Permit v •
• CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00544
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/13/2009
Parcel: 1 S 136AD04000
Jurisdiction: Tigard
Site address: 11507 SW PACIFIC HWY D
Subdivision: Lot: 0
Project: Bear Printing
Project Description: 10 circuits for print shop
Owner: FEES
PACIFIC TERRACE COMMERCIAL LLC Quantity Description Date Amount
BY EDITA M SMITH, 833 NW 170TH DR 10 crt Branch Circuits 10/13/2009 $122.96
BEAVERTON, OR 97006 wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 10/13/2009 $14.76
Electrical
Contractor:
ABC ELECTRIC
135 NE 9TH AVE
PORTLAND, OR 97232
PHONE: 503 - 233 -7551
FAX: 503 - 233 -7552 •
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: B
Total $137.72
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 OAR 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: C\J\ J Permittee Signature: 51z Ap .
OWNER INSTALLATION ONLY r 0
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 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.
•
� V 10/9/2009 10:48 AM FROM: ABC Electric ABC Electric TO: 503 -598 -1960 PAGE: 003 OF 003
Y
RECEIVE
Electrical Permit Application Tull OI 1 1( 1: 1 ,1: om.,
City of Tigard OCT 0 9 2009 ; : a , ,
II 11125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.19(QITY OF TIG ' ° 1 iffili Omer Permit
T 1 ` : ,,„ 1 l CCtion Line: 503.639.4175 BUILDING DIVISI I I • ` yam: tw: ® See Page for
Iacmet: www.ti Supplemental Information
Please c heck l
al that (submit sets c
❑ New constriction Addit / a l tera ti on / r+ep l acemettt apply ( S of plans wlioeme checked below);
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Dem0liti on ❑ Other
where the available fault current 0 Marinas and boatyards.
: ;.-; . ; • .. 000 amps at 150 volts or 0 Floating buildings
' ', exceeds 10,
I .:.
" " . - - - - less to ground, or exceeds 14,000 0 Commercial -use agricultural
❑ 1- and 2 -fatly dwelling ® CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-farni ' DI Master builder ❑ Other: 0 Fm pump. ❑ Installation of 75 KVA or
t : ❑ l mergeocy system• larger separately derived system.
i .. .. .. , , ' - ❑ Additbn of new molur load of
Job no.: • i • .s Job site address: / • /W/ a mom. aocy.
❑ six ix o or r moore taideatiel unit. 0 tt Remeecteatioml vehicle parka.
City/State/ZIP: ❑ Health-cam facihtirs. O Supply voltage for more than
AI' 4 r • I. 0 Hazardous location. 600 volt; nominal.
Suite/bldg. /apt no.: Project name: `, , L_ r i 0 Service or feeder 600 amps or mom
ill , ..
Cross street /directions to job site: neseristko Qty. Fen Total •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or leas 145.15 4
Tax map/parcel tro.: Es. add'l 500 sq. ft. or portion 33.40 1
`; Limited , residential 75.00 2
( 4$; i S :: (with above R)
�� . ... .. r -.::. ; ..:. ..:. :. . ... Ltmrt multr- famuly 75
• ®erBY •
.00 2
. ran
esidenual (w ins above sq. ti)
1� t Services or feeders instailadon and/or relocation
1 nl t• \ 200 amps or less 80.30 2
y 2018mps ho 400 amps 106.85 2
M el t � 401 amps to 600 160.60 2
60l amps to 1,000 amps 240.60 2
Address: fiVIMIMINE Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) r . S 7A111 Fax: ( ) 200 amps or less . 66.85 1
Owner Installation: This installation is • g 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 _
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
7yE 1 f 2
above service or feeder fee,
6 .63
each branch circuit
Business name: 1 B. Foe for branch circuits S6, i el �r
without service or feeder fee • Il 8
Contact name: ( / / 1 !! jL first branch circuit - f 1iZ, 'c 2 10
�
Address: — _ Each add'I branch circuit q 7' ` ) .A r R'.. 2 b Cult
Miscellaneous (service or feeder not Included)
i / / Each manufactured or modular
dwelling, service and/or feeder 90.90 2
er
Phone: ( . t — r i Reconnect only . 66.85 2
E -mail: Pump or irrigation circle 53.40 .2
t t ai Signor outline lighting 53.40 2
4r
Signal circuits) or limited-
• Y energy panel, alteration, or
Address: • I
i .' . extension. Describe: Page 2 2
_
City/State/ZIP: . r / / l / L ` Each additional inspection over allowable in any of the above
,r �� Pa inspection 62.50
Phone: ` ,, I
�� i nvestigation per hour (I tr min) 62.50 n 4
M Electrical Lice, , , t Industrial plant pa hour 73.75
• iii ' '': l•
Suprv. Electrician signature, required: �i � Subtotal: I(, , 76 laaAb
Print name: Date: et , o
Plan review (25% of permit fee):
• 1 / f /= State surcharge (12% of permit fee): /.a . 114 ,7 b
Authorized signature: 4 � All TOTAL PERMIT FEE: / J 9
`+ This permit application mire, If a permit Is not atoned within ISO a 27 / I,
L Date / • days after It has been accepted as complete. 7
• Number of inspections allowed per permit
1:\BuildioglPamus\ELC•Pe mitApp.doe 0523/06 440- 46157(11/05/COM/WEB