Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00266
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/24/2011
Parcel: 2S 102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HVVY
Project: BI -MART STORE Subdivision: FREWINGS ORCHARD TRACTS Lot: 15
Project Description: (4) branch circuits
Contractor: ALLIED ELECTRIC SOLUTIONS LLC Owner: MERCER INVESTMENTS LLC
360 SHELLEY ST., STE. C 629 NW SEAN CT
SPRINGFIELD, OR 97477 BEND, OR 97701
PHONE: 541 - 521 -7771 PHONE:
FAX: 541 - 747 -8735
FEES
• Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 05/24/2011 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/24/2011 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 • • . 9 40-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 6 6 / C c Al
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.
05/20/2011 16:48 5417478735 ALLIED ELECTRIC SOLU PAGE 01/02
vFr Electrical Permit A.pplicatioxa EC C
Aeceivea
111 - City of Tigard �.2 y / Permitl lo. : 6 - 60// - 400.26 , 6
• 131.25 SW Hall Blvd., Tigard, OR 97223 MAY 2 0 2 011 Datosy: plan Review
. a Phone: 503.718.2439 Fax: 503.598.1960 D Other Permit:
T f i ; R r, Inspection Line: 503.639 CITY OF T GA " 1 D pate Ready/By: lur ® See Page 2 fbr
Internet: www,tigard- or,gov
Rq III DING DRIISi0 r r Nortfied/Method ati
3upp[cmeatalInformon
<
� ,i r . y a .. . . i 1 v n,li � ," r, Y , v la � :. .
' i i �ii� : - "'''a' "1 .11� -t i" i r; ? , Rl . , i m
r. . 1 _ -a ,1... PK4 4i. ! 4It:' i` .. A t . , 17:746 r m,. n.. ems...:. _;'t " rsr lRN "`r t r t! 1. 13 91 � r I VZP.<a $s . 4 1
!I E � ra il)1 lCitiii lied 3 Nl n.' , ∎�Tlb. tile. .Mtdli' WStue :z,13 : 1i,. r ( :)ildl ILlit ict.Aii4ki 1 ; l. li tri ttr+i„",i'; t! 1�rza s: N/ St t :Pt` I.,, , l 1 l' I
'Z „ 4f II R ! lti�lr. 2
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or fbeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
where the available fault current 0 Marinas and boatyards.
} fe J 9j(t i c 1 rtI 1' Ny, S S . a X lil rt t !N , �a y 4 ttYlc ;;i s f{�t�plip tt'M+22 f e I rr'4+n t,1tP ' } [ W I, Ill � ita amps at 150 volts or
. ' ciShiSr i li f irren v � ;:emit ibel 'A S � � xf Fl 20 1 ii. ( 6,g less to exceeds ground, P ❑Floating buildings.
�eh,.m+ ry a u,rw.a:r rrt�rtA�tr,�rt� e�x.0 w ae, nn takaPh,t„ ti,. (lt�f,,,,e.., ;.t.. less m ground, or exceeds 14,000 ❑Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi -family ❑ Master builder 0 Other ❑ Fire pump. ❑ Installation of 75 KVA or
+sitar tr a ,, .„ ,v , ' - -- li , ❑ Emergency s stem. larger separately derived stem.
s
.r ^ s �.�., i "♦ � . i � p �" + , Ft, ` ( x , r, 6'e Y r Y ag P Y Y
p,pp i l 1�� ,. t , Ji ! 1 , l i a u , r d ❑ „ <, , -2 >, '.
"d �;r1i a jllr • &atMnl! l" tf!(1SI� #� � l ' hl i t�a ;� #1�+rhe , 8t� ,.. a !, ru„ „ .. , � , s a ^?k �� — FHII " :. . s �� ❑ Addition of new motor load of
Job no.: 11 -117 Job site address: 13500 SW Pacific Hwy 1001IP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, Oregon 97223 • ❑ Health -care facilities. ❑ Supply voltage for more than
.— U hazardous locations. 600 volts nominal.
Suite/bldg. /apt - no.: Project name: P640 Bi -Mart Reser's ❑ Service or feeder 600 amps or more.
tP e } j , E r„,,..9. t S 13 . IF T °{
Cross $treetldireetions to job site: SW Watkins and SW Pacific Hwy I l `! e. ' ` .. u
J wJ ' nan7ptlaa Qa. Fee I o t a
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
',, Tax map /parcel no - Ea. add'I 500 sq. ft. or portion 33.92 1
s t r! t ,t 4 y p ! t p1# Limited energy, residential
i H 4 9 a dbt,Fi1,4 a l.,4: g
7'. ',it?- 1,!.. k7, 1:,,! r6 1 1, , 4 a 64 c.'„l'tt d�llllg lihy t li 1 ` : 9;s with above s4 ft.) 75.00 2
Install up to (4) b ranch circuits Limited energy, a1 (w th above sq. 75.00 2
p ( ) residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
X11 aim {il ` i "4'. ,f l ii ' " ,, t r IP i l i mil i , 'l ,) U 4r ill." t 111 U d IR t1a 4" , I ire? 201 amps to 40 amps 133,56
� <, l , , i ! r �?' , 9 r li ai I i ' .. t : t • , _„ i 1 ." III' ll I ii L'-_'-4, , Ps P 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
Temporary services or feeders installation, alteration, and /or
City /State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or lass 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
Branch circuits — new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
r , i a ", ", rn�� r +a " �+ ttnrat t+caaao� re t a above 1 l i,l " it l!m L y t" a iFi rtt3 {{t ) i , it l $�i l ! ' lE3 i I4 1 1 i1 �a3r�i i r bo se rvice or feeder fee,
M - X,a l i i..s a, /4 a1ys , aIta S,,FaiiQ4 a . ,, x:. ■ llsrra tats tz atIX ,r # rp T each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 5618 56.18 2
Contact name; branch circuit
Each add'l branch circuit 3 7.42 22.26 , 2
Address: Miscellaneous (service or feeder not in cluded)
City/State/ZIP: Each manufactured or modula 67.84 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
gt�� Sign or outline lighting 67.84 2
l' jli p 6 �itY (IEFRAiUM t f, . i ,!,iat# lldl� 3a,t a t : iE "; ;1 't i f.'V p `' � 0. - Signal circuit(s) or limited- energy
Business name: Allied Electric Solutions L-t C panel, alteration, or extension. Page 2 2
Each additional inspection over allowable In any of the above
Address: 360 Shelley St. Suite C Additional inspection (1 hr min) I 66.25/ hr
Investigation (1 hr ruin) 66.25/ hr
City /State /ZIP: Springfield, Oregon 97477 Industrial plant (I hr min) 78,18/ hr
Phone: (541) 521 -7771 I Fax: (541) 747 -8735 Inspections for which no the is 90.00 / hr
r1 s cificall listed 'A hr mm
CCB Lic -: 187877 gj /Electrical Lic 3 / / r i S . pry Li , .:195 /0 �f" i1" w" ' t s i t� L'Il r� ^"": r `� t ' 1'' ZIP 11
6 / / i!. :.r..vrf�n s.a n?( .1�uL, w:»_.lf rit �'ta.,?hk,'(.i_Li.,� fit,, 1:! „1P�t..1: ',
• 1 / ' , !7 %� Subtotal: 78.44
Suprv. Electrician signature, required: ,w �� .
�l .if i Plan review (25% of permit fee):
Print name: Bob Hanson ` I Date: 5/20/11 State surcharge (12% of permit fee): 9,41 ✓
a r TOTAL PERMIT FEE: 87.85
Authorized signature
�� A1......._ _ Tf1is permit application expires if a permit is not obtained within 180
days after it bas been accepted as complete.
Print name: Marla Ro:'rs Date: /20/11 • Number of inspections allowed per permit.
ruBoadingo 'eCnitstel.e- eermnnpp.00c rum 1/10 440 4615T(11105fCOM/WEB