Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT
°; COMMUNITY DEVELOPME Permit #: ELC2011 -00385
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/13/2011
Parcel: 2S 112AD00900
Jurisdiction: Tigard
Site address: 14800 SW SEQUOIA PKWY
Project: Home Depot Subdivision: Lot:
Project Description: (1) branch circuit for lamp ballasts above Disney display and Behr paint section.
Contractor: MCCOY ELECTRIC CO INC Owner: HD DEVELOPMENT OF MARYLAND, INC
2014 SE 9TH AVE BY HOME DEPOT USA, INC
PORTLAND, OR 97214 PROPERTY TAX DEPT #4002
ATLANTA, GA 30348
PHONE: 503 - 234 -7521 PHONE:
FAX: 503 - 234 -9473 •
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 07/13/2011 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/13/2011 $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 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 R 952- 001 -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: B/(/
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.
,, Juul. i 2011 c Co Electric Co. ri)tti)rrIC;1,l 5644 P. 1 •
City f Tigard Reeei,ed 1 ri, re nnit No.: J // 003o _5
- g Date/13 •: 3 A Z E1
,
y 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
P h
Phone: 503.7182439 Pax: 503.598' 12 2011 Date/13 : Other Permit:
MARL) lrlspectionLine: 503.639.4175 DateReedyBy: runs : / o Sec Page 2for
Internet: wwW.tigard- Or.gov gg ` 1�.� � Notified/Method: 7 '' SupplementalInforme(iort
` -v a � ' . . " er °'. *�. • =5. -4.1..y 1,Y ' , I.a t - i . i `ke r�� PLA Y' b. '� s 4r c ' :-,
11 New construction . 0 Addition/alteration/replacement Please check all w apply (submir 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more 0 Building over three stones.
❑ Demolition : Other: Cohere the available 5ult current ❑ Marinas and boatyards.
CATEGORY OP CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ floating buildings.
°' ' less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
(J 1- and 2 - family dwelling ® Commerciailindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑fire pump. ❑ installation of 75 KVA or
,*� >r :;w 113 s. ':rn ❑ Emergency system. larger separately derived system.
' ;; ;., ; ;,.., "', cola s3r1 nvioi'ra ri Y:ob, ;
pr�,. •. 1 ..... ❑Addition of new motor load of 0"A", rr "
Job no.: 05773 Job site address: 14800 SW SEQUOIA PARKWAY lUGHP or more occupancy.
❑ Six or more r4Slddntial units. ❑ Recreational vehicle parks.
City /Siate/ZIP: TIGARD, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
011scardous locations, 600 volts nominal.
Suite/bldg. /apt. no.: Project name: HOME DEPOT ❑ Service or feeder 600 amps or more.
J ' Dtse Nson FEE SCHEDULE ' Fee, a I .:` Total .•„� ti I job site:
Cross street/directions to
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot Ito_: 1,000 sq, ft, or less 168.54 4
Ea, add'l 500 sq. R. or portion 33.92 1
Tax map/parcel no.:
«r :.; i ' Limited energy, residential 75,00 2
en "
:,tk 3 n :.:. DESCRi['.T.AQN • PEO.VPRK r t : • (with above sq. ft.) .
Limited energy, multi- family 75.00 2
Change one 2 -lamp ballasts above Disney display; change three 4 -lamp ballasts & residential (with above sq. ft.) _
Serv or feeders installation. alteration, and /or relocation
three 2 -lamp ballast abpve Behr section. 200 amps or less 100.70 2
D PROPERTY OWNER. ' . .. Cl ,,TENANT 201 amps to 400 amps , 133.56 2
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
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I Pax: ( ) 200 amps or less 59.36 1
20I amps 10 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps f0 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
A pt" 31 rti ;.; . CO NTACT .0> ' , ,42 2
'l: above service o r e e ee
7
- 1 - • each branch circuit
Business name: B. Fee for branch circuits u'itliaut
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 _ 2
Addrtss: Miscellaneous (service or feeder not included) ._ _
City /State /ZIP: Each manufactured or modular 67.94 2
dwelling, service and/or feeder
Phone: ( ) 1 Fax:: ( ) Reconnect only 67,54 2
E-mail: Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
. • CONTRACTOR ` •. Signal circuit(s) or limited - energy
Business name: MCCOY ELECTRIC CO., INC panel. alteration, or extension, Page 2 2
Each additional inspection over allowable In any of the above
Address: 2014 SE 9 AVENUE Additional inspection (1 hr min) 66,25/ hr
Investigation (I hr min) 66.25111r
City /State /ZCP: PORTLAND, OR 97214
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 234 -7521 I lax: (503 -) 244 Inspections for which no fee is 90.00 / hr
specifically listed (%: hr min) _
CC Lic.: 8277 ;` I Electrical Lie.: 26.82C '7f upn. Lie.: 5 208S v `l trtM 11 iOtA tta: ' ?;,;;; •.'s • :r�:
Supra. Electrician signature, required: Subtotal: 56.18
�{ Plan review (25% of permit fee):
Print name: ZACK ARMSTRONG F ~ I Date: 07/11/2011 State surcharge (12% of permit fee): 6.74
TOTAL PERMIT PEE: 62,92 I ✓ '
Authorized 3igt1ahlIC: This permit application expires if a permit is not obtained within 180
Print name; Date: days after It has been accepted as complete.
_ Number of inspections allowed per permit.
1: 18ui !diag\PermitdeLC- PermitApp.doe 07 /01 /10 440.4615T(11 /05 /COMM'Ec