Permit ' rt CITY OF TIGARD ELECTRICAL PERMIT
"-l. COMMUNITY DEVELOPMENT Permit #: ELC2011 -00373
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/06/2011
Parcel: 2S101DC04603
Jurisdiction: Tigard
Site address: 7405 SW TECH CENTER DR 120
Project: National Maintenance Contractors Subdivision: Lot:
Project Description: (1) branch circuit for replacement of RTU.
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Contractor: WILLAMETTE HVAC Owner: WPC TIGARD LLC
3075 SW 234TH AVE. #206 307 LEWERS ST 6TH FL
HILLSBORO, OR 97123 HONOLULU, HI 96815
PHONE: 503 - 628 -6841 PHONE:
FAX: 503- 848 -2597
FEES
Quantity Description Date_ Amount
1 crt Branch Circuits wo /Purchase 07/06/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/06/2011 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 - •r•ance • 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. • " ENTION: Oregon :w -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -00 - 0010th . OAR 9� r 1 - 009r •u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.00. 32.23
f {/1
Issu d By: , � I ' � ‘ Permittee Signature: 4 /
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 Applicatio " I FOR OFFICE USE ONLY
Received �,t� / �O ✓/ Q'7
City of Tigard 2�1i Date /By: 76' �� / Permit No.: f ��C/6
Pr
a 13125 SW Hall Blvd., Tigard, OR 97223 JUL 0 Plan Review
Phone: 503.718.2439 Fax: 503.598. ®f OF TIGARD Date /By: Other Permit:
TIGARD Inspection Line: 503
RP! DING DiVI�IOf' Date Ready/By: luris: See Page 2 for
Internet: www.tigard or.gov v Notified/Method: Supplemental Information
iit . T OF WORK n PLAN REVIEW s ,.
❑ 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 CONSTR C ,ION tt .' 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 E Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
iiii t r' . 0 Emergency system. larger separately derived system.
�. _ x JOB SITEw INFORMATION =- -AND LOCATION i in , li ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 7405 SW Tech center dr 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard Or 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: 120 Project name: NMC ❑ Service or feeder 600 amps or more.
4tFEES0HEDULE - °%
, a
Cross street/directions to job site: Description l 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 1
Tax map /parcel no.: Li mited energy, residential
,: c ' •., r (with above sq. ft.) 75.00 2
DESCRIPc1;L N !OF WORK ( q
Limited energy, multi - family 75.00 2
Reconnect RTU residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
P O r� - TE NAN T ' ' ' 201 amps to 400 amps 133.56 2
k ,;, -. ', a„ da b � ,.., ,... »,. ... < ... ....,. F�;'.
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
Temporary services or feeders installation, alteration, and /or
City /State /ZIP: 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 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, per panel
Owner signature: Date: A. Fee for branch circuits with
- above service or feeder fee,
'' e
i ; ❑ APPL ICANT „_ f - ®CONTACTh PERSO each branch circuit 7.42 2
Business name: same as below B. Fee for branch circuits without /,
service or feeder fee, first 1 56.18 �/ , fa 2
Contact name: branch circuit n v
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
• CONTRACTiOR t , ' ; ,.. $'. Signal circuits) orlimited- energy
Business name: Willamette HVAC, LLC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 3075 SW 234 Ave suite 206 Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: Hillsboro, OR 97123 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: (503) 628.6841 Fax: (503) 84 .2597 Inspections for which no fee is 90.00 / hr
specifically listed (A hr min)
CCB Lic.: 56951 Electrical Lic.: 343 CRE Suprv. Lic.: 4025LEB ,, ", ELECTRICAL, PERMIT FEES : a,.
Suprv. Electrician signature, required: (25% Subtotal ��p !g
Plan review (25 /o of permit fee):
Print name: Mike Sicard Date: 7/5/11 State surcharge (12% of permit fee): CP,'j y
_ 7 ` r� TOTAL PERMIT FEE: (off, • 5i 's
Authorized signature: Y/ r✓1 T his permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Michael Malstrom Date: 7/5/11
* Number of inspections allowed per permit.
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I: \Building \Permits \ELC- PermitApp.doc 07/01/10 440- 4615T(I l /05 /COM/WEB