Permit CITY OF TIGARD ELECTRICAL PERMIT
e COMMUNITY DEVELOPMENT Permit #: ELC2012 -00263
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/04/2012
Parcel: 2S103AB00800
Jurisdiction: Tigard
Site address: 11345 SW WALNUT ST
Project: Bank of America Subdivision: CLYDESDALE Lot: 24
Project Description: Corrections to reconnect permit #ELC2012- 00159. (1) panel change and (1) branch circuit.
Contractor: SQUIRES ELECTRIC Owner: BANK OF AMERICA
1001 SE DIVISION STREET #1 931 CORPORATE CENTER DRIVE
PORTLAND, OR 97202 POMONA, CA 97169
PHONE: 503 - 252 -1609
PHONE: 303 -467 -8044
FAX: 503 - 253 -5831
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/04/2012 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 05/04/2012 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 05/04/2012 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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 thro952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 32.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
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' D 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.
05/02/2012 18:14 5032535831 SQUIRES ELECTRIC #1459 P.002/002
Electrical Perm Application Received FON OFFICE USE ONLY
City of Tigard 5 d
RECEIVED e /
I s ilk b� , Al;. Permit No.: � e 3
A 13125 SW lull Blvd., Tigard, OR 97223 Plan Review f(,.e. 69/.1--66/5
Phone: 503.7182439 Fax: 503.598.196O' - 2 2012 Dar : Other Permit:
Ti ' AFD Inspection Line: 503.639.4175 Date Ready/By: Ws: la See Page 2 for
Internet: www.tigard -Or.gov CITY OF TIGARD Notified/Methvd: Supplemental lutormation
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❑ New construction ® Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Huilding ovet three stories.
❑ Demolition ❑ Other: where the available fault current 0 MlitieltS and boatyards.
,=. rF r , 3k L � " •" T exceeds 10.000 amps u 150 volts or ❑ Floating bmldm
-_ � less to ground, or exceeds 14,000 ❑ Commercial -nee agricultural
® 1- and 2 - family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other inst btuidin .
❑ Multi family ❑ Master builder ❑ Other ['Fire pump. ❑ Instillation of 75 K VA or
�.r -.. � . 3,.. ,• +,,:. •" • l,. _ r ❑ l arersc systan. larger separately derived system.
� , , • - : 1 Y r r � '. t - . , . : q t v . Addition of new motor load of ❑ " A " . "8 "1.2 ", "I -3 ",
Job no.: Job sitc address: 11345 SW Walnut St or more.
❑ six ix or or more rK,dentisl units. ❑ Recreational vehicle path.
City/State/ZIP: Tigard, OR ❑ Health-care taciltties. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldgJapt. no.: Project name: Duke Development �. ❑ / Service or feeder 600 amps or more.
Cross street/directions to job site: Description - • I Qtr. I Kee. I 'a ij -
New residential single or multi family dwelling unit.
_ Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R or less _ 168.54 14
Ea. add' 1 500 sq. ft. or portion 33.92 1 i
- Tax map /parcel no.: l.imited energy. residential
:`. _w ao ;
S _ { x:A =. r a Tr ; (with above sq. ft) 75.00 2
Limited cncrFy, multifamily 75.00 2
Panel change a 1 0 l i U .- % ( residential (with above sq. tt.1
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
°'l ` � ` 2 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
Temporary services or feeders installation, alteration, and/or
City /State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 5936 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rcnt, or exchange, according to ORS 447, 449, 670, and 701. -
Branch circuits - new,alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
�, , « s ti Rte above serviCd or feeder fee, 1 7.42 2
a te ' . ?±. 3 %: � " € i <. esch branch Circuit 7.42 _
Business name:
B. Fee for branch circuits without
- service or feeder fee, first 56.18 2
Contact name: branch circuit _
Each add' I blanch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Ciry /Statc/Z1.P: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
' Phone: ( ) Fax: : ( ) Reconnect only 67.84 2�
- - Pump or irrigation circle 67.84 2
E _ Sign or outline lighting 67.84 1 2
6 W:i Ve` . �, `.' O ^.,p`- . ' s : Y . r -r: Signal circuit(s) or limited-energy
Business name: Squires Electric Inc panel• alteration, or extension. Page 2 2
Each additional inspection over allowable in any of tbe abov
A ddress: 1001 SE Division St., #1 Additional inspection (1 hr min) 6625/ hr - r-
ts lik - Investigation (1 hr min) 6625/ hr
City / State/ZIP: Portland, OR 97202 Industrial plant (1 fu ruin) , 78.18/ to
Phone: (503) 252 - 1609 I Fax: (503) 253 - 5831 inspections for which no fee is
90.00/ hr
specifically listed (4 hr min) •
CCB Lic.: 135085 l Electrical Lic.: 26 - 11010 Suprv. 4882S '�'5' •' .� ' - � ' ' -:`'
Subtotal: 108.12
Suprv. Electrician signature, t 'red: _ Plan review (25 %of permit fcc):
Print name: Joe Squires r Date: 5/2 /2012 State surcharge (12% of permit fee): 12.97
-
TOTAL PERMIT FEE: 121.09
Authorized signature: This permit application expires if a permit is not obtained within I$0
days after it hag been accepted as complete.
Print name: Date: .. - Number of inspections allowed per permit
1:tBUileinglpetmits C•PeraritApp.0oc 07/01/10 +10-4615T(1l/Q$/COM/WPB