Permit CITY OF TIGARD ELECTRICAL PERMIT
1 11- g . COMMUNITY DEVELOPMENT P ermit #: ELC2010 00660
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/22/2010
Parcel: 1 S 136AD04000
Jurisdiction: Tigard
Site address: 11513 SW PACIFIC HWY
Project: Pacific Terrace Subdivision: Lot: 0
Project Description: Altering (1) branch circuit.
Contractor: STEELE ELECTRIC LLC Owner: PACIFIC TERRACE COMMERCIAL LLC
716 ROXE DR BY EDITA M SMITH
FOREST GROVE, OR 97116 833 NW 170TH DR
•
BEAVERTON, OR 97006
PHONE: 503 - 332 -1280 PHONE:
FAX: 503 - 372 -6448
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 11/22/2010 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/22/2010 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 -0090. You may obtain - • • •. the rules o irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
W IPP
/ t
Issued By t_ ! �� -/ rw Permittee Signature:
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 the next available inspection date.
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.
11/22/2010 09:20 5033726448 Steele Electric #0434 P.002
Electrical Permit Application
foR OF }7C :E !_SE ONLY . , . .
City of Tigard , ',� r�Q�Q Received
� _ 'I 503.598,i9
13125 S W Hall Blvd,, Tigard, OR; el l Date/t;r. !� �/
Phone: 503.639.4I71 Fax; B A � plan Review ......1 I. 6Q C`' l ' I?stCB : Other Permit:
!' l L' A li � Internet: don Line: 5 03.639.4175 `y G ``,,15 � Date ReadyB
Bard -or gov Q� 9 Notified/Method: P z
m Pka 4,r i w r . Supplemental information
ifA.,gµ4tfV.!,w of to 4s ot"o-9`t,J,x *' f2
❑ New construction � IL - .: ....: ; : :. �+�, ,r �, �,. „ 0 ' t
• Addition/alterati sir ; laeemetll Please check ali that afro
p p ly (submit 2 sets of plans w /items checked below): s
❑Service or feeder 400 am
ID Demolition ❑ Other: s or more
v P ❑ Sodding over three stori.
G
x ads* where the available fault current ❑ Marlins and
. i t5' �r ;Z: C'. ''�'; rr'7 „" ai o o , a" 4 i∎ exceeds 10,000am s boatyard.
'Aiii �raiitee;A ^ „ a t .... P at i so votes or ❑ Floating buildings.
❑ 1- and 2-family dwelling !/ CommerciaUindustria! ❑Accessory building Ims to agricultural
ground, or exceeds 14,000 ❑ C buildings.
Commercial-rice
❑ Multi- family amps for all other insaallxions. buildm
❑ Master builder
jxa � �° 1 r ❑ t��� Other: El Fire pump. ❑ Installation of TS KVA A or
. ' ' 6 .. _ > L'. 71t" v µ v \ �, c , ✓ t .t t ❑Emer $ Cm-
. .. � s �+8C7 scparasel rived s
�rc . +?. ra wo , . ,4 f `ib ❑ Ad dition of flew moror load of
Job no.: Job site address: d "A" <`�" "t -z° " -3 ° ,
SW ptci - i ' 100HP or m ore. .
City/State/21p ' j'� rq P ` ��j El Six or more midcntial units. ❑ Reaeatmnal vehicle parks,
1 a q' 2 z ❑ Health -care facilities. ❑ suppl volb for more than
Suitelbld / t n0.: ❑ Hszvdous location;. 600 volts nomimti
g aP Project name: • QC. 1 vr - ❑ Service or feeder 600 amps or more.
Cross Strcct/di .. z
sections to Ob site: , , r t ' ; °,'` e 6 d i ev
New residential single- or multi - family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fL or less
16854 4
Fa, add'i
Tax teal? /parcel no.. R or por
sq. tion
F ... ,-max ..,
Limited energy,
r c t t :Z -7rM . 75.00 2
' t � ,. $e s 5 ,,_� M1 t ar � x,.cai t residential
�rnt7u� re- 1.19 L imited energy, mul farnily
0 I " l e i'S b �i O tA: residential (with about Sq. R.) 75.00 2
(A.) LOA OUdS C Services or feeders installation, alteration, and/or relocation
r, s 20 am or 1 76
�
.v �t.'✓ � 'r',,.,,�R 1.r , � y t ,� �. e33 � 100.70 2
' ' �. tfi ... ' �.a"1at ^ .. .. ^ f+. �x sin °, a x! r, iE 1 am 10 400 amps
133.5
Name. / l f -errace 1�1k�rC iQi C.
amps to 600 amps 200.34 2
Address: (a 2. 1 , W h/l v 11-)s tr-1 -1 Over 1,000 ' amps 301.04 2
amps or volts 55226 2
City/Statt /L1P: r + i a O �y Temporary services or feeder s installation, alteration, and/or
T relocation
Phone: ( ) F ax: ( ) 200 amps or less r 59.36 l
Owner installation: This installation is being made cm property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449. 670; and 701. 401 amps 10 599 amps 168.54 2
Owner signature: Date:
Branch circuits •- new, alteration or extensio i
w r �vtTS °5 M o , F ee for branch w i t h r
d D A o a, pane
S.; 4 kaMt�,w-k 4.' ° , 2 ,C v' 7 < ;54.w, e- ' 1 3 'b �S v� T S i above branch ircuit service [fee, H ,, 7 s s a ' 8 each r fattier "
a 7.42 2
Business name: B. Fix for branch
circuits withptd
Contact name: service or feeler fee, first
branch circuit 56.18 g 2
nddicss Each addl branch circuit 7.42 2
I Miscellaneous (service or feeder not incindec
Each manufactured or modular
dweliing, service and/or feeder 67.84 2
Phone: ( ) t Reconnect only 67.84
E-mail: Pump or irrigation circle 67.84 2
�.�'..f^'„.. u w.'at.'r 'go-�,r.+r s . t `a '• < <G ,a, t l_ r r .. t Sign or outline lighting 67.84 2
k
Business name: fc. • im� ..,. ;t ..t.., '� �. :,a . '''°X"�a-, °: "4 Signal circuit(S) or limited - energy
'ems panel, alteration, or extension. 2 2
Address I 6 e` Each additional ins tioa over allowable iu'alQof the above
Additional inspection (1 hr min) 6625/ hr
City/State/ZIP; rQ C rove_ pa coil Investigation (1 hr miry) 66 _25/ hr
( ) 332= Fax: t Industrial plant (1 hr min) 78.18/ lir
(� 3) 7 6 lnsptxtions for which no fee is
•
Cal Lie.: ! (, 1 40 Electrical Lie.: c q 1 specifically listed CA hr min) 90.00/ hr
�^ -.:c , yam ,, : . xt s y e✓:;.. �.•• ;• � ::vr . •• . ,� ,
Suprv. Electrician signature, „�µ "s",' Subtotal: `"`'°u' r°�,�n"°,�`'4 °' "x� '';
tgn e, required:
Subtotal: Zta : i
Print name: ,.�i � �„
Plan review (25% o f p ermit fee);
�`� 3D2tc: 1— 23— t O - State surcharge (12% of permit fce): ,z -
Authorized signature: TOTAL PERMIT FEE; ( z , e l
7Lc Permit application expires it a permit is not obtained within /80
Print name: Date: days after it has been accepted as complete
■ Number of ins
1:Sui it:lEI Pcmar.App.doc 07/01/10 inspections allowed per permit
440.461 ST(11 /05/CMWEB