Permit F
CITY OF TIGARD
•
f ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00378
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 .'718.2439 Date Issued: 07/07/2011
Parcel: 2S 101 AD03100
1 Jurisdiction: Tigard
Site address: 6950 SW HAMPTON ST 340
Project: Energy Connect Subdivision: Lot:
Project Description: Electrical for TI.
Contractor: BACHOFNER ELECTRIC LLC Owner: WESTON INVESTMENT CO
12031 NE MARX ST 2154 NE BROADWAY
PORTLAND, OR 97220 PORTLAND, OR 97232
PHONE: 503 - 327 -8872
PHONE: 503 - 284 -2147
FAX: 503 - 327 -8869
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo /Purchase 07/07/2011 $100.70
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/07/2011 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 • • "-.2-001-0090. You may obtain a cosy oft or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B _ �_i Permittee Signature: _G2' G
f"
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 Application FOR OFFICE USE ONLY
City of Tigard Q.#1' 4 Plan Review
Date /B 4 r Permit No.: III
■ 13125 SW Hall Blvd., Tigard, O L 1'+ \ Received ��• ■ /L1I �' .� _ i
Phone: 503.718.2439 Fax: 503.9 .196q� Other Permit: 0 Date /B : , 0/ , — ( Lj5
TIGARD Inspection Line: 503.639.4175 J r i ® Date Ready /By: El ee Page 2 for
Internet: www.tigard-or.gov n e l��A %rx Notified/Method: K/ Supplemental information
i . l T1 'E OF VY ? 6e ..._ ;.... .. ??�.. Q.. ...�� la�� }?LANTRE W `�:a ,i .>.
�� . � �. a .:. ,. ,
❑ New construction ® Addition/altera . 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.
' It's Y exceeds 10 amps at 150 volts or ❑ Floating buildings.
CATEGQRY f? Cp.-STRUCTION F .. 1,.. P g
" "' "' °° "' " • less to 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 ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
. ., ...:, ice,.... � Emergency system. larger separately derived system.
�t3B�ITE INF O.�.. .. „ RMA TION ��� A LOCATION ,,, ❑ Addition of new motor load of ❑ "A”, "E" "1-2", "1-3",
Job no.: 532 Job site address: 6950 SW Hampton Street #304 Six 100HP 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
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Energy Connect ❑ Service or feeder 600 amps or more
nd it�.�a �.a .. �;,.,. \ =FEE SC VO > t �,.::
Cross street/directions to job site: SW 72 and Hampton Street Description I oty. 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
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 I
U s—,o P o ro: K ,�' ' i j,,. Limited (with above sq. ft.) residential 75.00 2
Limited energy, multi - family 75.00 2
Small tenant improvement residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
(?PE I Ya OWNE R t3 PI ANT 201 amps to 400 amps 133.56 2 •
+h 3.; PP
a . - ' ^i 8d•, �aT .x � '., .. e... EE GJ,d✓ ' fi'}
H
Name: American Property Management 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: 2510 NE Multnomah Over 1,000 amps or volts 552.26 2
City/State /ZIP: Portland, Oregon, 97232 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)224 -9554 Fax: (503)284 -1667 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
►< i' I:ICANT . ❑ CONTACT PERBUN , above service or feeder fee, 7.42 2
,,,�.. _,.�a, ,, , , „a. _� circuit
eac branch c
Business name: Bachofner Electric LLC. B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: Rob Bachofner branch circuit
Each add'l branch circuit 6 7.42 44.52 2
Address: 12031 NE Marx Street Miscellaneous (service or feeder not included)
City/State /ZIP: Portland, Oregon, 97220 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 327 - 8872 Fax: : (503) 327 - 8869 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail: rbachofner @bachelectric com
err 7\ CQIVTRACT,UR 1 \ k Sign or outline lighting 67.84 2
g 1'
, . ,,. il t /w / \;' b- Signal circuit(s) or limited- energy
Business name: Bachofner Electric LLC. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 12031 NE Marx Street Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Portland, Oregon, 97220 Investigation (1 hr min) 66.25/ hr
industrial plant (1 hr min) 78.18/ hr
Phone: (503) 327 - 8872 Fax: (503) 327 - 8869 inspections for which no fee is 90.00/ hr
specifically listed ('A hr min)
CCB Lic.: 187062 Electrical Lie.: C514 Suprv. Lie.: 5625S 2 ,. , ,ELECTi �,R)fCAL RERMiT FEES ;,,a t
Suprv. Electrician signature, required: Subtotal: 100.70
�� Plan review (25% of permit fee): 0
Print name: Troy Connors Date: 7/7/11 State surcharge (12% of permit fee): 12.08
Z TOTAL PERMIT FEE: 112.78
Authorized signature: !! LC This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Rob Bachofner Date: 7/7/11 * Number of inspections allowed per permit.
I: \Building \Permits \ELC- PermitApp.doc 07 /01 /10 440- 4615T(11/05 /COM/WEB