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Permit CITY OF TIGARD ELECTRICAL PERMIT ;F ! •• COMMUNITY DEVELOPMENT Permit #: ELC2012 -00131 T l GAA.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/08/2012 Parcel: 25101 DA00104 Jurisdiction: TIGARD Site address: 13333 SW 68TH PKWY, STE# 220 Project: ACS Subdivision: VARNS ACRES Lot: 9 Project Description: (2) branch circuits Contractor: COCHRAN INC Owner: TRIANGLE POINTE LLC 7550 SW TECH CENTER DR. #220 901 NE GLISAN ST, #100 TIGARD, OR 97223 PORTLAND, OR 97232 PHONE: 503 -234 -6564 PHONE: FAX: 503 - 238 -2098 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 03/08/2012 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 03/08/2012 $7.63 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 ordance 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. A ' NTION: Oregon • - = s you to follow the rules adopted by the Oregon Utility Notification enter. Those rules are% set forth in OAR 952 -001 6010th ough OAR • 2- 001 -06 6 ou may obtain a copy of the rules or direct questions to OUNC • >• - 7'3.232.1987 or 1.800.33 . 344. Issu. By: 42-0(_4_,4_& Permittee Signs re: : iii' �► • 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. 01 09:25:08 03 -07 -2012 1 /2 Electrical Permit Application \C(°C, F OR OFFICE USE ONLY Received ' r u aO; ��� �2 City of Tigar DateB : e 5 � � Permit No.: C J I C • 13125 S W Hall Blvd., Tigard, OR 9 .• - �, Plan Review Phone: 503.718.2439 Fax: 503. :11.! s ���444 r I: D Other Permit: TIGARD Inspection Line: 503.639.4175 V` 'SL e y a% Date Ready/By Jors: Hi See Paw 2 for InteInternet: www.tigard -or.gov . : jed/Method: II Co Supplemental information PP � :. ; : � : • ' • :TYPE:OF ...: ; 0` ���� ❑ New construction Addition/alteration/ry� itgrmr ID Demolition ❑Other. 4jV V Please check all that apply (submit E sets of plans wliterns checked below): ``\ V El Service or feeder 400 amps or more ❑ Building over three stories where the available fault current ❑ Marinas and boatyards. CATEGORY' OE..CONSTRUCIION exceeds 10000 amps at 150 volb or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural, ❑ 1- and 2- family dwelling ,,Commercial/industrial ❑ Accessory building amps thrall other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or ' ,. > ❑ Emergency system. larger separately derived system. : 44,'4ITE. INFORMATION AND LOCATION' ❑ Addition of new motor load of ❑ "A ", Job no.:4 %12 Job site address: \ S�J (J3 - l 0 . 1 4 � Six o more occupancy. \ `T ❑ Six or more residential units. ❑Recreational vehicle parks. City /State/ZIP: 7 . & ©� °C1 22-i ❑ Health-care bcilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal Suite/bldg. /apt. no.: Project name: t C,S ❑ Service or feeder 600 amps or more J FEE SCHEDULE :: : `,; : Cross street/directions to job site: Description I Orr. I Fee I T utal 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'I 500 sq. R. or portion 33.92 1 Limited energy, residential 75.00 2 r ; ;::.; ':.:. DESCRIPTION OF WORK i :. i't' (with above sq. IL) ( Limited energy, multi- thmily 75.00 2 k2 326 (9 7 - 7 r) A �c�.t� -} el residential (with above sq. ft.) ` Services or feeders installation, alteration, and/or relocation (r r 11 \ t5 f - Cs ( O �s �e.e•-.. 200 amps or less 100.70 2 ,:;04ROPERTX TENANT . : is 201 amps to 400 amps 13156 2 401 amps to 600 amps 200.34 2 Name: A GS 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders Installation, alteration, and/or City/StateJZIP: relocation Phone: (5 ) e-1 _-3c lei Fax: ( ) 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 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 ❑ APPLICANT I vi CONTACT PERSOh1 ::: each above branch serce circuit or feeder fee, 7.42 2 Business name: • B. Fee for branch circuits without _ service or feeder fee, first 56.18 56 ' 2 Contact name: vet � . branch circuit Each add'l branch circuit 1 7.42 •"l , 4 2 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City/State/ZIP: dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 E mail: l ' - , c Pump or irrigation circle 67.84 2 ‘E (a C.cc �r�v Clv� \ v1 c_- . (.LW\ 67. Sign or outline lighting 67.84 2 CONTRACTOR -.. . • .. -.. Signal circuit(s) or limited-energy Business name: COCHRAN INC panel, alteration, or extension. Page 2 - 2 Each additional inspection over allowable in any of the above Address: 7550 SW TECH CENTER DRIVE SUITE 220 Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 6615/hr City/State/ZIP: TIGARD, OREGON 97223 Industrial plant (I hr min) 78.181 hr Phone: (503) 234 -6564 Fax: (503) 238 -2098 Inspections for which no fee is specifically listed ('.4 hr min) 90.00 / hr CCB Lic.: 72942 Electrical Lic.: 37„ Su prv. Lic.: 3447S _ ..... ; ELECTRICAL PERMIT 'FEES Suprv. Electrician signature, required: \L�C C — - Subtotal 6 3, ( Plan review (25% of permit fee): Print name: KENNETH KATO Date: 2, ("7 ( CA 1 State surcharge (12% of permit fee): -- 1 , Lo j TOTAL PERMIT FEE --/ ( �3 Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: • Number of inspections allowed perpenuil I :1 Build ing\Permira\ELC.PermitAppdoe 07 /01 /10 440-06IST(11/05 /CoMIwEB