Permit q CITY OF TIGARD ELECTRICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: ELC2010 -00722
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/30/2010
Parcel: 2S101 DB00100
Jurisdiction: Tigard
Site address: 7320 SW HUNZIKER RD 102
Project: Plaza Home Mortgage Subdivision: Lot: 0
Project Description: Electrical for TI.
Contractor: AC & E ELECTRIC Owner: HILLTOP BUSINESS CENTER LLC &
3535 DEL WEBB AVE #100 HUNZIKER LLC
SALEM, OR 97303 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 363 -2301 PHONE:
FAX: 503 - 363 -2302
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo /Purchase 12/30/2010 $122.96
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/30/2010 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 R 952- 001 -0090. You may obta y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: ,G�� Permittee Signature: G� - �� �_
• 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.
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 Applica 'o ; , % . FOR OFFICE USE ONLY
City of Tigard ` W
Received Permit No.: L r ,)-)- 3 D to ) /50110 err LCd D v en
13125 SW Hall Blvd., Tigard, OR 9722��C Plan Review
Phone: 503.718.2439 Fax: 503.598.19 0 `��� � Other Permit: ' (' i ag-3
Date /By: _ L1 � V - 7
TIGARD Inspection Line: 503.639.4175 o \ f S� IDN Date Ready /By: luris: El See Page 2 for
Internet: www.tigard- or.gov ' q( ;1�N \1 Notified /Method: - 1 - ::69 Supplemental Information
TYPE OF WiK \'t PLAIN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 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
❑ I- and .2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family El Master builder • ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: Job site address: 7320 Hunziker l00HPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR • ❑ Health -care facilities. ❑ Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no. l() \- Project name: Plaza Mortgage TI ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: - Description I Qty I Fee. I Total I
. 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. or portion 33.92 I
Tax map /parcel no.: . • Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
Minor TI Remodel 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
City/State/ZIP: Temporary services or feeders installation, alteration, a_ nd /or
Y 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 -
40 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 .
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: B. Fee for branch circuits.tvithout
service or feeder fee, first I 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit ' 9 7.42 66.78 2 • Address: . Miscellaneous (service or feeder_not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y d welling, serv and/or feeder
Phone:( ) Fax::( )
R econnect 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: AC &E Electric panel. alteration, or extension. ' Page 2 2
Each additional inspection over allowable in any of above
Address: 3535 Del•Webb Ave . Additional inspection (I hr min) 66.25/ hr
City /State /ZIP: Salem, OR Investigation (I hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr '
Phone: (503) 363.2301 Fax: (503) 363.2302 Inspections for which no fee is 90.00 / hr
specifically listed (' /: hr min)
CCB Lie.: 591 Electrical Lic.: - . S uprv. Lic.: 5387S ELECTRICAL PERMIT FEES
• Subtotal: 122.96
Supry. Electrician signature, required: • Plan review (25% of permit fee):
• Print name: Carl Duncan Date: 12 /30/10 State surcharge (12% of permit fee): 14.76
TOTAL PERMIT FEE: 137.72
Authorized signature: ,
This permit 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 permit.
It\ Building \Permits TLC-Permit App.doc 07/01/10 440- 461 ST( II /05 /COMM'EB
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