Permit CITY OF TIGARD • ELECTRICAL PERMIT
Permit
COMMUNITY DEVELOPMENT #: ELC2012 -00160
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/27/2012
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L13
Project: Spec Space Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: TI
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
6 crt Branch Circuits wo /Purchase 03/27/2012 $93.28
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 03/27/2012 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
Total $104.47
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 -0090. You may o• = • • of the rules =ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: v �� "�'v �� r Permittee Signature: _ _ ✓L■..a
OWNER INSTALLATION ONLY
The installatiorfis 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 protect
Approved plans are required on the job site at the time of each Inspection.
•
Electrical Permit Application 1 1 EC 'VEf Received r, , l< (, I R I.1 I ( ) )
City of Tigard MAR 2 2 2012 Datc/B ' '" �:>,r tef1nitNo. - , • - I(aO
• 13125 SW Hall Blvd., Tigard OR 97223 Plan Rev
' Phone: 503.718.2439 Pax: 503.598.1 Date/15y: other Permit:
R,.\ It 1, Inspection Line: 503. 639.4175 D IIY OF TIGPD t)ate Ready /SY: June. I f 121 See Panel for
lInternet www.t;gard4f,gOV BUILDING ni�/ jSJON 1 Notifi mathxl: , 2 sy(o I Supplemental Information -
TYPE OF WORK PLAN REVIEW
❑ New construction Addi (loft /altcration /replacement 1'leaso c I all that apply (submit j acts of plans w /items checked below):
❑ Service or feeler 400 amps or mom ❑ Building over thine stories,
❑ Demolition ❑Other: whew the available fault current O Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps id ISO volts or O Floating building•
•
teas to gmund, or exceeds 14,000 0 Commercial•usc agriwhural
❑ I- and 2- family dwelling Commercial /industrial ❑ Accessory building amps Loran oiler installations. buildings.
❑ Multi- family Master builder 0 Other: ❑ i•iro pump. ❑ installation of 75 KVA or
01'mergeney system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION 0 Addition of new motor load of ❑ "A" i 9 -2" "l-1",
— occupancy.
lob no.: Job site address: O'L 7 5. ri1`�•13d (_ -1 3 ❑Six or
more mistrials' un DRecreational vehicle parks. •
'.
City/State/ZIP: (� 1/4 ►'�' A Q l kahh.care facilities, ❑ Supply voltage tar mom than
❑ Ilutrsdmn locations. 600 volts nominal,
Suite/bldg. /apt, no.: j. /3 Project name: Sp Fetus_ _ ❑ service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: oacrlmuwn [9w. I Fee. I Taal I
New residential tingle- or multi - family dwelling unit.
Include. attached garage.
Subdivision: I Lot no.: I,000 sq. A. or loss 168.54 1 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map /parcel no.: Limited energy, residents'
( with a bove S q. ft .) 75.00 2
DESCRIPTION OF WORK
Limited energy, multi - family 75.00 2
G L� to `- A j $ . a lee tA z it s residential (with above S R)
.- Services or feeders installation, alteration, and/or relocation
• 200 amps or less 100.71) 2
❑ PROPERTY OWNER _____L___.-
❑ TENANT 201 amps to 400 mops 13156 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
Temporary services or feeders instslLtloo, alteration, and/or
City/State/ZIP: relocation
Phone: ( ) I irax: ( ) 200 amps or less 59.36 I
201 amps to 400 amps 1 25.08 2 '
Owner installation: This installation Is being made on property that I own which is not 401 sumps to 599 amps r
ump 168.34 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits - new, alteration, or citensioaper panel
()wrier signature: _ Date: _ A. Pee for branch circuits with
- -~ C ONTACT PERSON above service or fesxter toe 7.42 2
❑ APPLICAN ` ❑ retch branch circuit
Business name: B. Fee for branch circuits wiv unit
service or feeder fcc, first 56.18 �(e .(B 2
_ branch circuit �„(
Contact name: Each add branch circuit 7.42 1 37.(0 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: �t yN_ � manufactured 67.84 2
Phone: ( ) w ] rant:: ( ) - Reconnect only 67.84 2 •
Pump or irrigation circle 67,84 2
E. Sign or outline lighting 67.84 , 2
CONTRACTOR signal circuit(s) or limited-energy
'"" t panel, alteration, or extension, Page 2 2
Business name: 44/t,_ j�( i t ( �(,�( t (� L f/1� Each additional Inspection over allowable In any of the above
Address: /Sr, 6 O �! / 1r 2 6 Additional inspection (1 hr min) 66.25/ hr
Oa r /) Investigation (1 hr min) 66,25/ hr
City/Slate/ZIP: _ ___ Q� Q a Industrial plant (l hr min) 78.18/ hr
Phoue: (IGo3) 65')- 1,13x1 Fax: (,'e3) '1 (o - 3qQ$ _ Inspections far which no fee is 90.00/ hr
specifically listed (K hr min)
CCB Lie.; / 579'0 Electrical Lic.: Z(, . /lytiC Suprv. Lic.: 4 17 / — ELECTRICAL PERMIT FEES
• Subtotal:
Suprv. Electrician signature, required: p A ar "" Plan review (25 %ofpermit fee)• -
Print name: D 4446 ,.k bv., j Date: 3_27..42 Slate surcharge (12% of permit fee): (trig
TOTAL l'NkMff FEE; 104 ")
Authorized signature: / , 7l per mit application expires It a permit is not abtalned witIsla 180
days after it has been accepted as complete.
Print name: e Y w I Date: 3� 27- • Number of inspections allowed per permit
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