Permit CITY OF TIGARD ELECTRICAL PERMIT
11114 COMMUNITY DEVELOPMENT Permit #: ELC2011 -00236
Ti GARS 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/05!2011
Parcel: 1 S 126CA01100
Jurisdiction: Tigard
Site address: 9009 SW HALL BLVD 100
Project: Macy's Subdivision: FAIRVIEW PLACE CONDO Lot: 20
Project Description: Add (2) branch circuits for 2 floor boxes.
Contractor: ACCURATE ELECTRIC UNLIMITED INC Owner: DAYTON HUDSON CORPORATION
PO BOX 871866 BY TARGET CORP T -0345
VANCOUVER, WA 98687 PROPERTY TAX DEPT/TPN -0950
MINNEAPOLIS, MN 55440
PHONE: 360 - 567 -3330 PHONE:
FAX: 360- 567 -3320
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/05/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/05/2011 $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. All work will
be done in agc ce 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: Or on law re uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001,0010 through OAR -00j 09 . You may obta'n a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1.800.332.2344.
67 4 , J,
Issuec�By: a 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' — , f 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.
MAY -04 -2011 09:48 Accurate Electric, Inc. 3609947013 P.001
Electrical Permit Application FOR OFFICE LSE ONI.1
0 il-e-(9.011—e02.40 Received w�/%� C City of Tigard �Y Date/B : 3� Permit No.:
1111 I J o 13125 SW Hall Blvd., Tigard, OR Plan Review
Phone: 503.639.4171 Fax: 503.5 Datc/B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 ��� Date Ready /By: luris: El See Page 2 for
Internet: www.tigard- or.gov ', �` ,r � ` 0
.� �F `` Notified/Method: Supplemental Information
TYPE OF WORK e � y \' PLAN REVIEW
•
❑ New construction igl Addition /alteratiorlltt,111Iteinent Please check all that apply (submit 2 sets of plans w /items checked below):
['Service or feeder 400 amps or more Building
•,. mP ❑ Buildin 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
❑ 1- and 2- family dwelling ,J Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
0 Addition of new motor load of ❑ "A ", "E ","I- 2 ","1 -3 ",
Job no.: 10 Job site address: o 100
f 11P or more.
occupancy.
Q � Ha •� � ° ❑Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 1 l( v O Q Q 1 2 . 2 � ❑ Health -care facilities. ❑Supply voltage for more than
(ICU( t A l ❑hazardous locations. 600 volts nominal.
jQ `
Suite/bldg. /apt. no.: Project name: �►/ j � Pki_ y `� //tS ❑ Service or feeder 600 amps or more.
` c� x ]11 J�eS �./ FEE SCREDULE
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: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPI ION OF WORK (with above sq. ft.) _
67.84 2
Add 2J ` 1 /' /� C ' / Limited energy, multi- family
l ^d ` �`�u .L�') l r 21 ✓ -Plot) 1` residential (with above sq. ft.) 67.84 2
I y Services or feeders installation, alteration, and/or relocation
'' JO /1 200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/Sta[elZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 l
made on property 201 amps to 400 amps -
125.08 2
Owner installation: This installation is being p perry 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, . er panel
Owner signature: Date: A. Fee for branch circuits with
0 APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: • B. Fee for branch circuits without
service or feeder fee, first l 56.18 5 1 . 18 2
Contact name: branch circuit
Each add'l branch circuit 1, 7.47 - 1 . 2
Address: Miscellaneous (service or feeder not included) _
City /State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) [ Fax: : ( ) Reconnect 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: � J panel, alteration, or extension. Page 2 2
Cu }� C m ,+ Ld 1 a- Each additional inspection over allowable in any of the above
Address: p 0 - x 8-1)8( W(o Additional inspection (1 hr min) 66.25/hr
City/State/ZIP:\ c r , q p! Q $ .- investigation (I hr min) 66.25/ hr
LlA _ r ` s l, "{ l Industrial plant (1 hr min) 78.18/ hr
Phone: (Nap 5(D7 _ ,
Fa ��!f _r�rGJ[p 1 f --'7 ` �J 3320 Inspections for which no fee is
51314(s �U specifically listed (V2 hr min) 90.00 / hr
CCB Lic.: lectrical Lic.: C , uprv. Lie.:T3905 ELECTRICAL PERMIT FEES uu ,, 7 `
Suprv. Elec ltlKsignature, required: f0I/ I/ 3 Subtotal: l o 3 . (DC)
_ Plan review (25% of permit fee):
Print name 1] 1 a n n Date: 5_1_ I State surcharge (12% of permit fee): ---i .( 3
Authorized signature: l 1 , 1 1 —_ TOTAL PERMIT FEE: -7 (_ 23
_`/ _ i./ E �_ This permit application expires If a permit is not obtained within 180
Print name: t 1 )t j,, l Date: 5 ' Number of inspections allowed per permit.
I: Building 'Permits PermitApp.doc 10,01/09 440 - 461511 11105'COM'WEB
MAY - - 2011 09:48 Accurate Electric, Inc. 3609947013 P.002
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $67.84
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other: _
COMMERCIAL WORK ONLY:
Fee for each commercial $67.84
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
•
[I Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: Building Permits rLC- PermihApp -doc 10∎01,09