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Permit CITY OF TIGARD ELECTRICAL PERMIT '`'- a COMMUNITY DEVELOPMENT Permit #: ELC2011 -00684 T,tGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2011 Parcel: 25101 BD00100 Jurisdiction: Tigard Site address: 7650 SW BEVELAND RD Project: Paychex Subdivision: 1994 -025 PARTITION PLAT Lot: 2 Project Description: TI Contractor: BEAR ELECTRIC Owner: PNWP LLC #2 PO BOX 389 PO BOX 2206 DONALD, OR 97020 BEAVERTON, OR 97075 PHONE: 503 - 678 -1355 PHONE: FAX: 503 - 678 -1108 FEES Quantity Description Date Amount 16 crt Branch Circuits wo /Purchase 12/07/2011 $167.48 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/07/2011 $20.10 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $187.58 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 OA' • X01 -0090. You may obtain a copy of the rul- - - - t questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By_ 4 11. ; �!. Permittee Signature: •� /. �� =z I '' WNER 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. DEC- 05- 2011 (MON) 07:57 Bear Electric (FAX)5036781108 P.001 /002 Electrical Permit Application RECEIVED FOR OFFICE USE ONLY City of Tigard 2011 Received I� , ;ems .. (` neteln . ' 13125 SW Hall Blvd„ Tigard, OR 97223 Plan Review Phone: 503.7182439 Fax: 503.598.1 O TIGARD Date/B ' Other Permit: T I G A P. D Inspection Line: 503.639.4175 D al Ready/13f FM1 0 Sec Page 2 for Internet www.tigard.or.gov BUILDING DIVISIO l Notified/Mcthod; Supplemental Inform ation IM 1 '.'r , �. '. 'N p� B , N u . !�. t . ,� ,. 1 I�dh firs'+ R'M �.�..�4�i�O _ r M. �r ,�, AI, A ..iGr {'d "n�rc�r �� B, +�ilu- I ' Ni{ +�,w„ ,M ,�r.L rCt :V! • """ karYONDOgigeiatifiNg Eli (] New construction [ Addition/alteration /replacement Please check all that apply (submit ants of plans w /items checked below): Other: ❑ Service or feedw 400 amps or more 0 Budding over three stories. ❑ Demolition whets the evelleble fault carrert 0 Marinas and boatyards. ,4i„i'" 74 Plte',,, ",�?ri w r r. , 1•._ .._.,..,.- - -... . m5 ( t „� q a ! p ❑ 8 u °,y / r w 1 h w i . k; ;; exceeds {0.000 amps l5o vents or Floating buildin gs. © I- and 2 - family dwelling CommerciuIindustriut Accesso buildin amps so ground, all other or exceeds 14.000 Q Cormncrciel.use agricultural ❑ � building amps 1br all edit installations, buildings. ❑ Multi - family Di Master builder © Other. ❑ Fire pump. ❑ Installation of 75 KVA or 11 l "' : „ t ;, � JO�3 O st d " -.. ,. w" rep ')' I f: ^w,'.v« . ❑ Addnrwi system. larger E", "1 separately ", derived system. ❑Addition of new motor loud of ❑ "A ", "E", "1.2 ", "1 -3", Job no.: Job site address: 74.5r) 1E.1;116L,444.1S gd11'lb, roarthormom occupancy. Slz or more residential units. Recreational vehicle parka. City /State/ZIP: Ct. N i 0R 9 `7 ,2,:),-3 O Health.carelhdWnes. 0 Supply voltage ibr more than 0 Hazardous locations. 600 volts nominal. Suite/bldg. /apt.no.: Project name: (t.b Q. e ,-! ❑ervice or feeder 600 amps or more. ��t N e • i ��� P� y�N- , t. S rr.. Cross street/directions to job site: }' D ,4 i w: 'CHID a 11 tll) t, ,.,.:,,,, New residential single- or multi -f fa a mil dwelling u nit es - _ Includes attached garage. Subdivision: Lot no.; 1 ,000 s q. R or Ices _ L 168,54 4 Ea. add'l 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: w . Limited energy. residential s ue , iii' < , .. 5.00 2 „M! ..�+� .' I0! G M> � .. �` � '' �: v�e.'�s:�'iiAiaal, ° ' : d�inr� (with above N. fl.) Limited energy, multi-family 0 b • C at A>04 residential /with above sq. II.) 75.00 2 Services or feeder's lnstallation and/or relocation _ — 200 amps or less 100.10 2 " $ i i . t . 0e ,.. , . _ .. , � - , ,,,, ,„ Y F , + " 7 ' ti, ,■,„ i m ' *r t , w ' I „ � . 201 smog to 400 Atnps 173.56 2 Name: ' 401 amps 10'600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City /State/LIP: Temporary services or feeders installation, eltenaUon, and/or relocation I Phone: ( ) Fa ( ) 200 amps or leas 59,36 - U Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125,06 p 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" altcration st nsio1 • _panel Owner signature: Date: A- Fee for branch circuits with M .. + ri itl. shave service o feeder fco iM " , 'l, N�vrivvr r', ._ � '!k, 4 ! . I , ., � w r,!. n : '1 a ., , ! - +1 each branch circuit 7.42 • I Business name: B. Fee for branch circuits wltlarar service or feeder fee, first / 56,156,1x /•. 2 Contact name: brunch circuit Each add'l branch circuit /I r 7.42 / /( 2 Address: Miscellaneous (service or feeder not Included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and /or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail Sign or outline MX , „„ outline lighting 67.84 2 1'1'4: try , NA6 ' .,,.." . .„ . 1� (",.tQ� , no , OW: . W „ ,! la 2 M.r"«” M".;I;AiI(iva$Wr, ]..., .': Signal circuit(s) or limited - energy - ( „ g 1. !�• C 7 "j.71..! r C panel, alteration, or oxlonslpn. Pinto 2 2 s . Business name: 1 c I t r ' Each additional inspection over a /Inviable In any of the above Address: fd I/`d. 3-R..9 Additional Inspection (1 hr min) 66.25/ hr City/State/ZIP: ' 4, N Y14...\ 1 4 9) O Investitpttion (l hr min) 66.25 / hr IIII Industrial plant (1 ltr min) 78.181 hr Phone: (.03 ) G ?Er._ iss ` Fax: (s713) 0 7'- red t: Inspections for which no fee is � e tftca1 listed '/s hr min 90.00/ hr CC13 Lic. : ( )(f �j / O/ I Electrical Lic. :r�ti ' C Suprv, Tic 5 . / 1 7,..,.?; II:I ICi.3 ai'r rr yli E iw Suprv. Electrician signature, required: Subtoml; /6 4 �r „f''f -r /i/1 Phu review (25% of permit fee): Print name: & ('1 _ ..S.' 9Date: A9. II a -.. // St sumhurgr` (12% of permit fee): ,......e363 • I 0 ) - - LI g--;--1A TOTAL PERMIT FEE: _ A4 Authorized signature: This permit application aspires ira permit le not • ned wit ISO I F 7r s8 days after Ohm been aecepted an complete. Print name: 1 Date: + Ntuubet of Inspections allowed per pemur. t:l HtrildleelPvrroitaltI .C- PannitApp.doc 07/01110 440- '1615T(1IN5/COM/WI30