Permit CITY OF TIGARD ELECTRICAL PERMIT
I- 1 ' COMMUNITY DEVELOPMENT Permit #: ELC2009 -00131
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/19/2009
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7320_S.V,V_H.U_NZIKER -RD 100
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Subdivision: Lot: 0
Project: Agri- Business
Project Description: TI
Owner: FEES
HILLTOP BUSINESS CENTER LLC & Quantity Description Date Amount
HUNZIKER LLC, 9430 NW KAISER RD 10 crt Branch Circuits 03/19/2009 $106.70
PORTLAND, OR 97231
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/19/2009 $12.80
Contractor: Electrical
AC & E ELECTRIC
3535 DEL WEBB AVE #100
SALEM, OR 97303
PHONE: 503 - 363 -2302
FAX: 503 - 363 -2302
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: B
Total $119.50
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 952 -0 1 -0100. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.246 ..• tr +x1:800.332.23.4.
Issued By: 6 / O"` Permittee Signature: _AliC4
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'N S.E-C - ff"/ / 649 aN Date: ,3/g 4, 7
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 RECEI VED FOR, OE"E10E USE 'ONLY
Received /9' 0 n r�/y y n `
City of Tigard Permit No . G C (� p( 0D 7 ��o/ /
I I 13125 SW Hall Blvd., Y d., Tigard, OR 97223 MAR 19 2009 Plan Review'
Phone: 503.639.4171 Fax. 503.598 1960 Date /By Other Permit
!s a/4)02D09_4OD ypZ
T i GARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Faris BI See Page 2 for
Internet: www tigard- or.gov BUILDING DIVISION Notified /Method• Supplemental Information
TYPE OE,WORK PLANREVI> VV,:, . "
Please check all that apply (submit 2 sets of plans w /items checked belowp
❑ New construction ® Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ['Marinas and boatyards.
exceeds ((1,000 amps 150 volts or Floating buildings.
=
_o".: - " '4' " CATEGORP "C ONST R U C T IO N P g b
'� � less to ground. or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - 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
❑ Emergency system. larger separately derived system
A
' OB':CI`E INFORMATION 'AND .LOCATION ' " El Addition of new motor load of ❑ - `E" -' I -2 - "I -3"
� � ; J
Job no.: Job site address: 7320 Hunziker Rd looHP or more occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks
City /State /ZIP: Tigard, OR ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite /bldg. /apt. no.: 100 Project name: 43 U -. 44.4, ❑ Service or feeder 600 amps or more.
` °.,;r:s ; ; ':FEE;SCHEDUL .
Cross street/directions to job site: Description I QtO I Fee. I Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
' °' DESCRIPTION' OFjI " ' ' :":: above sq ft.) _
Tl remodel Limited energy, multi - family 75.00 2
residential (with above sq. ft )
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ TROPERTYiO. VNER"` `'`r'';" ,k<` ❑.,TENAN` ^, - ".. ` 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447. 449. 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
above service or feeder fee.
❑ APPLICANT." ® CONTACT.PERSON, ,y 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, I 46.85 2
Contact name: 46.85
first branch circuit
Address: Each add'I branch circuit 9 6.65 59.85 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
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'' " �" '` ; :t",, toNTRACTOR "'' f" " Sign or outline lighting 53.40
Business name: AC &E Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: 3535 Del Webb extension. Describe: Page 2 2
City /State /ZIP: Salem, OR 97301 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 363.2301 Fax: (503) 363.2302
Investigation per hour (1 hr tiro) 62.50
CCB Lie.: 591 Electrical Lic.: 2 - IC Suprv. Lie.: 5387S Industrial plant per hour 73.75
' <M' _ ";,ry: ° PERNIff ; ,FEES"i''``'/1. .
>, >w` , ,. '
Suprv. Electrician signature, required: a Subtotal: 106.70
Print name: Carl Duncan Date 3 /18/09 Plan review (25% of permit fee):
State surcharge (12% of permit fee): 12.80
Authorized signature: TOTAL PERMIT FEE: 119.50
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.
I:\ Building\ Permits \ELC-PermitApp.doc 05 /23/06 440- 4615T( I I /05 /COM /WEB