Permit CITY OF TIGARD ELECTRICAL PERMIT
• - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00438
T I. G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/24/2012
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST
Project: Plaza West Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: Install (4) branch circuits for (2) airhandler and (2) roof top unit connections
Contractor: BOB'S ELECTRIC Owner: SUN LIFE ASSURANCE CO OF CANADA
2700 NE BURTON ROAD STE A BY NORRIS BEGGS & SIMPSON
VANCOUVER, WA 98662 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 360 - 254 -7200 PHONE:
FAX:' 360 - 254 -8219
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 07/24/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/24/2012 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 -001 -0010 through OAR 52- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 o)� I 1987 or 1.800.332.23 Al Issued By: Permittee Signature: f 01 1: . f 0Al
OWNER INSTALLATION ONLY ,v /�
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
FROM (SAT)JUL 21 2012 4:19/ST. 4: 18 /Mo. 9302926833 P 2
RECEIVED i
i
Electrical Permit Application FO)It (11 1 IC1•: I ti1•: (1.1 .1
City of Tigard JU L 2 3 2012 ;iiilli ....a llill Permit Na.:
13125 SW Hall Blvd., Tigard, OR LPiJo) , -017(ey':
Phone: 503.639A 171 Fax: 503 n W F'TIGARD e • W other Penn %t- , I Z - » (.4, ,. i , ) In Line: 503.639.4175 B u u.DING DIVISION �� Ready/By ® See Page 2 for
Internet: www.ligard-or.gov Notrfiod/Metb MI Supplemental Information
r ,,,r
ti :
0/" e _... _-'-.- _._.t .,C .. - .- __.$.. .:', ' . - u ... _ .5r__ .. .:,a : "t. .,7_ . - : -- .1:- �
❑ New construction ® Addition/alteration/replacement Please chock all that apply (submit t sets ofplans wrdems clucked belo
El Servtcc or feeder 400 amps or more ❑ Building over three stories.
❑ DemOlitiOn ❑ Ot}
T----R-F-____ where air available fault current ❑ Marims and boatyards.
����
_ .... R ` , n v r F exceeds 10,000 amps al 150 volts or ❑ Floating buildings.
_ .', s l - . ' `. n lets to gmurd, or exceeds 14,000 ❑ Commercial -use agricultural
❑ I - and 2- family dwelling ®•tommerciaVindusttial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
1"'-= m l r ... "?? ,r rc t F r -1 , 13 Emergency system larger separately derived system.
z , 8 v
c: �- .... � ._,.,_, _ . ....1: � _ . :�.rl.� ;:- r { : ,.. ., __. . ...__ .•. , t . , . _ _, ❑ Addition of new rnoNr klad of ❑ «A••, «E••, «1_2 ", «1_3«
100HP or more. occry.
Job no.: 12 - 21 Job site address: 9600 SW Oa , ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/Z[P: Ti_and OR ❑pHazardouslocations. voltage for
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more
Cross street/directions to job site: 5 !: ., -. _,.__1;' y. .. s 4,ti .i ,.
Dealptloo ^. ' Qty. Fee. Tatar •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
Limited energy, [+� .'r ;� r. '' , ri i r +-;. v� t r 't '• r : �' '.S, , , �` , - (wilt above q IL ) nttal 67.84 2
C:S -F�. L1.. s . 1' 6 , ., ..,.an ,, 4 , - . 4 . a 4 ...I.. . .. e_._ ._. _T-t.: - .. ? q _ _d: Limited energy, r ti-family •
residential (with above sq. ft.) 67.84 2
• 2 Airhandler 6 2 Roofto• unit connections ServicesorfeedersInstallation zalteration,andlorrelocation
200 amps or less 100.70 2
gd .4 ' i r0/ I +$ P' -, M .. .e. , _� ir�� a -
h . .i u r' ' 1 201 amps to 400 amps 133.56 _ 2
I .f.�� _ . _ x .. . `C,t._ 4 .J0/. v. _ . ... . 3.w _tY ,.� ., 3� ; ...C.�.li ..-r w.4 +2 4. . . . . . - .r.. .. . ..f i
401 amps to 600 amps 200.34 2
Name: Plaza West 601 amps to 1,000 amps 301.04 2
Address: • • l , S ` 0 . Ova 1,000 mops or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP: Ti: and OR relocation
Phone: ( ax ( ) 200 amps or less 59.36 I
503 ) 80 e : , _ ... F 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 o 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, r panel
Owner signature: Date: A. Fee for branch circuits with
pi s� ry, , r: a ( - , l r +' , r , , ab eh brarv e m feeder fee,
T , .. , 7.42 2
r . r. ..... : 1,¢,,k� .. +. _.:. �>c ., „ �... � .._ ,- .... o ,.:.. .i L 3[ f _ efl el Il l
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 5 6.18 2
Contact name: branch circuit
Eachadd'Ibranchcircuit 3 7.42 22.26 2
Address: Miscellaneous (service or feeder not included)
City/ State/ZlP: s Each manufactured or modular 67.84 2
dwelling, service and/or feed
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mall Si or outline light 67.84
--��r !Y 1 -{ _ w K L l t 2. - _.r"e U .`••.�� =i.`•` � -�..�� L L a 6" � 2
5,, .., i t.,_..:, . r , t_ :'.. _� mot_. .._`M , cT _ ' i _ - .-r:: ..-'a Signal circuit(s) or limited - nergy
panel, alteration, or tenston Paget
Busins name: Bob's Electric Each additio ral l s 2
es
pection over allowable In any of the abov
Address: 2700 NE Burton Rd. Ste. A Additionalinspection(1 hr min) 66.25/hr
Investigation (1 fir min) 66.25/ hr
±- • • - - Industrial plant (I hr min) 78.18/ hr
Phone: ( 360 ) 254 -7200 Fax: ( 3. 0 )254 -8219 Inspections for which no fee is 90,00 /hr
fical listed ''A hr min
a e ectrical Lic.: 37- A , prv. Lic.: 43225 -,:,:: -s' : �: -_ _ _ °'�';s= aja : _ FX
Suprv. Electrician signature, requi • ` Subtotal: 78.44
Plan review (25 % of permit fee):
Printname: Kevin Broselle Date: 7/20/12 State surcharge(12 %ofpermitfee): 9,41
TOTAL PERMIT FEE: 8 7.8 5 i /
Authorized Signature: This permit application expires If a permit is not obtained within 180
days after h has been accepted as complete.
Print name: Date: • Numher of irspectiors allowed per permit
INiuOdieePermits 5LC- PermitApp.doe 10/01/09 440.461ST(11i05 /COMM'EB