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Permit
CITY OF TIGARD ELECTRICAL PERMIT 3 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00327 TI TIGA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/30/2012 Parcel: 1S136DA02300 Jurisdiction: Tigard Site address: 6900 SW ATLANTA ST 100 Project: OME Subdivision: FRUITLAND ACRES Lot: 5 Project Description: (7) branch circuits for TI Contractor: COCHRAN INC Owner: OREGON EDUCATION ASSN 7550 SW TECH CENTER DR #220 6900 SW ATLANTA ST TIGARD, OR 97223 TIGARD, OR 97223 • PHONE: 503 - 234 -6564 PHONE: 503 - 684 -3300 FAX: 503 - 238 -2098 FEES Quantity Description Date Amount 7 crt Branch Circuits wo /Purchase 05/30/2012 $100.70 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/30/2012 $12.08 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OA 9 2 -001- 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1f r Issued By: Permittee Signature: ©V A P1/ C 3 171&L OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the Job site until completion of the project. Approved plans are required on the Job site at the time of each Inspection. 01 09:08:20 05-29-2012 1 /3 . Electrical Permit Applicati flEcEii,1:1/Er) . FOR 01•11( I'. 1 SI': ()Nil City of Tigard -, ., :-, .,,,,' Received . '' - Date/By: s l w i 7 Sir Permit No.1Qe.. ao ia-cr).3.1-7 " 13125 SW Hall Blvd., MAy 2 9 Z V 2012 Pbn Review 11 11 II Phone: 503 Tigard, OR 9722 .639.4171 Fax: 503.598.196r ' Date/By: Other P OCIO3 1 1 A l) Inspection Line: 503.639.4175 Date Ready/By: ..l c 91 See Page 2 for t;it r Internet: www.tigard-or.gov cny OF tGAFi Notified/Method: Supplemental Information :. .:::,.'... : ....i ?,$ ,: ;!.;,j.;;:;:.....,:: '` .. ,u r ri liA : •.'t'lgi'l;'.r. ' F; 1 %;•:4ni.0.1:MY/AWC . :•.:i. : ;::•g:. 1 .:::"...i:;;i' , •••.:"'. ' 121 New construction fig Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other where the available fault current 0 Marinas and boatyards. :•....i.!.:1,7•;:',‘,:::•':::;1.,..'.■31:.....,ky,,.::;•;.-..:.y....:Y.,•::•U';'&4tikoilktiAc to#0,00:070g,,,, exceeds 10,000 anips at 150 volts or 0 Floating buildings. ground, or exceeds 14.000 0 Commercial-use agricultural 0 1- and 2-family dwelling Commercial/industrial 0 Accessory building amps for all other installations. buildings. 0 Multi-family Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or • . .,...,... . .... .., larger separately derived ‘ 1,, '. • , ... .4911 srrF::.p■IF9..Rmolv ANp.,!4c.N.r.m.P1: system. .. : ..... : . DAddition of.motor load of 0 1001IP or more. occupancy. NI Job no.: Job site address: t sit M ilit i a . „ $t 0 Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: A oe ci 1 22, ..- I in E kssoc.• 0 Health-care facilities. 0 Supply voltage for more than 0 Hazardous locations. 600 volts nominal. • Suite/bldg./apt. no.: Project name:Or D °Service or feeder 600 amps or more. '....; 0 .gt.4..i.tigigr''.....:..,..1;:.a I' Cross street/directions to job site: 50 pri,tailAct_s+ Description . I Qty. I Fee. I Total 1 • New residential single- or multi-family dwelling unit. N Su 3 (D13 pi:u.) t ? Includes attached garage. �) Subdivision: i Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'1500 sq. IL or portion 33.92 Q Tax map/parcel no.: Limited energy, residential • .00 75 ' •' . : iDESCRIPTION . 01? WOK - .. (with above sq. ft.) 2 ' Limited energy, multi-family 75.00 2 150812, - 309 540 - l'enan :Cmix.ovemen`r residential (with above sq. R.) 75. Services or feeders installation, alteration, and/or relocation 200 amPs or less 100.70 2 ' • 0 PROPERTY OWNER .. ,!'..i!: ..7 ; ,... ."Z:: ; In:, :1:4(ANT - . :..: ,,..: 201 amps to 400 amps 13156 2 Name: 401 amps to 600 amps 200.34 2 601 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 • 59.36 i 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not 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 .., . 0, APPLICANT . ' •.... ,. s, [. :,•,' • . i . .B . .C.P 117 4C- 7. ...P.P#SPN . '..- .. : each branch circuit 742 2 • Business name: .:, me C.(,S C..orck B. Fee for branch circuits without c2‘-'" service or feeder fee, first 54 13 Contact name: branch circuit 1 56.18 1 2 Each addl branch circuit 10 7.42 Lig bz- 2 Address: Miscellaneous (service or feeder not included) Each manufactured or modular City/State/ZIP: dwelling, service and/or feeder 67.84 2 Phone: ( ) I Fax: : ( ) Reconnect only 67.84 = 2 Pump or inigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 Signal circuit(s) or limited-energy panel, alteration, or extension. Page 2 Business name: 0 _ift,l, ca , Each additional inspection over allowable in any of the above 2 (I Address: 1 5 50 5\4 Te_ ...., 4,. *22 o Additional inspection (I hr min) 66.25/ hr _ " Investigation (1 hr min) 66.25/ hr City/State/ZIP: - n O a(; OR 72 2_ Industrial plant (1 hr min) 78.1 8/ hr hone: 503 ) 2.3q— 1,56,c/ I Fax: ( - 3 )2_3a zo q .8 inspections for which no fee is specifically listed (A hr min) 90.00/ hr I CCB Lie.: -- 72_5(.4a I Electrical Lic.: 75146,C,1 Suprv. Lic.: 34475 (i. • : \ Subtotal:. /AO j 70 Suprv. Electrician signature, required: ,. Plan review (25% of permit fee): Print name: K Etnn .--- • 101 Date:5, Z'7--/Z__ , State surcharge (12% of permit fee): /2 0 El Authorized signature: / pilii Print name: Yo cc , e t .... i / lb i ,, ' . ntic Date: e ,5 * . z491 —/ a TOTAL PERMff FEE: ii 2 S 7 8 / This permit application expires if a permit is not obtained within 180 ' days after It has been accepted as complete. • Number of inspections allowed per permit. Inuildingl.PcmihrELC-Permitnpp.doc 07'01.10 440-461ST(11,03,COMAVED 01 09:08:49 05 -29 -2012 2 /3 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for a ll residential systems combined........ $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. COMMERCIAL *Oft .ONLY: . ., , : . • Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations L1RuclnmrAPown■tdRIP- rmniiAnn ne mmv10