Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00315
• Date Issued: 06/24/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 25101 DD00101
Jurisdiction:
Site address: 6975 SW SANDBURG ST
Subdivision: Lot: 0
Project: VERIZON WIRELESS
Project Description: 4 branch circuits dor HVAC equipment
Owner: FEES
WESTON INVESTMENT CO LLC Quantity Description Date Amount
2154 NE BROADWAY, STE 200
PORTLAND, OR 97232 4 crt Branch Circuits 06/24/2009 $66.80
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 06/24/2009 $8.02
Electrical
Contractor:
MCCOY ELECTRIC CO INC
2014 SE 9TH AVE
PORTLAND, OR 97214
PHONE: 503 - 234 -7521
FAX: 503 - 234 -9473
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $74.82
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 52- 0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
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 an Inspection that business day.
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.
Per. Jun. 23. 2009 .11:13AM , M iiitoD R med No. 3071 P. 1
E im :Li-mai r cru ^City iii ttip oo FOR OFFICE .. , o •
1 of Tigard Dards. I 1 o.: [ � GZapj -- UO �Z1S
13125 SW Hall Blvd., Tigard, OR 9).1.11m 2 3 2009 Plan Review
Phone: 503.639.4171 Fax: 503.598:7'980' Date/By Other Permit.
-
TIGARD Inspection Line: 503.639 Date Ready/By: lws: 0 + See Page 2 for
Internet: www.tigard•or.gov CITY OF TIGARD . Date - Supplemental Informaden
' . -.t ., o. .. " r...- qi*;' - .. c'�r• •'ra - - zrr - " "�'" - _ ___.._ -
�••� -tt. . _ � �t� �� � . 7�= i 1 a r !� ��s �.r_ .' "wc�.i�c,T�C` .i.k� ��•1: �� � �:w° �- '�::_:
❑ New construction . Addition/alteretion/replacement Please check all that apply (submit 2 eels of plans wfitems checked below):
❑ Service or feeder 400 amps or more ❑ Balding oatr three stories.
0 Demolition ❑ Other: where the available fault current D Marinas and boatyards.
_
-,``°` =' "- ..0. •' `c � "�"" =� " ',.., exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
1' ;�r ..:�;�.:,,.:......e; e.raa .t;.�.. c.:.�me ,..' .•�'• �� = °--= •2:' =' loss to ground, or exceeds 14,000 ❑ Commuciel•ose agricultural
❑ 1- and 2- family dwelling ►_ CommerciaWindustrial ❑ Accessory building amps for all other installations. buildings,
ID Multi-family 0 Master builder ❑ Other: D Fitepump. ❑ installation of751.VAor
s it -• > • , F r - r r :.- ❑ Emugency system. larger separately derived system.
[., _ . _ .i x _.,. I,S� �
l - �, s DAdduion of new motor load of ❑ "A ", "E ", "1.2", "1_9 ",
Job no.: / ! I 8 Job site address: _ 10DHP or more. oaupa Li
�_ ` L , ❑ Six or more residential units. ❑ Recreational vehicle parks. y.
City /State/ZIP : - 4 . ; 1 O Heahh•carefacilities. D Supplyvoltage for morethan
�. ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt.no.: I Project name: •1pr - ■ O S c rviceorfeeder600ampsormore.
��..
".. SCS.:•• � h� Gf � „- � :'�':. <:., := 4>:^ _f1
Cross street/directions to job site: Description O. Pea. total •
•
New residential single- or multi family dwelling unit.
_ Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R. or less 145.15 ' 4
Tax map/parcel no - Ea. add•I 500 sq. ft. or portion 33.40 1
n : T�•.2 • Limited energy, residential
n, c. ewe- �
t d i'it G : r r" � 75.00 2
: _s T y4 _ `- ;r ' .,� Q, .MI ?..' .; -:-', ;_,. ;- r_: Swish above Ell R.)
�L ' Limited erg }•, muifamily I I 75.00 2
C Vk \r •AC/ e(')I () I P re ent ;wim above lt aq. fl.)
1 r Services or feeders installation alteration, and/or relocation
__ 200 amps or less _ 6 80.30 2
" . 3 - .. , .. l k. •t • r- � - -, -_ - _ - "tfd ?� u _. i =` -= -:? =- 201 amps to 400 snips 106.85 2
Name: 401 amps to 600 amps • 160.60 2
. 601 amps to 1,000 amps . 2
Address: Over 1,000 amps or volts - 1 454.65 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1 •
• Owner Installatlont This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits- new, alteration or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
_
:;•cam _` .�-•. ' d �oY;lc �q. n, 1h,. • 1..e� . ■ 'G I I I:p . 0 ` n", u above service or feeder fee
mss:_ . -_ _ _� � � - -_- :...... -•:7 � _:: :: 6.65 2 • each branch circuit
Business name: McCoy Electric B. Fcc for branch circuits
Contact name: Kell!
without service or feeder fee, 1. 46.85 ��• t 2
first brdich circuit
Address: same Each add'! branch circ 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: same Each manufactured or modular 90.90 2
dwelling, service andlor feeder
Phone: (503) 234 - 7521 I Fax: : (503) 234 - 9473 Reconnect only 66.85 2
E -mail: ksloper®mccoyelectric.com Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
Business name: McCoy Electric Signal circuit(s) Or limited-
. energy panel, alteration, or
Address: 2014 SE 9 Ave extension. Describe: Page 2 2
City /State/ZIP: Portland, Or 97214 Each additional inspection over allowable in any of the above
- Per inspection 62.50
Phone: (503) 234 -7521 Fax: (503) Z34 -9473 Investigation per hour(i hr min) 62.50
CCB Lie.: 8277 44 4 /,4 / Electrical Lie.: 26 -82C rSuprv. Lic.: 2175S I r Industrial plant per hour 73.75 _
k . 7‘g l � � ' ;r.r, �__ : J .W ' 2 .. a
Suprv. Electrician signature, required: K. �, Subtotal: t t i • -
Print name: James R. Hall s ; Plan review (25% of permit fee):
•t State surcharge (12% of permit fee): , Q 7
Authorized signature: TOTAL PERMIT PEE: 17 t $2.
'ILIa permit application expires if • permit is not obtained within 180
m Print name. bate. days after it has been accepted as complete
Number of inspections allowed per permit.
ftBu ng \Permhs\ELGPermi 440.4615T1I1AS/COMJWEu