Permit CITY OF TIGARD ELECTRICAL PERMIT
" 1 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00461
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/02/2012
Parcel: 1 S136DA00101
Jurisdiction: Tigard
Site address: 11410 SW 68TH PKWY
Project: PERS Subdivision: PFAFFLE PLAZA CONDO Lot: GCE
Project Description: (2) branch circuits for light fixture and generator •
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Contractor: BEAN ELECTRIC, LLC Owner: OREGON, STATE OF PUBLIC
325 MISTLETOE HILL LN EMPLOYEES' RETIREMENT FUND
ROSEBURG, OR 97471 11410 SW 68TH PKWY
TIGARD, OR 97223
PHONE: 541 - 672 -6550 PHONE:
FAX: 541 - 672 -6550
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 08/02/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/02/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
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Total $71.23
Required Items and Reports (Conditions)
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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 0 1 -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: / / I �P� ,7 O4.
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.
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8/2/2012 11:28 AM FROM: Fax TO: 1- 503 -598 -1960 PAGE: 002 OF 004
RECEIVEt. •
Electrical Permit Application F (MR •
OFFICE USE ONLY - . -
AI. 1 0 2 ?_ 012 ice ived . N7'
City of Tigard � • I Permit Vin.
Iii tY ixac l �� �� � /.2 - ,ti y
a [,i 12 5 SW 1'i;tll Blvd., Tigard. OR 9 7225 Pl• Rcvicvv
pr„fl'tyry ()pluck: ( Hher Permit:
Phone: 503.718.2439 fns: 503.598.1
L �i D u sy
lrsp�`ctio l Line: 503.639.4175 tro p" , Rerdy;By: Paris i H Sec Paget for
TIE7AI tij t''
Internet: www.tislard-or.gov d)
ard- oi.gov DY:L9Lx` =`a13 hJ " °Li ro iGcdMethott 76 Supplemental Information
`- - '43'X' t•lt;t1 -llii ti i'zi-- TYP1 F ;- ' 814 TAg: 3i" ,j. s._ r- � i : .#_T_.s4r -7" ,:.-? t ".zrifk ii PLLAN REV!,'` -`'» . A
- _ r. , �
❑ New construction ❑ Addition /alteration /replacement I Please check all that apply (submit j s seta of piano w•'ihnns chocked below):
i (3 service or feeder 400 amp; or inure El Building o'er tutee sorties. El Demolition Other: where the available fault current 0 Marinas and boatyards •
_' , t. , . , - ,,.
,.� �:1-:. ... �tz Y " a ,^.� -('Y ; (''''XY''1�ir, tt�� 1 t ''' . ' i
--_. :. _Sr,'s r - -.� - �_� . Q_ _. VIA•.• �Y'C -�.ta �''ia.'`+:u�t exceeds 10 000 amps al 150 volts or ❑ Floating building
�r lu >e to nand or r:cu;et!s 14.;)ilii
`' •, gr ❑ Commercial vase agricultural El I - and 2- family dwelling Commercial/industrial ❑ Accessory building amps fbr all other instatlaiions. huildinps. '
• ❑ Multi - family ❑ Master builder ❑ Other: (3 Fire pump. ❑ Installmirm of75 KVA or
. ,. - , S - - .� _ - . : ❑lanerbwrocy5y,tcnL
larger separately derived system. •
t. 496 [7 r.A.PAF4V. TltY- A h <LOC>. 10\ .. , 4 ^ '
�-`Y- �:._::s= r- `._= _�_.� _ �5.� O-,,.-. �.,1 ��_ ��? '�`Ni�T��x:;�++°�"Y.� '>>1Y1.5 ❑ Addition nf new mctnr load of
I-)G31 72,0 J o b site a ddress: j- 100 or nn1re. uarmcy.
Joh ro.:
r (� "f (. .SLt� t,1� . h per k .} a �� ❑ ix er mare residential w:itc. ❑ Re Ovati,mai ,chicle parks.
Ci[y : /SiaLG71P: Tl 90 r` ` o ' (` ❑ Ilealth -care facilities. ❑ Supply voltage for more than
r \ .__... -.. ) 72 - ' 2 ' 3 ❑ Haw-does I:Y.- alions. 600 volts nominal.
1 Suiteibldg./apt. no.: Project name' - � �` , f - sU.r k._ Lc... l' ' - ❑ S,'iv' or der60 or mare.
4 - -) -f1h vE ,w+ us =,- ice r : - f - s 0 amps r'•}c'tk e s �;w; ':F xrr.;-
• Cross street /directions to job site: l:
a *.d. z, r wt; �r - ;: ;., I < y . T otat i g . - ".5,_
J ��,/ S Description i Q7 Fn:. 7 Total ---- ` New residential single- or multi- family dwelling unit.
includes attached garage.
Subdivision: Lot no.:
1,000 sq. ft. or less 168.54 4 l
-- -- E:. add'! 500 sq. Il. or portion 33.92
Tax map/parcel no.:
Limited energy, residential
-- - � ; - .,,. _ys .a:, ;. - . ;,d,.f, -s- - _ .fir br ,z-; .
i 5.00 2
�=� -= =� - =;� 5 ��.5 [ *sGi� [ P� 1 piati�t���Rit= • � :t,o -- : �'�:�.:>.�.�` (with abowsq.:t.)
��Z ... 7�� « 3�' � L.: c:f3
Limited energy, multi-family 1
nil p� .00 I
ItVe Mk f Fix 1: 1 /e. rn� C )f•t'.(,1,4 frorY1 1 residential (with above sq. ft.)
} L
Services or feeders Installation, alteration, author relocation
/ � L - . 1 .2- 200 amps or less d 10070 2
' ' 1 � r Gt,'T � Y 1�9 � �1�•��Ci. p "
J` s s' :•:t,} f; cif -g-- •m _ z'1f L "vl+*•,•; :t7 201 amps ro 400 amps 133.56
❑ eft r�x7� o� %tin' E� a�.rl��� , p- p
_..., _ 401 amps to 600 amps 20034 2
Name: -
-- 601 amps to 1,0(X) amps 301.04 2
I Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
': City /State/ZIP: relocation
' 200 amps or less 59.36 I
Phone: (, ) Fax: ( ) - •�
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 n p ' amps . 59a am s 16(t.54 2 .
intended for sale, lease, rent, or exchange. according to ORS 447. 449. 670. and 701. .- f
Branch circuits - new, alteration, or estension, per panel 1
Owner sigtalure: __ l)-ate: A. Fee for branch circuits nig:
x utiE .. _..__ =_u3 3 r ;g; :' T 'y "'-b :' above ;ceder fee, .42
, .: � : ;f � s PR, r a 7 t>t < „_:::- , ._4t = ... - vl<DD`CO.Pifr9 i�?,`0 �' "tx,k, - . 4 c=0 branch circuit '
Business name: i3 ea r B. fee for branch circuits urlliorit _ -- i •
- -.__ -__.. I J..f:f r) `� � C� ; 'Li ,- , (-'� -_ service er feeder fee, tryst 56.18 1 � .1 �6 .
Contact name: y branch circuit -- -
J / L .. tit r - Each add'I branch circuit 7.42 - n Z
Address: 2):2-5 /) - ") j$ 4- f j fj,1. f'1) 1 f 1.i , I Miscellaneous (service or feeder not included) .
P: 3 C� '` l Each ntanul'ac�wexl
CitylStalc %II -
jC,Sra.W - r c j ' -`11 _ i • d i vvellin„ 6
Reconnect only 67.84 •
Phone: ('�4 / -71 Fax:: n-coft)U
PI wnp or litigation circle 67.84
E -mail: rt(,41[r 2%J•1 (' fri e s. ,•nR'-f- " f I si m outline lighting 67.84 -
.>r-:_: ;r=::,- $:._..: - ; 4 , .a .ta, =- ka ,, 7 • s . � - - - - -t,.Q . i,bs .k ' ' `er,f, *'f t-u i• I Signal c or limited •
Business name.: 7 panel, alienation, or extension. • Page 2 2
kJ�'Ltrl fce�rr I L..1., is _ Each additional inspection over allowable in an • of the above .
Address: 325 ini.s i u i e m } - i l I {.(1 _ Additional inspection (I hr inn) 66.25i i t •
City:StateiZIP: Apse ih( �.f 9 r;-' 1 � Lf "j I Iares igation tl h: min) 6ti.1
1 i - IndusYtial plant tl hr mini 78.18; hr - •
.
Phone: (y (II 1 jt7 •r1_ J tax: )6,12..6 _ Inspections f which no fee is
90001 hr
u (� .
--- _ - specifically listed t`•, hr min2 •
� Lie.: t x 1 S yr J ic.: Z rwe ,,: ELLE G'[AIC G ePPIVF A • i I f i 0 .wit ,rte= - I 3 ?. �, ::; - .::. { ;x.
- + _� % ;1 a i (p g
Suprv. El.ct it ian sib .arc, rcyu red: I' �__� t ,
_ (` � �•-' Plan review (25% of permit fee):
T Print name: )( 0 , - . ~1 \` Drt c. -: `x State surcharge (12% of permit fe): 1 -'. l ' • f -- -,-- TOTAL PERM IT FEE: I { Z6
I Authorized signature ;'
: y ,�y� This i
+,L i is permit application aspires if a permit is not obtained within 180 ^ •
- •r ~ . _ y� �y ~ days after it has heen accepted as completes n r /J�
Print name: I•� ,l/; n V r° ln cail Dare: � 'd? - � Number of in:puGitn,s allowed per permit. / , /'+
t� Duilding\ emusc
- LC- , Pccrmu,:pp.dnc n%'et•to 540r,6151(11:35. CO ?t W'Ell
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8/2/2012 11:28 AM FROM: Fax TO: 1- 503 -598 -1960 PAGE: 001 OF 004
RECEIVED
AUG 02 2012
CITY OFTIGARD
F A X • • • • BUILDING DIVISION
To: City of Tigard
Fax number: 1- 503 - 598 -1960
From: Bean Electric, LLC
Fax number: 541 - 672 -6550
Business phone:
Home phone:
Date & Time: 8/2/2012 11:28:08 AM
Pages: 4
Re:
We are located in Roseburg and will be heading up to do this job on Sunday. Please call me today
so I can figure out how we can get the permits and also so I can give you our credit card information
for payment.
Thank you,
Jessica
Bean Electric and TruEdge Communications
541- 464 -4664
oPAAZ. c: /� 3 v R/->