Permit CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY. DEVELOPMENT Permit #: ELC2012 -00336
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
Parcel: 25101 DD00200
Jurisdiction: Tigard
Site address: 7051 SW SANDBURG ST 400
Project: Plastic Metal Technology Subdivision: 1998 -147 PARTITION PLAT Lot: 2
Project Description: (1) branch circuits for TI
Contractor: PRECISION NW ELECTRICAL Owner: SUMMIT PROPERTIES INC
12020 SE ANNA CT 5550 SW MACADAM AVE, SUITE 205
DAMASCUS, OR 97009 PORTLAND, OR 97239
PHONE: 503 -413 -9870 PHONE:
FAX: 503 - 594 -2873
FEES
Quantity Description Date Amount
1 ea Services or.Feeders - 200 06/04/2012 $100.70
Specifics: amps or less,
1 crt Branch Circuits w /Purchase 06/04/2012 $7.42
Type of Use: COM Service or •
Class of Work: ALT 1 ea, 12% State Surcharge - 06/04/2012 '$1
Electrical •
Type of Const:
Occupancy Grp: •
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Total $121.09
Required Items and Reports (Conditions)
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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 You may 52- 001 -00 0. Yy obtain a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 7
Issued By; � jr �� � , ,( dili_4f .t Permittee Signature: Qk . ►1 PPL! CA TO K
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 503.839.4175 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.
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05/31/2012 02:32 FAX 5035942873 PRECISION NW 61i
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Electrical Permit Applica h " 1 1 11; (II I 'i: t E cI_
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City Of Tigard m � a_. Received a Permit N. / LC .- iD1 y' 603 •
13125 SW Hall Blvd., Tigard, OR 97223 Play Rcvicw
Other Permit:
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Phone: 503.7) 8.2439 Fax: 503.598M 3 1 201 Date/15 : �, : or sec Pane z for
,. ; t u I, Inspection Line: 503.639.4175 Daze Ready/By:
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Internet www.tigard•or.gov li • 1 ' Notified/m te Supplemental Information
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ID New construction ,. Addition/alteration/replacement Please chovk all that apply (submit I acre of puns Whams checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the availnbk fault cerreal ❑ Marinas and boatyards.
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r, , {{ � , ,,, i 4, 1 , L 1 ; , i'. n u n '.∎ ', „4i , ,}.}u , 11 :i 1. •: ,.i_i Ei Il i o't aaitr 1" r �� i { h r!.i, r, . ; ;., , , I h . 1 ii z t exceeds 10,000 ground. amps at 130 14,000 unite or Fl mare buildings.
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. 7d1 „!�I r, k it 3 J „ , r 1 , J 11, Jill !', r <<( 1 , �.
� ,. ( ices to greed, or exceeds 14,000 ❑ Commereiel - agri,.•rrltural
El I - and 2 family dwelling ! ommercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Mu - family ❑ Master builder ❑ Other: O rin pump- O installation of 75 KVA or
It (I!� rt, , ' 1 ' r 11 M t ;,I, r`}o i1, .Y , 41, 14} :: :: ! li I 1 ti! ;:712 ❑ Emergency system. larger separately derived system
5�,.,, ! t l;t: 1iiin ; 6 .WSU t t , , .S.Sr,i1 ttil.::. f 4. 1 lS r0 1 t r' t 'i { i ,, I ' j { 1(i r ❑ Addition of new motor load of ❑ "A” "E "1 -2 ", ..1.3 ",
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Job no.: Job site address: �`� n 10011P or mere. occupancy.
x'31 W �M ❑ Six or more residential ails. O Recreational vehicle perks.
City /State/ZIP: "t 1 , i'• W.. u/. 1 2'Z 0 llealth.care Ihcitities. ❑ Supply voltage for more than
0 Hazardous localisms. 600 volts nominal.
Suitc/bldg. /apt. no.: 4.00 Project name: p ...v ❑ Service or fewer 600 amps or more
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Cross street/directions to job site: L_, 77 ( / '7 e7 - 7 ji J I. D,, npiiou Q. res. Tend •
New residential single- or multi- family dwelling unit
Includes attached garage.
Subdivision: 1 Lot no.: 1,0 sq. R or less 168.54 4
Ea. add'I 500 sq, ft, or portion 33.92 1 •
Tax map /parcel no.: limited energy, residential 75.00 2
' 11.41 ., _ Y ,1p r; i, j ' r Z 14 ` ( 1 cN i,llri o rr , i i I I t (with above ml. ft.)
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�+ Limited energy, malli•IAmily 73,00 2
e -,.. re.✓ ` ., CA itt � l 4- — &P1 . . _ residential (with above . . II.)
-� '� Services or feeders Installation alteration, and/or relocation
44 - • If M - ♦ 00 200 amps or leas g. 100,70 108:711 2
41"mrnlr.l { Ir y �; I i r , -1 < a (Ifu ,, 1'• 1' 7 1! r , , r 1 )01 !t I ' �
, li 201 aII1Q3t0400 131.56 2
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hi�n! `. �lFit ,.r..:+��a8ua. , �rtr.M1 „ern r. scti!Ja.,H.n r,rc`4c�htfr, �1. ::, l:di:nH 1!.II ,�,� r, f',. � t'L'L:I�.ur.11l 1 ;; ,;. ..� � `ur.., :. ,1..�!II , .I ±.LL....!
401 amp 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
Ciry /StatcJZIP: �� Temporary m services or feeders Installation, alteration, and/or .
Phone: ( ) I Fax; ( ) 200 amps or Itaa 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 ()RS 447, 449, 670, and 701. Branch circuits – sew alteration. or extensiao . er . Del _
Owner signature: Date: A. Fco for branch circuits with
��,� ]�^ir , 1,'m , r. ,. ., ni hJi , +, i1i1:5gr T � r i 1176 r l r' r i ,,,Y i i n ! , , , I abeve service Or feeder lee, . /t
( ( 1' I Sp. I^ �� (iI1` 1 . : ,r;,w, Y 1 ., i. . „T
' , h q ,s1.�� )f � ' N r 6 1 � i i {i , ,' ,', ' ;�i11, each br anch citouR 1 7.42 2
u u6 �,r,,,a ,r. {.,i,iu5 rhi }!�t r ., ; .lux U, Ii,: ,. 1ti f2, t .,.
Business name: 13. Fcc for branch circuits witbeat
- service or feeder fee. first 56.18 2
Contact name: branch circuit
Each add'I branch circuit J 7.42 2
Address: Miscellaneous (service or feeder not included
City/State/ZIP: 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 -mail:
s(r �( } Signor outline lighting 67,84 2
iiie
„� dry i _.,, , ul '''.6,r,'” , , ah(stl1( r+ I t W 1 , 1 1 { a ill1f„ t {fit •
J Nil : J•'I r' , ; *O: ;,i � )a. '
"' •mm P. $tlllMl� rla„ r... , �1n61 .. 1 . ; . !^ d. i,1 }llLt: ; r.. r'�IJ6t.,„ . !l.lial. Signal circuit(s) or limited - clergy
Business came: panel, alteration, or extension. Page 2 2
�/� tL5 S �� �V I �'a� — Each addidonal inspection over allowable in any of the above
Address: I2.f„,2la Se 6
+ Additional inspection (I hr min) I 66.25/ hr CA' tINIMOSPINClitt”. City /State/ZIP: c q"'l
Investigation m (1 hr min) 66,25 / hr
(V 1 Industrial plant (I hr min) 78.18/ hr
Phone: (S)J) 4 3 q 1?j'� V I F ax: (a) Get 4,^Z8'"� Inspections fur which no foe is 90.001 hr
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t 22 Q � �.� s Immesh
listed Si 4i hr m
CB Lic.: `k71 P ✓° p(cctrical Lk.; r�" /� ! "1 WYN. Lic.:'IS 01r04.4... . , ,bli}Ir d ,. _' f , / w) Il YP ,1 :Lifii I Ttiiil. I?i JL L ,'' ..
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Subtotal: 10% . 1
Suprv. Electrician signature, required:
r,..h.A.�,��d(2J1/1 Plan review (25% of permit fee):
Print name: x. , t0 lvv ,. , , 0 Date s+ —201) state surcharge 02% of permit fee): ee��
TOTAL PERMIT FEE: 12,
Authorized signature: . \
This p ermit appliance aspires H a permit is not obtained within 180
Print name:: n Date: �+ .�i • days after it has ban accepted as complete.
, ,1( , P >)V� �, \/QA, via `7-"g 1 4001 Number of inspections allowed per perml. ( .1 , C St ✓
.t 5ullding 1 PerrehOE t.C- PermitApp.doc 07/01/10 440.4610(11/05/COM/W116 1