Permit , CITY OF -- IGAFZ® ELECTRICAL PERMIT
'! ;_ COMMUNITY DEVELOPMENT Permit #: ELC2011 -00552
Date Issued: 10/05/2011
TIG,A D 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 2S102CB00302
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Jurisdiction: Tigard
Site address: 13285 SW PACIFIC HWY
Project: 7 -11 Subdivision: NORTH TIGARDVILLE ADDITION Lot: 33
Project Description: (4) branch circuits to replace light fixtures.
Contractor: ACCESS ELECTRIC & CONSTRUCTION Owner: CJ GLOBAL LLC
2870 SE 75TH AVE SUITE 108 PO BOX 5668
HILLSBORO, OR 97123 ALOHA, OR 97006
PHONE 503 - 642 -4333 PHONE
FAX 503 - 642 -9699
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 10/05/2011 $78 44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 10/05/2011 $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 i ccordance 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 TENTION Oreg requires you to follow the rules adopted by the Oregon Utility Notific- on Center Those rules are set forth in OAR
952 -00 -0010 thro gh OAR 2 -00 090 You may obtain a copy of the rules or direct questions to OUNC by c• 03 232.1987 or 1 800 332 2344
Issued 61-4/KA—Li Permittee Signature i .1_.1
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' ' ��ir Date: /0/
LICENSE NO. itiel 5
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.
10/05/2011 10:11 1 ACCESS ELECTRIC PAGE 01/02
Electrical PermitApAniffi;' Ely ED FOR OFFICE USE ONLY
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lhi . City of Tigard e.... ,-.
13125 SW Hall Blvd., Tigard, OFh M211 5 2011
- -. Phone: 503.718,2439 Fax: 501-598!19180- Received
osic/nv: (0 - frAMM- " nnli N°- El e a-07 -061 .57.5: 2 -
Plan Review
Datc/13 ; Other Permit.
Inspection Lino: 503.639.1175 Pot; rtoruly/13y for
Ii3 Sec rags 2 o
TIGARD OF TIGARD ,
Internet, www,tigard-or.gov CITY Notified/Method Supplemental Information
‘ ,, ,, . .,•. :, , .,..,■,!, , ',..:' , ', , I .. :':•" , -•.,! .„ ' , $)v.',, ;y: itivirk .•,,' ,: ;,,
. •.,..., .,, ,. .• ... .," , •:, :;,- . . .:. , . i tk W1\1210 ..
0 New construction E Addition/alteration/replacement Please check all that apply (culimit 2 cent of plans w/items checked below);
0 Service or feeder 400 amps or more 0 Building over three stones
0 Demolition Li Other: where the available fault current 0 Marinas and boaiyaills,
l' ''. ' ' ' ' ' ' '.- '': .• i''' ," `CAltdoleiNitif..CONSTIWCTM111 '. ' ..'''' i - ' " .- i .'i. exceeds 10,000 amps at 00 volts or 0 bloating buildings
less to ground, Or exceeds 14,000 0 COMmertial.use agrieultural
0 1- and 2-family dwelling El Commercial/industrial 0 Accessory building amps for all other installations. buildings
0 Multi-family ID Master build 0 Othci. 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived system,
40ii.kit:':IiiibitikkfttoN tOcATio14 ',,.,' ! 1 ' , , .,. . :1' , r D13merfcene
0 Addition of new motor load
.,, ,• „. „ • " ',A ',' " " , ' ,;,,, , , of larger
Job no.: 7 g2565 I Job site address: 13285 SW Pacific Hwy. 10014P or more occupancy
0 Six or more residential units. p Recteatiomii vehielt parks
City/State/ZIP: Tigard, OR 97223 0 Hcalth•care AleilibtS, ID Supply voltage for more than
0 Haaardous locations 600 volts nominal.
Suite/bldg/apt. no.: Project name: 0 sin vp..c vi fordct 000 ulliim vi 111V15.
' :■:■'■ t k ICIttptitit: ; ',. ■':;:, : ': ,,, '
Cross street/directions to job site: nemer4pt1en Q . Fee. Total • ,
New residential slngle or multi family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq, ft, or less 168.54 4
La, aderl 500 sq, ft, or portion 33.92 1
Tax map/parcel no,: Limited energy, residential
75,00 2
i ,.!.:1 ' 5 1 1: ' , ' It ' , ' $ ' ' n ;,;.!.):tr,g0Riltilpr,41..Pr, WORK , ..:,- ..,,;‘ 1';i `. ";'0.7:r; (with above sq, 11,)
I muted rnrrgy, multi-family
Replace Light Fixtures residential (with above sq ft ) 0.0U 2
. Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
T .11:1';:jotojpktiti,;(i k.:' - '" . ' ,. ''' . ' • q 1=1; h'ENT . ■ , , ,• , C ,1 .. ,. 201 amps to 400 amps I 3.56 2
Name: 401 amps to 600 amps 200,34 2
601 amps to I .nnn amps A I 04 9
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 . ,. i - 59.36 1
Owner installation: This installation is being made on pro 201 amps to 400 amps 125 08 2
. perty that 1 own which is not -
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 399 amps 16854 2
Branch circuits - new, alteration. or ettension, per panel
Owner signature: Date: A Fee for branch circuits with
-' 't ''1_ ''' -, ' , U ;'•!CONTA6ttlitit,§111- " . . above zerviee Or rancircu fencIer foe, 7.42 2
A. each bh cit
Business name: 13 lice for branch circuits without
service or Ceeder fee, first 1 56 18 .,
fi
Contact name: branch circuit
SC.
Each add'I branch circuit 3 7.42 22.26 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/Z1P: cli..2211ingerviee and/or feeder , 67,84 2
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Phone; ( ) I Fax; ; ( ) Reconnect only
67,84 2
E rump or irrigation circle 0 /.44 2
-mail :
------, , — — Sign or outline lighting -
67.84 2
' , :. Y: ',:'.. ''..!.:. ' .,.., ;'10*.t ilaCTOrt . ..., 1 . Signal circuit(s) or limited
„
Business name: Access Electric & Construction, LLC panel, alteration, or extension. rage 2 2
Each additional inspection over allowable in any of the above
Address: 2870 SE 75 Ave., Ste. 108 Additional inspection (1 hr min) 66,25/ hr
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investigation
City/State/ZIP: H (i hr min) 00 25/ hr illsboro, OR 97123
Industnal plant (I hr min) 78 18/ hr
Phone; (503) 642.4333 Fax: (503) 642.9699 Inspections for which no fee is
90 00/ hr
specifically listen (y, iv
CCB Lic.: 162666 Electrical Lic.: C-16 Suprv. Lic.: 493IS ..i ' . '' '2: . l' Ft;Sr'
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Subtotal: 78.44
Suprv. Electrician signature, required: ..,__ ' -
Plan review (25% of permit fee):
, . .
Print name: Kent Zimmerman Date; 10.05.11 State surcharge (12% of permit fcc): 941
TOTAL PERMIT FEE: 87.85
Authorized signature:
This permit application expires if a permit is not obtained within Igo
days after it has been accepted as complete.
Print name: Date; • Number of inspections allowed per permit.
i \5ui1tbrg VrermitnELC-PermitAno doe 07/01/1n 440-4615M I ms/comrwp,a