Permit IN r .1
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2010 00670
TIGARD. 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/03/2010
Parcel: 2S101 DA00104
Jurisdiction: Tigard
Site address: 13333 SW 68TH PKWY, STE# 220
Project: ACS Subdivision: FARMERS INSURANCE Lot: 0
Project Description: Phase 3, electrical for south wing of 2nd floor. (1) feeder, (50) branch circuits and low voltage for fire alarm.
. 12/7/10, Reprint to correct suite address from 210 to 220..XE—
Contractor: COCHRAN INC Owner: TRIANGLE POINTE LLC
7550 SW TECH CENTER DR. #220 901 NE GLISAN ST #100
TIGARD, OR 97223 PORTLAND, OR 97232
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 12/03/2010 $100.70
Specifics: amps or less
50 crt Branch Circuits w /Purchase 12/03/2010 $371.00
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Signal circuit or Limited 12/03/2010 $75.00
Energy Panel
Type of Const: 1 ea 12% State Surcharge - 12/03/2010 $65.60
Occupancy Grp: Electrical
Total $612.30
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 do . n accordance • 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
da ATTENTION: Oregon I -. -. i •s iou to follow the rules adopted by the Oregon Utility No'' - -nter. Those rules are set forth in OAR
9:2- 001 -0010 through OAR 952 -0• -0090. Y may obtain a copy of the rules or direct questions tq•BU C by ca 1 • +K 1987 or 1.800.332. :44.
Issued By: / / UV -al i/L . _ Pe rmittee Signattr _de, i' ,,11 r' (.C� l
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' � .', jrA gf /l..)--------- Date:
Ar
LICENSE NO.
Call 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.
Electrical Permit APPlicatiotiihUti V tli ",,,,.' ;.:,,,';:';. i..:-..'...eog: ipPft:et ;;:;,,'.;:,
-•`... :''. -..r. Cit of Tigard Received /
Date/By: / y Permit No.: e (076
13125 SW Hall Blvd., Tigard, OR 97223 DEC 3 201
..,:. .. y Plan Review
7
?: - . .• - . -:, Phone: 503.639.4171 Fax: 503.598.1960
11
Date/By: Other Permit:
I econ Line: ..1
TIC, A RtlY ns ti Li 503639475 , P CITY OF TIGARD Date Ready/By: Juris: El See Page 2 for
• ,.,--' --
Internet www.tigard-or.gov
BuILDING DIVISION Notified/Method: Supplemental Information
_
• — ,, - - :r 1., ' : .., •• „'''' '''.II' 11 .; --„,.. 0 . • 1; • '1,: ;...7.V. : " ':•l t: , '''' ' '',V• : : . '+'t - •' "' •`"• ... ;' '.: 1 ; tilv itEVig . 0F %'ORK 0 New construction 1,21 Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
['Service or feeder 400 amps or more 0 Building over three stories.
0 Deinolition I=1 Other: where the available fault current 0 Marinas and boatyards.
F; 2( .:Affaii:,di--ediki,siiieciiiiiiV;ir;:•r,;-11:.]•*.' exceeds 10,000 atrips at 150 volts or 0 Floating buildings.
:.1i,tr,.1:.' /..''',....•:''S , '.../ L. ', ... ...si -:. . c :0•.:.ir..s.r.:.:r 1 •••■). f.c. ;.• •,,,,; ' W' . ,A. ' i t•• less to ground, or exceeds 14,000 0 Cominercial-use agricultural
, -v.t..ii ,::,,,.,
El 1- and 2-family dwelling - .ffiCominercial/industrial CI Accessory building
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
. 0 Emergency system. larger separately derived systen:
. '. • ... ••.: . .„, . .ios. sr.r.: . .,kripl,.,opiyriorii .. ...,..:.,,...„, , .. ,..:
,•...,::::,;:. D Addition of new motor load of
,
100HP or more. occupancy.
Job no.: 1 ( Job site address: 1 - ;-; 3 2, G j 9,-k-k.,1 ,....,.
more residential units. 0 Recreational vehicle parks.
City/State/ZIP: /State/ZIP: k s . () •?...._ 9, --7.22..-z, 0 Health-care facilities. 0 Supply voltage for more than
f(A .
0 Hazardous locations. 600 volts noininal.
Suite/bIdglapt. no4<" roject name: t\ C ')c...c....,r,.._ El Service or feeder 600 amps or more.
';.... . .... - 1 ‘ -11 . f . :". 7 : :; ! . ..?......:.;•, - ; . .k ' :. :
Cross street/directions to job site: Description 1 Qty. I Fee. I Total 1 .
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or less 168.54 4
' Ea. add'I 500 sq. R. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
75.00 2
'' v:' '" ••••• ' • - • •:' • . ' .".'• : D,ES ' ' • , ,. , ' • . (with above sq. R.)
Limited energy, multi-family
s t / 2A (K.J '2_0e.) 1., .-e.4_L2_,F I ?c...,.cLX .,-- 'f- residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
1,-- 60 , -<, ,-.61.64-tti pa,4___6 200 amps or less I 100.70 (00.70 2
.••,'-':..' ; : pao Ppz'r ikovv NER" .-.'."..:!-,- f ,. "1,E N'ANT:,:iy:-...':',.%:.::;,.;`:!-.1:: 201 amps 10 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: A c5
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 ainps 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 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not -
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701,
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee "--; 42 ,....,
, ' • .... • . E. APPLICANT r . .' .. • .. ... .. '• ". - . - i. CONTACT :PERSON': • ..s.' -.. . 7. 11- 11 2
each branch circuit -7(:) i t 1
Business name: 5 0 _ 01 . Ne... a..... c c i,_. 0 . „( .._ B. Fee tor branch circuits thou/
service or feeder fee, first
Contact name: .< TA (_.0 IN
'c branch circuit
L - e-- Th\
Each add'I branch circuit 56.18 2
..
7.42 2
Address: Miscellaneous (service or feeder not included)
• Each manufactured or modular
City/State/ZIP:
dwelling, service and/or feeder 67.84 2
Phone: 142_,L 0
GC-rs-) Fax: : ( ) Reconnect only
Ptunp or irrigation circle 67.84
67.84 2
2
E-mail: 61,,,k, leA-c, ct , C. 6A/1x7 ■V\ (_. , LO WI Sign or outline lighting 67.84 2
- . ,1 1 = . .. -. ...!:.' '.• ,, "..'','.• '• • ...,..: ... .C9N`01Aci[fcW.,:. •.... II ,:.; ' ,: ., J. 4. . ;.• 0 ' Signal circuit(s) or limited-energy
Business name:
panel, alteration, or extension. ( Page 2 - 75 - . ° ` ) 2
CL an
• Each additional inspection over allowable in any of the above
Address: 1 5 5 ( e-c-Ti- c 42-2D Additional inspection (1 hr min) 66.25/ he
Investigation (I hr min) 66.25/ hr
City/State/ZIP: --- 71 - 6 6_ CA OK R 72 2_
Industrial plant (1 hr min) 78.18/ hr
Phone:503 ) 23 &, Fax: (.13 ) 238 2_0 c; .8 Inspections for which no fee is
90. 0 0/ hr
specifically listed CA hr min) . ... .. .., , . ,
. ,.. ,
CCB Lic.: 7 2_ Electrical Lic.: 37 54/6, e , Suprv. Lic.: 3i--44 ;;!::'::. • . -..;; .
Suprv. Electrician signature, required: \C3
\
Plan review (25% of pet
Print name: ,,..., \<A., Date: ( 24 -- 5/2 ( 0 State surcharge (12% of pennit fee): (`' 4,0
TOTAL PERMIT FEE: • - 0
'
Authorized signature:
This application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: . * Number of inspections allowed per pennit.
1: \ Buildineennils'El_C-Perinit A pp.doc 07'01'10 440-4615T( 1 1 '05,COMiWEI3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Mat.iSEIWIAINOWTOI.:T ,
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
l . COIV MER-QIAL WiORK ONLY: ` �- 7Hi' 1
Fee for each commercial $75.00
system
(SEE OAR 918 309 - 0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ D ata Telecommunication Installation
Fire Alarm Installation
❑ I • VAC
n Instrumentation
❑ Intercom and Paging Systems
n L • andscape Irrigation Control*
❑ Medical
❑ N urse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Buildin \Permits \[LC- PennitApp.doc 07/01/10