Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00331
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/31/2012
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16260 SW UPPER BOONES FERRY RD
Project: Game Day Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 30
Project Description: (6) branch circuits for TI (furniture feeds)
Contractor: PRAIRIE ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
6000 NE 88TH ST ATTN: N PIVEN
VANCOUVER, WA 98665 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 800 - 573 -2750
PHONE: 503 - 624 -6300
FAX: 360 - 573 -9866
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 05/31/2012 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/31/2012 $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 -0 1 -0 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 or 1.800.332.2344. /
Issued By: Perrnittee Signature: LW /r/ G/ e 770 /"
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 503.639.4176 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.
05/29/2012 16:16 FAX 360 573 9866 Prairie Electric Inc. Z1001/002 9 1 -
Electrical Permit Applic ,tion . • \ "'A‘ I FOR ()F FICE LSE (1i l..l
City of Tigard t .1- - ' ' Received S' � / , r P erm i t No. 6" , - de 033
T ° 13125 SW Hall Blvd., Tigard, OR 9722 9 2012 plan Review
C Phone: 503.718.2439 Fax: 503.59%9'6B Dm : Other Permi .4 ; / AA - 100..5 -
I 1 GA 1: U Inspection Line: 503.639.4175 1 t m
Date Ready/By: ® See Page 2 for
Internet www.tigard-or.gov -PV Q r1�' S , Notified/Method: Supplemental Information
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a z .�Y i II-.� ^ _ II l:- - y . yam"',", i p i-.P .._, .. r z I . 7, -"1iC ^ 'Lt•1 :1: . r � e •� 1 zi i'i• ' -
4 t r : ., I. # 7, •-i' P .G.3 iVms T. .= c 4 : - ' - ?.m ._e .av ;5 =t,,,- ...,,_6. , T4k. o.° a:. 7r
❑ New construction ® Addition /alteration/replacement Please check all that apply (subm 2 sets of plans wl checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
- ; 24. ' '-- :,-_ .. -7r .°rte, s it, : q I ' : fh ' —� y ° : = 't rF -.. • .`.":'a^i _ '
:: - .'. exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
- '._�.'-� °� tm _ � l_ � r::a . .1;6 h . �.�� = �� j , ��^ -- . . .— K , ; •." ••• less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ I - and 2 - family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
stem. larger separately derived system.
- - -, ...7-_-_v,.,15,.. v - E •ir,--ci17 --- et•.,.. !?y � 7tj c k� - : ;. - ..;=.1-...%. _ ['Emergency sY g ep� Y sys
•_ , . , 0 t ' =.• , 1' tS ..• :a �.e:f. " - F a F� ❑Addition of new motor l oa d o ❑ "A „ E ", "1 - "lA ",
Job no.: SCO Job site address: 16260 SW UP BOONES FERRY RD 100HP or more. Occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: TIGARD, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: a FIr-F. FURNITURE. niRF -T ❑ Service or feeder 600 amps or more. s'
J. i:r."' ago-^ -. -V;8.4.- a� ��t >�- = ;r.'__c,•_• 25��';
Cross street/directions to job site: t `QTY 1 4' De cription on- 1 Tatar •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add"! 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: msted energy, residential
r TY-a :1 - . • _- . - -- f -err. — sc _ T.0 _ ::-. • . — 75.00
_. '' T : -' 1004. . - _ ' , - - - - - -. w : t . � m z- :-. - : � ¢1 ; '� t (with above sq. ft -)
2
-.. ;.
' ^: ._ iCa :tom r°_ ° L ener multi-family gy, mu tt -famil 75.00 2
CIRCUIT WORK FOR FURNITURE FEEDS residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
1., -• ,� q�� 1� a :RIFT * ^i7 ' six'- 'ir "" r"' 65': y.,.
"t4:,•. • X3,31 -;.4.:,„.-;,-,..,-A-, Z: liu. �, ,U - .A''' i .. f;fi7 _ ..., ax..., i 201 amps to 400 amps 133.56 2
" b= _r
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 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, 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
=.W ; xL Ts- rr•a ,� -�rf: a - ^ _ __ - u . i '_ -. . ' i . above service or feeder fee
�� � ... � • _ + � �- rr '•.!• • t : v • "s � � w _ _..- �i' "�i�"�...:.;. CE "'... y et . 7.42 2
r rz:
.r _ . .. . .
. .. � _....�ar.� ;- r•.- ,.....° �.•x?E�ir� - ;;y,s S., � _ rG _.. -.Fi •� -: r:_...... :.. -.? -�- each blanch circuit
Business name: PRAIRIE ELECTRIC, INC. B. Fee for branch circuits without I �j
service or feeder fee, first 56.18 51,0 't v 2
Contact name: ANITA PASOITOM LINDBERG branch circuit
Each add'I branch circuit 7.42 31
Address: 6000 NE 80 STREET Miscellaneous (service or feeder n t included)
City/State/ZIP: VANCOUVER, WA 98665 Each manufactured or modular 67 84 2
i
ty R, dwelling, service and/or feeder
Phone: ( ) 503.286.9209 I Fax: : (360) 573.9866 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: anitap@prairielectric.com _ Sign or outline lighting 67.84 2 • ..!i .= i >< G ; u == � • _ i : * .,- _...'c. Signal circuit(s) or limited�ner
Business name: PRAIRIE ELECTRIC, INC. panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the abov
Address: 6000 NE 88 STREET Additional inspection (1 hr min) 1 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/State/ZIP: VANCOUVER, WA 98665
Industrial plant (I hr min) 78.18/ hr
one: ( ) 503.286.9209 ,Fax: (360) 573 866 1 pections for which no fee is 90.00 / hr
s . ificall listed A hr min
CCB Lic.: 60178 Electrical d Lic.: 37 • C Suprv. � 56 rij' ;u; is -F ;�''� ^'° ` - ' ' ' "
`++: Subtotal: ' r
Suprv. Electrician signature, require °
Plan review (25% of permit fee): q
l
Print name: BILL HALBERG Date: 5.29.12 State surcharge (12% of permit fee): `'tW . tj
TOTAL PERMIT FEE: 0 v
Authorized signature: This permit app expires if a is not o med within 0
Print name: Date: f ns iipe ' ., / L (�
i cs w o7 t ( oslco L O /
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