHAM RD 300
Subdivision: Lot: 0
Project: Optum Health
Project Description: (5) branch circuits for TI
Owner: FEES
BEHRINGER HARVARD WESTERN Quantity Description Date Amount
PORTFOLIO LP, BY EASLEY MCCALEB & 5 crt Branch Circuits 10/27/2010 $85.86
ASSOCIATES I, PO BOX 190700 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/27/2010 $10.30
Electrical
Contractor:
HILLSBORO ELECTRIC LLC
21185 NW EVERGREEN PKWY #110
HILLSBORO, OR 97124
PHONE: 503 -439 -9666
FAX: 503 -601 -3680
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $96.16
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 AR 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.
'42 — "A/ ,f7 - 7 ) / 6 i e�i�o/l/
Issued By: Permlttee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNERS SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 603.639.4176 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.
From:Hillsboro Electric,LLC 5036013680 10/25/2010 21:44 #907 P.001/002
•
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Electrical Permit A $ lie •(j,tui r olz qt 1 Ic l i 51 0
City of Tigard ( � c 2 6 2010 DE€IC a 7 /d Pit Nezewv0 • 131SW Hall Blvd, Ti ard, OR 9 9 � g
Phone: 503.639.4171 Fax: 503.598.19 0 Date/13 : Other Permit-if 1 0Z0/0 — 00.2/ •
l 1 t A 1t'i- lnspeclion Line: 503.639.4175 CM OF TIUP Date Ready/By: InEl H See Page 2 for
Internet: t% % .tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
f TYPE OF WORK PLAN REVIEW J
❑ New construction Addition/alteration/replacement
Please check all that apply (submit a 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
/� ❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION
�� `7 _ ❑ Addition of new motor load of ❑ "A'. "E ", "1 -2 '• 1 _3•
Job x10.. -- 11 lob site address: 6:-0 � 100HP or more. occupancy.
1 1 � � - • • t" / ■ more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Y ` `- ( \ C '' ❑ Health-care facilities. ❑Supply voltage for more than
y l "� 7 i �� ❑ Hazardous locations. 600 volts nominal
l ip ldg. /apt. no.: g do, O J Pro name: ( ' , 1 to (k. } 1 „ ❑ Service or feeder 600 amps or more.
1 V 1 FEE SCHEDULE
toss strcet/direclions to job site: Description 1 Qty. 1 Fee. 1 Total 1 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. orponion 33.92 I
Tax map /parcel no.: l Limited energy, residential 75 00 2
: DESCRIPTION OF WORK (with above sq. ft.) 2
Limited energy, multi - family
75.00
- residential (with above sq. ft.)
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 I
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 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, ger panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
❑ APPLICANT I ❑ CONTACT PERSON each branch circuit 7 42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first �� �
Contact name: branch circuit 56.18 0 2
Each add'I branch circuit 7.42 ;- 2
Address: Miscellaneous (service or feeder not included) v
Each City /State /ZIP: dwelling, service e and/or feeder
67.84 2
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: panel, alteration, or extension. Page 2 2
Hillsboro Electric, ec t r i c , LLC Each additional inspection over allowable in any of the abov
Address: 21185 NW Evergreen Pkwy #110 Additional inspection (1 hr min) 66.25/hr
Investigation (t hr min) Hillsboro / OR 97124 m) 78. 8/ hr
Industrial plant (I hr min) 78.118/ hr
Phone: ( inspections for which no fee is
( 503 439 - 966 ( 503 �O1 -3680 /y / 1 specifically listed CA hr min)
90.00/ hr
6, / CB Lic.: 1 34481 4 4 81 /Electrical Lic.: Lic.: 1 - J G ELECTRICAL PERMIT FEES
Suprv. Electrician signature. required: , it/
3 4 - 4 9 9 C, Suprv. Subtotal: lc, 3(g) Plan review (25% of permit fee):
,--t
Print name: � C\c' .( Date: j c ` / r 0 State surcharge (12% of permit fee): 10 t 3� ./ /
Jae \ vl t7+ `?
TOTAL PERMIT FEE: if 5�
Authorized signature:
This permit application expires if a permit is not obtained within 0
days after it has been accepted as complete. ��r er
Print name: Date: • Number of inspections allowed per permit. . �
1 .1Building\Pcrmits\ELC- PermitApp doc 07/01/10 440- 40I5T(IIi05 %COMAVEB