Permit CITY OF TIGARD ELECTRICAL PERMIT
1,,
., - COMMUNITY DEVELOPMENT Permit #: ELC2011 -00013
Ti G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/05/2011
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L3
Project: Scholls Business Park Subdivision: SCHOLLS BUSINESS CENTER Lot: 0
Project Description: (2) branch circuits for ground lights around monument signs located in common area fronting Scholls Ferry Road.
Contractor: COCHRAN INC Owner: ROBINSON, CONSTANCE A &
7550 SW TECH CENTER DR. #220 ROBINSON, LYNN ET AL
TIGARD, OR 97223 BY KG INVESTMENT MGMT
10240 SW NIMBUS AVE #L3
PORTLAND, OR 97223
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 01/05/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/05/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 work will
be done in - ,, • - _ = with approved plans. This permit will expire if work is not started within 180 days of is - , - ' w• is suspended fo • = the 180
days. A ► NTION: Oreg • • la , - • uires you to follow the rules adopted by the Oregon Utility Notific. on Center Thos: • - = - se ••rth in OAR
952 -00 0010 through OAR 9 001 -0o •0. may obtain a copy of the rules or direct questions to OUNC by calling 03.232.1987 • ;00 332 23- -. . .• i
Iss •d By: ■ ! _......A.: :� . i L Permittee Signature: ....ft...-. rill � �
"NUM/
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' •- I / Date: f��/
i
LICENSE NO. d e/ 7 S
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 Application FOR OFFICE USE ONLY
City of Tigard Rived s
I Date ece iv : /M G -000/
° 13125 SW W Hall Blvd., Tigard, OR 97223 Plan Review
!
Permit No.: ..�
Phone: 503.639.4171 Fax: 503.598.1960 Date /By: Other Permit:
T I L; A It 17 Inspection Line: 503.639.4175 Date Ready /By: Janis: ei See Page 2 for
Internet: www.tigard- or.gov Notified /Method: Supplemental Information
. TYPE OF WORK , PLAN REVIEW • , '
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ❑ Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
where the available fault current 0 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 ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE I NFOR M ATI O N A N D LOCATION ❑ Emergency system. larger separately derived system.
, i , ❑ Addition of new motor load of ❑ "A" "E" "l -2" "I -3"
I ( (I� Job site address: (\%3 I00HP or more. occupancy.
lob no.:
° �` ` 0 . [ 0 2(f '3w \WI. Vs ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: ` �� f ` o �� �Z ❑ Health -care facilities. 0 Supply voltage for more than
C ❑Hazardous locations. 600 volts nominal.
Se ite/bldg, /apt. no.: L Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE Descr I Qty. I Fee. 1 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. fl. or portion 33.92 1 -
Tax map /parcel no.: Limited energy, residential
'75.00 2
DESCRIPTI OF WORK . . • ' , , . . (with above sq. ft)
(( e � ' Limited energy, multi- family 75.00 2
I S� Cf7 (0 — Z 2 Z `.e (2c JU v ,ti v < �.� residential (with above sq. ft.)
Se
5 S Services or feeders installation, alteration, and/or relocation
C.��r b o J 0 �v �,11\.2V\� S k-LjV's-s 200 amps or less 100.70 2
❑ PROPERTY OWNER ', "I ' ❑ TENANT 201 amps to 400 amps 133.56 2
Name: S ( S 'e J 5 <v.� ' ?� 401 amps to 600 amps 200.34 2
v 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, and /or
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
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, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I , ONTACT PERSON - abov service or feede fee, 7.42 2
each branch circuit
Business name: + Ck,.S COt1 c -(_,��� i B. Fee for branch circuits without
�� ��Jr service or feeder fee, first i
Contact name: �G�.r� `3 `;��� branch circuit l 56.18ec( 2
Each add'I branch circuit ` 7.42 7,'-(2_ 2
Address: Miscellaneous (service or feeder not included)
City / State/ZIP: Each manufactured or modular 67 84 • 2
dwelling, service and /or feeder
Phone: ( ) ZOS — 4 Z5(4 Fax: : ( ) Reconnect only 67.84 2
(11
E - mail: Pump or irrigation circle 67.84 2
QD e ".0C_oG \j, v ti(vr, e.co %A/\ Sign or outline lighting 67.84 2 -
• •CONTRACTOR Signal circuit(s) or limited energy
Business name: \.A can panel, alteration, or extension. Page 2 2
-! _ Each additional inspection over allowable in any of the above
Address: - 1 5 50 $k j \1 ( eLh (�1 Ce.(s 2 (� 2 *2 Additional inspection (1 hr min) 66.25/ hr
City /State/ZIP: -1. Ci.,0G. OR. -1 7Z Z J Investigation (1 hr min) 66.25 /hr
� Industrial plant (I hr min) 78.18/ hr
Phone: (503) 23q.._ 1056 c/ Fax: ( 3 ) 3g - Z0 9 $' Inspections for which no fee is 90.00 / hr
` � specifically listed (%3 hr min)
CCB Lic.: ',Z l � Electrical Lic.:3 , 7SG�C Suprv. Lic.: L�7t5 ' • ELECTRICAL PERMIT FEES- . • ,
Suprv. Electrician signature, required: \C � Subtotal:: 3 ,
�Q,� ( Plan review (25% of permit fee):
Print name: \<P C1 n� , \ r ` k A`- Date: k 1 G ( ((, State surcharge (12% of pennit fee): 1 , Go
TOTAL PERMIT FEE: 1 (, Z�
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.
I?. Bu ildingPennits .ELC- PennitApp.doc 07 4404615T(II'05'COM /WEB