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Permit CITY OF TIGARD ELECTRICAL PERMIT 11111 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00019 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/06/2011 Parcel: 2S112DA01200 Jurisdiction: Tigard Site address: 15060 SW SEQUOIA PKWY Project: Office Depot Subdivision: Lot: 0 Project Description: (8) branch circuits to reconnect (8) RTU's. Contractor: CONRICH ELECTRIC LLC Owner: PACIFIC REALTY ASSOCIATES PO BOX 42126 15350 SW SEQUOIA PKWY #300 EUGENE, OR 97404 PORTLAND, OR 97224 PHONE: 541 - 359 -1192 PHONE: 503 - 624 -6300 FAX: 541 - 461 -0507 FEES Quantity Description Date Amount 8 crt Branch Circuits wo /Purchase 01/06/2011 $108.12 Specifics: Service or Feeder 1 ea 12% State Surcharge - 01/06/2011 $12.97 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $121.09 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 952- 001 -0090 You may obtain a cop or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B --4 11111111111111P--- s= 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. Call 503.839.4175 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. Jan 0511 06:04p Con rich Electric LLC 541 - 461 -0507 p.1 Electrical Permit Applicatian By: P_,c7 FOR OFFICE USE ONLY City of Tiga ' � ) R V� /p ' [[ ® i i Da te B Permit X°.: L I IN • 13125 SW Hall BIv 7ti v garit 97223 sti p, Plan Review /� �'� C '"tlt'iC) �( Phone: 503.718.2439 Fax: 503.598.1960 DatuB Other Permit: (U — 00G T 1 GA F� D Inspection Line: 503.639.4175 J \N. Date Read /B K Internet: www.tigard- or.gov "0` Notified/ d : —_!'. See Page 2 for t v9 ir , l r'c t L(p J Sapplemenmllnfprmation TYPE OF WO P '!` !!�y -„CP PLAN REVIEW ❑ New construction ® Addition/alteration/ l en C \� `` Pl ease chock all a rep t apply (submit 2 sets of plans w /items checked below): ID Demolition Other: �+ r © ❑ Service or feeder 400 amps or mom ❑ Building over three stories gt C\ ' \ where the available fault cement ❑ Marinas and boatyards. CATEGORY OF CONSTRUCT" ) exceeds 10.000 amps at 150 volts or ❑Floating buildings. less to ound, or exceeds 14 Commerc 11 1- and 2- family dwelling ® Commercial /industrial (§ Accessory building amps for all other installations ❑ buildings. a] - use agrierhrral ❑ Multi- family ❑ Master builder Other ❑ Fire pump. [I Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑' A' "E� °l_p' `1 -3" Job no.: 10 I Job site address: 15060 S.W. Sequoia Pkwy 100HP or more. occupancy. ❑Six or more residential units. ❑ Recreational vehicle parks. City /StateJZIP: Tigard, Or. 97224 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: I Project name: Ofice Depot HVAC Retrofit ❑ Se rvice or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Description f Qty. I Fee I Total I . New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: . Lot no.: 1,000 sq. k. or less 168.54. 4 Tax map parcel no.: Es. add'i 500 sq. ft. or portion 33,92 1 Limited energy, residential DESCRIPTION OF WORK (with above sq. It) 75.00 2 Disconnect eight existing HVAC rooftop units prior to removal. Limited tergy, multi - family residential (with above sq. R) 75.00 2 Recconnect eight new HVAC rooftop units once installed. Services or feeders insiallatioo, alteration, and/or relocation 200 amps or less 1 00.70 2 ® PROPERTY OWNER I ❑ TENANT 20] amps to 400 amps 133.56 2 Name: Office Depot - 40] amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: same as above Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I 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 to 599 amps 168.54 2 Owner signature: Branch circuits - new, alteration, or extension, per panel Date: A. Fee for branch circuits with ® APPLICANT I 0 CONTACT PERSON above service or feeder fee, i 7 2 each branch circuit 2 Business name: Conrich Electric LLC B. Fee for branch circuits without ' service or feeder fee, first ] 56.18 56.i 8 Contact name: Richard Salahor branch circuit Address: P.O. box 42126 Each add'I branch circuit 7 7.42 51.94 2 Miscellaneous (service or feeder not included) City /State/Z1P: Eugene, Or. 97404 Each manufactured or modular 67.84 1 2 dwelling, service and/or feeder Phone: (541) 3591192 I Fax: : (541) 4610507 Reconnect only 67.84 ' 2 E -mail: conrich_r@comcast.net Pump or irrigation circle 67.84 2 I CONTRACTOR Sign or outline lighting 67.84 2 Signal circuit(s) or limited- energy Business name: Con rich Electric LLC _ panel, alteration, or extension. Pape 2 2 Each additional inspection over allowable in any of the above Address: P.O. box 42126 Additional inspection (1 hr min) 66.25/ hr City /State/ZIP: Eugene, OR. 97404 Investigation (1 hr min) 66.251 hr Industrial plant (l hr min) 78.18/ hr Phone: (541) 3591192 L Fax: (541) 4610507 Inspections for which no fee is Li c.: Lic.: 149509 Electrical Lic.: 2 -482C fJ ptv. c.: 4879S - specifically listed (G hr min) 90.00/ hr Nil � � 4S2 -� li1 � ELECTRICAL PERMIT FEES Suprv. Electrician attire, required: / I V i 0 Subtotal: 108,12 ; r2 rf d l_ Plan review : 25% of permit foe ( P ) Print name: Richard Salahor Date: I/5/11 State surcharge (12% of pennit fee): 12.97 Authorized signattrrc: TOTAL PERMIT FEE: 121.09 This permit application expires if a permit is not obtained within I80 Print name: I Date: days after it has been accepted as complete. , a Number of inspections allowed per pemd. 1 \ Building \Permits\ELC- PermitApp.doe 07/01,10 4 e0- 461570 I O5/COM/wEg