Permit CITY OF TIGARD ELECTRICAL PERMIT
li g ° • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00138
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/13/2012
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10120 SW NIMBUS AVE C3
Project: Spec Space Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: (1) branch circuit for disposal.
Contractor: ALL AMERICAN ELECTRICAL CONTRACTORS Owner: HANSON, RONALD D
PO BOX 1426 ROBINSON, CONSTANCE A
GRESHAM, OR 97030 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 657 -4351 PHONE:
FAX: 503 - 496 -3995 •
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 03/13/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/13/2012 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
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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. ATTE∎ • c -gon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0f 0 through OA' 952- -0090. You may obtain a copy of the rules or direct questions to OUNC by callin• .1987 or 1.800.332.2344.
Issued y: 1 Permittee Signature: �� uiiLL / �`�
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' �� , � 0% . ._— 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.
Electrical Permit Application RECL RECEVEI F01<iriI1i1 „A., , Permit No.: �C p7r7la - 130
IIII City of Tigard Date/B : r D
- ` 13125 SW Han Blvd„ Tigard, OR 97223 MAR 9 2012 Man itevit:w Oahu Permit: �� �a . n
Phone: 503.718.2439 Fax: 503.598.1960 natelny_ - _ „
i t i ;; ; t Inspection Line: 503.639.4175 Date Ready/Dy: "�” Jarls; to See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD
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, Notifed Supplemental Information
TYPE OF WO 37 1 1 g r . t PLAN REVIEW
ED Now umslrrtetion Additionlaltetntionlreplaccment Please check all Mat apply (submit 3 sets of plans w /items checked below):
0 Service er feeder 400 amps or more 0 nulldieg over three stories.
❑ Demolition ❑ Other: where the available fault currant ❑ Marius and bialy rd'.
CATk CORY OF CONSTRUCTION exceeds 10,000 amps at (SO volts or 0 Floating buildings.
less to pound, or exceeds 14,000 0 Commercial-use agricultural
❑ 1- and 2- family dwelling p'Commercial /industrial ❑ Accessory building amps for all other inshillatiuus. buildings.
❑ Multi - family 0 Master builder ❑ Other: — 0 Fire pump. 0 installation or 75 KVA or
0 Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION 0 Addition of now motor load of 0 "A ", "E ". "1 -2" "1.3 ",
100riP or more.
occupancy
Job no.: Job site address: .
lot to 6,. W Olio pt►s S �►. G ? ❑ Six or more residential units, ( Recreational vehicle packs.
City/State/ZIP: &-I- 0 � I ZZ 3 q +, _ 0 liealth-care facilities. 0 Supply voltage for more than
y 1•larArd014Y locations. y ( ` 600 volts nominal.
Suite/bldg./apt. no.: Project name: 45P _t_. 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross strcct/dirce.•tions 10 job site: nncrlptloa IQty. ( " . Fre. I roW .L'
-- - New residential slunk- or multi-Bundy dwelling unit.
Includes attached garage,
—
Subdivision: 1 Lot no.: 1,000 sq. ft. or less ' 168.54 a
Ea. win 500 sq. (l. or portion 33.92 I
Tax map /parcel no.: - ._ limit energy, residential
DESCRIPTION OF WORK (with above sq. (l.) 75'40 2
Limited energy, multi- family 75.00 2
j ft fiu. U 1 _ L`.vL -Pdv cliSfesolr
residential (with above sQ, ft.)
Services or feeders Insuallatlon gltcration, and/or relocation
200 amps or less 100.70 2
El PROPERTY OWNER i .. 0 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
. - relocation I services or feeders installation, alteration, aad/or
City/State/ZIP:
Phone: ( ) 1'a ( ) 200 amps or less II 59.36 l
Owner installation: This installation is being made on property that f own which is not 201 amps to 400 atnps 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, alteratton extens per panel ..
Owner signature: ._ _ Date: A. Fee for branch circuits with
❑ APPLICANT - ❑ CONTACT PERSON 7.42 service or feeder fee, 7.42 2
each brand' circuit ,
H. Fee for brunch circuits without
Business name: -- , •r•• serViCu or feeder fro, first
Contact name: branch circuit I 56.18 �( ,($ 2
"-- --- - Each add'i branch circuit 7.42 I 2
Address: Miscellaneous (service or feeder not include)
City/State/ZIP: /State /7,1P: iach manufactured ormodular I 67.84 2
y dwelling, service and/or feeder
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Phone: ( ) Fax: : ( ) Reconnect only _ 67.84 67.84 2
--- Pump or irrigation circle 67.84 2
E -mail: _ Sign or outline lighting 67.84 • -�+ 2
_ CONTRACTOR J � Signal circuit(s) or or
Business name: A1!- A4ti4 R z ►a a an:c4 .- dovi ad panel, ultemtioi or extension, Pape 2 2
K Eaelt additional Inspection over allowable In any of the above
Address: 4), 0, sox / y2 b Additional inspection (I hr mil) 66.25/ hr
".i Investigation (l hr min) 66.25 / hr
City /State/ZIP: L d/1 970 2o
Industrial plant (1 hr min) 78.18/ hr
Phone: (5ot�) (o57 cop MIX: ( :d3 ? 91 C Inspections for which no fee is 90.00 / hr
.�.rG specifically,istod (K hr mi)
CCB Lie.: /rj, lqo + Electrical I.ic.: Z( f / Suprv. Lic.: (1/(1/73/4 73� .�.. E LECTRICAL PERMIT FEES —.1
Suprv. Electrician signature, required: 7 .. Subtotal: ST., 1g
, .1./..z„,./.../ VIA .. _ Pla review (25% of permit fee): AY
Print name: b, W►a 1 L? I . U Date: 9 / State surcharge (1 of pemlit fcc): G.IN
., - j pilcatlon TOTAL PERMIT' FEE: G ,2„, a Authorized signature:
This permit ap owes if a permit is not obtained within 180 t% "
Print name: ant � � s Date: / days after ii has been accepted as complete.
V /e/ � � �� Numtw of inspections allowed per permit.
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