Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2012 -00416
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 2S101BD00200
Jurisdiction: Tigard
Site address: 8001 SW HUNZIKER RD
Project: Tigard Distribution Subdivision: 1994 -025 PARTITION PLAT Lot: 2
Project Description: (10) branch circuits for new parking lot and exterior lighting
"REPRINT 7/17/12 Corrected Class of Work"
Contractor: WILLAMETTE ELECTRIC INC Owner: TIGARD DISTRIBUTION CENTER LLC
PO BOX 230547 4800 SW MACADAM, STE 120
TIGARD, OR 97281 PORTLAND, OR 97239
PHONE: 503 - 624 -3631 PHONE:
FAX: 503 - 624 -2938
FEES
Quantity Description Date Amount
10 crt Branch Circuits w /Purchase 07/16/2012 $74.20
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/16/2012 $20.99
Type of Use: COM Electrical
Class of Work: ALT 1 ea Services or Feeders - 200 07/16/2012 $100.70
amps or less
Type of Const:
Occupancy Grp:
• Total $195.89
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 OAR 9 ',� I r01 -00 ;0. You may obtain a opy of the rules or direct questions to OUNC by calling 503.2 or 1.80
Issued By: ' � ' / td "' Permittee Signature: D/V !T Pit/ WDLL
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.
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00416
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2012
Parcel: 25101 BD00200
Jurisdiction: Tigard
Site address: 8001 SW HUNZIKER RD
Project: Tigard Distribution Subdivision: 1994 -025 PARTITION PLAT Lot: 2
Project Description: (10) branch circuits for new parking lot and exterior lighting
Contractor: WILLAMETTE ELECTRIC INC Owner: TIGARD DISTRIBUTION CENTER LLC
PO BOX 230547 4800 SW MACADAM, STE 120
TIGARD, OR 97281 PORTLAND, OR 97239
PHONE: 503 - 624 -3631 PHONE:
FAX: 503 - 624 -2938
FEES
Quantity Description Date Amount
10 crt Branch Circuits w /Purchase 07/16/2012 $74.20
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/16/2012 $20.99
Type of Use: COM Electrical
Class of Work: OTR 1 ea Services or Feeders - 200 07/16/2012 $100.70
amps or less -
Type of Const:
Occupancy Grp:
Total $195.89
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 -0090. 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: 0/d APPLi
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 data.
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.
07/13/2012 FRI 13:21 FAX 5036242938 Willamette Electric al 002/002 .
Electrical Permit A li Fo OF lCC use ON Lv
City of Tigard A� Received Pc rmitNo
11 B1v �Q Date/Bv: 7 (g l tz �a- 1,041(0 13125 SW al d., Tigard, OR 97223 Plan Review
' p • Phone: 503.639.4171 Fax: 503 19 2012 Date/By: Other Permit:
• T I G A R D inspection Line: 503.639.4175 Date Ready/By: am 0 See Page 2 for
lntemct: www.tigard- or.gov cl •F T Notificd/Method: '� � Supplemental Information
❑ New construction ® Addition /a taro o z i t deiSteht Please check ell that apply (submit l sets of plans wfitems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition
❑ Other: where lha available fault current ❑ M arinas and boa
tyards
• i b }V P CON aly - exceeds 10,000 amps al 150 volts or ❑ Floating buildings.
:'. less to ound, or exceeds 14,000
❑ 1- and 2 - family dwelling RI Commercial /industrial ❑ Accessory building amps for all other installations. ❑buildiings a]- useagrieulnnal
❑ Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 K VA or
❑Emergency eystom, larger separately derived system.
4 10 :4-. 0. 110$' � '_ '
i'1�d)1T" Addition
❑ of new motor load of ❑ a B ...l _ .. _
{r Job site address /y looilP or more. occupancy.
Job no.:
I tl L^'/ 5 w yr, n 7-��, .+ ,,_ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /StateIZiP' ❑ Health -care facilities. ❑ Supply voltage far more than
�/ r r (� ❑ Hazardous locations. 600 volts nominal.
Suite/bldgJapt. no.: Project name Sr / ❑ Service or feeder 600 amps or more.
T h-4,4. / „r te ...,;,- :
Cross street/directions to job site: Du eription ' "fS . ' ” `
. . . I QtY. � Fee. � Total I -•
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. f . or less 168.54 4
Ea. add'I500sq. ft. or portion 33.92 1
Tax map/parcel no.: i e tia1
75.00 2
Lim tod nergy, redden
1RSCR WORK (with abovesq.fiJ
y - Limited energy, multi- family 75.00 2
N e Gt ( C,,^ /'j /he. 4 0 / oL iC Ake -A4' •� residential (with above sq. it.)
/ e 7' Services or feeders installation, alteration, and/or relocation
L J in G-. 200 amps or less / 100.70 fir;, /`. 2
Q PROPERTY OWNER 0;, 'ENANT 201 amps to 400 amps 133.56 2
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
City/StateJZIP: Temporary services or feeders installation, alteration, and /or
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 166.54 2
intended for sate, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits -new, alteration, or extension, Qer panel
Owner signature: Date: A. Fee for branch circuits with
area
: [] '
, .,. � . , . . ' 1,5�� : /0 7.42 � 2
a oveservlw r ee •� �
. ...: - each blanch c
Business name: B. Fee for branch circuits without
service or fee der fee, first 56.18 2
Contact name: branch circuit
. Each add'' branch circuit 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: ( ) I Fax :: ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
Signor outline lighting 67.84 2
_ . • _1YOiy;1`, it Ol : :;: , :'- ' Signal circuit(s) or limited- energy
Business name: Willamette Electric Inc. panel, alteration, or extension. Page2 2
Each additional inspection over allowable in any of the above _
Address: P.O. Box 230547 Additional inspection (1 hr min) 6625/ hr
City/State/ZIP: Tigard, OR 97281 investigation (1 hr min) 66.25 / hr
Industrial plant (1 hr min) 78.18/ hr
/CCB Lie.: 75059 lectrical Lic.: I 34 283C ) i 6 prv. Lic.: 4226 -S . s hrmin) � T , :: ,1-
Phone: 503 624.3631 Fax: 503 624 -293 Inspections for which no fee is
c ----- Subtotal:
% 7 / .,•='
Suprv. Electrician signature, requ' e
Plan review (25 /o of permit fte):
Print name: David Fife ' Date: 1`/ / /-?� State surcharge (12°/ of permit fie): '2 6
Authorized signature: l (( TOTAL PERNIIT FEE: / �s
This permit application expires If a permit is not obtained within 180
Print name: I DatC: days after it has been accepted as complete.
Number of Inspections allowed per permit.
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