Loading...
Permit , CITY OF TIGARD ELECTRICAL PERMIT 11 % -• COMMUNITY DEVELOPMENT Permit #: ELC2012 -00281 T1G 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/14/2012 Parcel: 1 S136CD00100 Jurisdiction: Tigard Site address: 11705 SW PACIFIC HWY Z Project: Petco Subdivision: 2006 -016 PARTITION PLAT Lot: 3 Project Description: Electrical TI. Contractor: GMD ELECTRIC INC Owner: PACIFIC CROSSROADS PROPERTIES IN PO BOX 72206 BY WYSE INVESTMENT SERVICES CO EUGENE, OR 97401 1501 SW TAYLOR ST STE 100 PORTLAND, OR 97205 PHONE: 541 - 741 -7369 PHONE: FAX: 541 - 988 -1800 FEES Quantity Description Date Amount Specifics: 3 ea Services or Feeders - 200 06/14/2012 $302.10 amps or less 1 ea Services or Feeders - 201 to 06/14/2012 $133.56 Type of Use: COM 400 amps Class of Work: ALT 1 ea Services or Feeders - 401 to 06/14/2012 $200.34 600 amps Type of Const: 115 crt Branch Circuits w /Purchase 06/14/2012 $853.30 Occupancy Grp: Service or Feeder 3 ea Sign or Outline Lighting 06/14/2012 $203.52 1 ea Plan Review Electricial 06/14/2012 $423.21 11 ea Info Process /Archiving - Lg 06/14/2012 $22.00 $2.00 (over 11x17) 1 ea 12% State Surcharge - 06/14/2012 $203.14 Electrical Total $2,341.17 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 95 -009 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Permittee Signature: 4N /97 6 -77 / 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 603.639.4176 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. RECEIVED 5 Electrical Permit Application JUN 0 7 2012-" FOR OFFICE USE ONLY III City of Tigard CITY OF TIGARD Da B Fam;t . 9 EICo?0 /a DacZe9/ 13125 SW Hall Blvd., Tigard, OR 9722AI in DING DIVISIO I Ban n Review Other P / �(/ /a -6�0 Phone: 503.718.2439 FaFax: 503.598.1 Da R TIGARD InspeuxionLine: 503.639.4175 DatcxcadyOw nee H See Page 2 for Internet: www.tigardor.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW Q New construction ❑ Additionialteration /replacement Please check all the apply (submit 2 sets of plans w /iterta checked below): ❑ Service at feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating building less to greend, or exceeds 14,000 ❑ Commercial -unc aipicultural _ ❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master bolder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION i ❑ Addition of new motor load of ❑ "A ", E`, "I -2 ", "1-3", Job no.: Job site address: 11705 SW Pacific Highway 100 res occupancy. Six or more residential [nits. ❑ Recreational vehicle parks. City/State/ZIP: Tigard Oregon 97223 ; 01-care facilities. ❑ Supply voltage for more than i ❑ Hazardous locations. tY g 600 volts nominal. Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more Cross street/directions to job site: Exit 6 toward Tigard/McMinnville ® onto FEE SCHEDULE Description 1 Oh- I Fee. I Total New residential single- or multi- family dwelling unit. Pacific Righway /ORW Includes attached garage. Subdivision: Lot no.: 1,000 sq. R or less 168.54 4 ' En. add' 1 500 sq. ft. or portion 33.92 1 Tax map/parcel no.: Limited energy, residential DESCRIPTION OF WORK j (with above sq. it) 75.00 2 Limited energy, multi - family 2 Tenant Inftll - Pe� , c. O - .,,� PG�) g.. I residential (with above sq. ft.) 75.00 Services or feeders installation, alteration, and /or relocation 200 amps or lass 100.70 2 ® PROPERTY OWNER l ❑ TENANT 201 amps to 400 amps 2 133.56 267.12 2 401 amps to 600 amps 1 20034 200.34 2 Name: Petro Animal Supply Stores Inc 601 amps to 1,000 amps 301.04 2 Address' 9125 Rehco Rd Over 1,000 amps or volts 552.26 2 Tem o services or feeders installation, alteration, and/or City/Slate2lP San Diego CA 92121 Phone: (00000)00000 I Fax: (000)0000 200 amps or less 1 5936 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 ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, l 7.42 _ 74 2 each branch circuit Business name: B. Fee for branch circuits without ' i service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'l branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) lStatu Each manufactured or modular City/State/ZIP: ry dwelling, service and/or feeder 67.84 2 Phone: ( ) I Fax: : ( ) 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 Business name: GMD Electric Inc panel, alteration, or edema ion. Page 2 2 Each additional inspection over allowable in any of the above Address: PO Box 72206 Additional inspection (t hr min) 66.25/ hr 'Investigation (I hrmin) 66.25 /hr City /State/ZIP: Springfield OR 97475 Industrial plant (I hr min) 78.18/ hr Phone: (541) 741 -7369 I Fax (541) 988 -11l 800 Inspections for which no fee is 90.00/ hr Ito specificallylistad (:4 hrmin) MIT CCB Lic �f 162L91 if r r V c icctrical Lie.: 20 -537C iAuprv. Lic3 487 fI '�3 ELECTRICAL PER FEES Suprv. Electrician signature, required: - 1 n Subtotal: 541.66 Plan review (25% of permit fee): Print name: Michael K Gowins Datc :eyo, 63 -,1'2- State surcharge (12% of permit fee): 65.00 TOTAL PERMIT FEE: 606.66 Authorized signature: This permit application expires if a permit is not obtained within 180 I Date: r days after it has been accepted as complete Print name: Michael K Gow' ID4 —OS —1 Z Number f inspections allowed per permit. InE aidrng1Perodts■ELC- Penni1App.doe OipOt/ta Av.-Ai:. ,'(.4.E 440- 4615T(1I,05,COM/WEa Z'd 0091.9861 79 'out 'o!I}oel3 'a'IN'o dg0 :90 Z l LO unr GMD Electric Inc. We Do It the Better Way P.O. Box 72206 Springfield, OR 97475 Phone: 541 741 -7369 Fax: 541 988 -1800 Email: gmd @gmdelectric.com CCB 162191 FAX COVER SHEET TO: City of Tigard FROM: Mike FAX: 1 503 598 -1960 PAGES: 4 RE: Electrical Permit DATE: 06/07/12 & Business License Application Site: 11705 SW Pacific Hwy (Petco Store 212) Hi: We have attached our applications for your processing. The bldg permit # for this site is BUP2012- 00072. Please don't hesitate to contact our office if we need to provide further information. Thanks very much! Sue© 1 •d 0081,886117g . out 'oppe13 .avi. d£0 :90 Z1 L0 unf r 4 Electrical Permit Applica ` i EIVED FOR OFFICE: USE ONLY City of Tigard A�,^�I ���Y( 1 4 2012 Received IN Date/By: /5 (I 7 / Permit No.6� 1: 9491 , 4, �gi o ' 13125 SW Hall Blvd., Tigard, OR'l`f223 Plan Review C Phone: 503.718.2439 Fax: 503. ,1960, Date/By: y /�'r /'rY Other Permit: BUP2012000y1 ?1 Inspectio Line: 503.639.4175 Cl l )G Ut TIGARD Date R B tcri9: 65 See Page 2 for "TIGARD Y y: / �y Internet: www.tigard- or.gov BUILDING DIVISIO Notified/Method: 7 � / Supplemental Information I TYPE OF WORK W ' PLAN REVIEW it ❑ Addition/alteration/replacement ❑ New construction I lease check all that apply (submit 2 sets of plans w /items checked below): ■.: Service or feeder 400 amps or more ❑ Building over three stories. t , ❑ Demolition ® Other: INTERIOR TI where the available fault current ❑ Marinas and boatyards. d CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. 1 - 2 dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ y g ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family . ❑ Master builder ❑ Other: ❑ Fire pump. ® Installation of 75 KVA or (� El Emergency system. larger separately derived system. V JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A " "E ", "1 -2 " "I -3 " ^ t' Job no.: 11512 I Job site address: 11705 SW PACIFIC HIGHWAY 100HP or more. occupancy. t. ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: TIGARD OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than '\ ❑ Hazardous locations. 600 volts nominal. X. ' Suite/bldg. /apt. no.: 2 l Project name: PETCO ANIMAL El Service or feeder 600 amps or more. ^ FEE SCHEDULE Cross street/directions to job site: SW DARTMOUTH ST Description • I Qty. I Fee. I Total I • Z New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. 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 Z�► DESCRIPTION OF WORK • (with above sq. ft.) Limited energy, multi - family 75.00 2 600 AMP SERVICE, 99 CIRCUITS AND 3 SIGNS residential (with above sq. ft.) - t �. Services or feeders installation, alteration, and/or relocation y 200 amps or less 3 100.70 509•/0 2 ❑ PROPERTY OWNER ® TENANT 201 amps to 400 amps J 133.56 )3 3.0 2 Name: PETCO "TIGARD, OR" 401 amps to 600 amps 1 200 • •3y2 T `b 601 amps to 1,000 amps - 301.04 2 I' Address: 11705 SW PACIFIC HWY Over 1,000 amps or volts - 552.26 2 S- City/State /ZIP: TIGARD OR 97223 Temporary services or feeders installation, alteration, and /or relocation Phone: ( ) 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, tension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ® CONTACT PERSON above service or feeder fee, j ' 7 42 g r 3 a �+ 2 each branch circuit / 9 Business name: PERMIT PLACE B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: JAMES MATTHEWS branch circuit Each addl branch circuit 7.42 2 Address: 13400 RIVERSIDE DR., STE 202 Miscellaneous (service or feeder not included) City /State /ZIP: SHERMAN OAKS, CA 91423 Each manufactured or modular - 67.84 2 dwelling, service and/or feeder Phone: ( ) 818.786.8960 Fax: : ( ) 818.230. Reconnect only - 67.84 2 Pump or irrigation circle - 67.84 2 E - mail: jmatthews @permitplace.com _ Sign or outline lighting 3 67.84 Ao3• '?. 2 CONTRACTOR Signal circuit(s) or limited-energy �— Business name: TO BID panel, alteration, or extension. Page 2 2 • Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Investigation (I hr min) • 66.25/ hr Industrial plant (1 hr min) 78.18 / hr Phone: ( ) Fax: ( ) Inspections for which no fee is specifically listed (A hr min) 90.00/ hr CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES Subtotal: I1 t . t Suprv. Electrician signature, required: Plan review (25% of permit fee): q a„, Print name: Date: State surcharge (12% of permit fee): Ads . ,q TOTAL PERMIT FEE: a 3 1l . 17 Authorized signature: This permit application expires it a permit is not obtained within 180 days after it has been accepted as complete. Print name: Date: • Number of inspections allowed per permit. 1:\ Building \Permits\EL.C- PermitApp.doc 07/01 /10 440- 4615T(11/05/COM/WEB