Permit CITY OF TIGARD ELECTRICAL PERMIT
1 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00403
T C G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/09/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: American University Subdivision: VARNS ACRES Lot: 9
Project Description: (5) branch circuits - remove existing light fixtures and adding new fixtures
Contractor: E C COMPANY Owner: TRIANGLE POINTE LLC
PO BOX 10286 901 NE GLISAN ST, #100
PORTLAND, OR 97296 PORTLAND, OR 97232
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
Specifics: 5 crt Branch Circuits wo /Purchase 07/09/2012 $85.86
Service or Feeder
1 ea 12% State Surcharge - 07/09/2012 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OA 9 2 -001- 90. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: lOI j, #PP1 ' 6 / 4 LD,L
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
• Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each Inspection.
Jul, 9. 2012 1:08PM RECE IVED No, 0819 P. 1
Electrical Permit ApplicationJIjL 0 9 2012 MR ()FFI( t'SI.: O.\1.1
City of Tigard Received Permit N
q 13125 SW Hall Blvd., Ti L. 4 �. OF Ii : , Da' k . a � - 0014,9‘.3 — `N C Phone: 503.639.4171 Fax Si 71: t j, l; - P D I a LRevtew Other Permit —
GDIVISION) : Permit/a,
t 1 t : fl p Inspection Line: 503.639.4175 Date Reedy/By:
Internet www.tigard- or.gov Noti6e d/Mabed: INEZ Supplem$vc Pamtage l 11nfor formatiou
T YPE OF WORK PLAN REVIEW •
❑ New construction El Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wfirrms checked below):
❑ Demolition ❑ Other:
❑ Service or feeder 400 amp or more ❑ Building over three stories
when the available fault current ❑ Marini and boatyards.
CATEGORY OF CONETREIC.TION " . exceeds 10,000 amps at ISO volts or ❑ Floating buildings.
❑ 1 - and 2-family dtvelling ® COtnmCTCiSUinduslrial less to ground, or exceeds 14.000 0 Commercial-use agriculroral
❑ Accessory building amps forall other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. Cl tnsteahon of 75 I:VA or
❑ Emergenky system. Niger separately derived system.
• JOB SITE INFORMATION' AND' LOCATION ['Addi of new motor load of ❑ "A ", "E',"1.2", •1-3
Job no.: 7 4 64 5 I Job site address: 13333 SW 68th pkwy O om r e r sidential units. ❑ RR oo vehicle parks.
City /Slate/ZIP; Tigard OR O Health-care facilities, ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suitc/bldg. /apt. no.: of 0 I Project name: National nmerican university ❑ Service or teeder 600 amps ormore,
• FEE SCHEDULE •
Cross street/directions to job site: nerrtieaao I Qa. I Fee. I Tau I •
New residential single- or mull- ramlly dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. tL or less ' 168.54 4
Tax rnnp/parocl no.: Fa add'I S00 sq, R. or ponion 33.92 1
Limited energy, residential 75.00 2
D)?,SCRIPTION OF : WORK • `: (with above sq. A.)
Limited energy, mutti - family
Remove existing light fixtures and adding residential (with above sq. (I)
75.00 2
new fixtures Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
PROPERTY. OWNER • ' I . ❑ TEtYA ∎lit ' . . 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 2002 2
601 amps to 1,000 amps 701.04 2
Address: Over L,000 amps or volts 552.26 2
City/State/ZIP: — Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner ins tallation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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. Poe for branch circuits with
.: ® . APPucANT • . • I • ❑' CONTACT..PF1%SON above service or feeder fie.
• each branch circuit 7.42 2
Business name: . EC Company B. Fee for branch circuits $56.10
service or feeder fee, first 1 56.18 2
Contact name: Ka thy Kelley branch circuit
Each 4 7.42 $29.60 2
Address: PO BOX 10286 Miscellaneous (service or feeder not included)
City /StatelZIP: Portland OR 97296 Each manufactured or modular - 6784 t 2
r dwelling, service end/or feeder
Phone: (5 0 3) 224 - 3 511 Fax :: (5 0 3) 295-3012 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: kathyk @e -c -co , com sign or outline lighting 67.84 2
CONTRACTOR . . . . • Signal cireuit(s) or limited-energy
Business name: EC Company paneL alteration, or =tension. Paget 2
Each additional Inspection over allowable in ant• of the abov
Address; PO Box 10286 Additional inspection (I hr min) 6625/ hr
City /State/Z1P: Portland OR 97296 lnvosl igation(Ihrmin) 6112$/hr
Industrial plant (1 hr min) 78.18/ hr
Phone:(503) 224 -3511 1 Fax: (503) 295 -3012 Inspecllans for wh;ehnofeeis
sLeciftcally listed (kA hr min) 90.001 he
• atB Lic,: 49737 I)2CectricalLie, :2 - 45C I t rv,Lie. :'Z,5ti5�S .• ELECTRICAL PERMIT .PEFS `
Suprv. Electrician signature, requi • t. _. Subtotal; $85 , 86
Plan review (25% of permit !be):
Print name: Ron Co f f man i AIIMi I I Date: 07/9 / 2 0 1 2 State surcharge (12% of permit fee): $10.30
Authorized signature: [` , M e j TOTAL PERMIT FEB: $96.16
u....... _ r`��J +.� ThIS patmil application j ill-es Ir permit t not obtained within ISO
Print name: Anna Ht3tt Date: 07/9/2012 a daysaferIthasbeanacceptedascomplete.
Number otinspecrions allowed per penml
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