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Permit CITY OF TIGARD ELECTRICAL PERMIT "a COMMUNITY DEVELOPMENT Permit #: ELC2012 -00482 T [GA R C5 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/14/2012 Parcel: 2S 101 AA09100 Jurisdiction: Tigard Site address: 12447 SW 69TH AVE Project: Capitol One Subdivision: WEST PORTLAND HEIGHTS Lot: A Project Description: (3) branch circuits for kitchen Contractor: COCHRAN INC Owner: TIGARD CORPORATE CENTER LP 7550 SW TECH CENTER DR #220 15325 SW BEAVERTON CREEK CT TIGARD, OR 97223 BEAVERTON, OR 97006 PHONE: 503 - 234 -6564 PHONE: FAX: 503 - 238 -2098 FEES Quantity Description Date Amount 3 crt Branch Circuits wo /Purchase 08/14/2012 $71.02 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/14/2012 $8.52 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 • 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 - 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: ��� P4 Permittee Signature: Q 1 r Li P 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 11 14 • I , fir Permit #: ELC2012 00482 COMMUNITY DEVELOPMENT Date Issued: /2012 08/14 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 8 100 Jurisdiction: Tigard Site address: 12447 SW 69TH AVE • Project: Capitol One Subdivision: WEST PORTLAND HEIGHTS Lot: A Project Description: (3) branch circuits for kitchen 8/28/2012: REPRINT permit to add (2) 200 amp or less service and (10) branch circuits. JOB NO. 410812 -31085 Contractor: COCHRAN INC Owner: TIGARD CORPORATE CENTER LP 7550 SW TECH CENTER DR #220 15325 SW BEAVERTON CREEK CT TIGARD, OR 97223 BEAVERTON, OR 97006 PHONE: 503 - 234 -6564 PHONE: FAX: 503 - 238 -2098 FEES Quantity Description Date Amount 2 ea Services or Feeders - 200 08/28/2012 $201.40 Specifics: amps or less 13 crt Branch Circuits w /Purchase 08/28/2012 $96.46 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 08/28/2012 $35.74 Electrical Type of Const: Occupancy Grp: • Total $333.60 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 -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 B Permittee Signature: en/ i°l ,r e��� ^ Y� 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. 01 15:24:50 08-13-2012 1/3 Electrical Permit Application RECEVE' ) Received LOR 01 l'S1.1 ONLY City of Tigard Date/By: 2fI (4113- SA Permit No.: " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 1 11 1 Phone: 503.639.4171 Fax: 503.598.1960 AUG 1 3 2012 Date/By: Other Permit: . 1 6A If) Inspection Line: 503.639.4175 Data Ready/By: Internet www.tigard-or.gov .--...TITn. /), li V Notified/Method: juJiti(0 SupSpeelemPaegnetallfonrformation . : ':..";.;:.: il'ii.r. .....N:C :, C El New construction jiglAddition/alteration/replacement Please check all that apply (submit Z sets of plans w/items checked below): ['Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. 1;:;!......;.::. ' . .....,,;:w'',. : ' , ,..Y.,:.:,q"::....::„: . ".::;' , .:'.. ; .. exceeds 10.000 aMps at 150 volts or 0 Floating buildings. Ej i- and 2-family dwelling ACommercial/industrial 0 Accessory building amps for all other installations. buildings. 0 Multi-family 0 Mr builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or • , .JOB. SiTE . . .,. ...... . ... . i ', HAD:cm:ion sYste Ltor load of 0 :f : system. Job no.:3.4025 Job site address: /2 w1 $o 6f-4 A.e., 100HP or ntore. 0 S ix or more residential unit& occupancy. 0 Recreational vehicle perks. ' City/State/ZIP: c rikfro b 1,-- Q 7z23 0 Health-care facilities. 0 Supply voltage for more than 1:1 Hazardous locations. 600 volts nominal. Suite/bldgJapt. no.: Project name: 1 2 4 1 .... , 13Service or feeder 600 amps or more. ' i:'."2': S '.:;;.. Cross street/directions to job site: 9( 7/4)y.1 1- , Description . i Q17. I Pee. I Toto1 I • New residential single- or multi-family dwelling unit. • =Sbt gt t7,941.?) Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 16834 4 Ea. add'I 500 sq. ft. or portion 33.92 1 Tax map/parcel no.: _ Limited energy, residential • • , . ' .: .... . ' . r DESCRIPTION OF WO*, . '. . .' (with above sq. ft.) .75.00 2 Limited energy, multi-family .006/Z — ./0,0 - .57 - 1)Z-Z- . . 5 neR) esi/zeitis residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation , IL k/rmifit/ 200 amps or less 100.70 '2 0 .I , ::::,:::,.,]:.:... :..,..: -:, . .....: .,...:. 201 amps to 400 amps 13156 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and/or City/State/ZIP: relocation Phone: ( ) I Fax: ( ) 200 amps or less - 1 59.36 I 1 201 amps to 400 amps 125.08 Owner installation: This installation is being made on property that I own which is not 22 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 Branch circuits — new, alteration, or extension, Rer panel Owner signature: Date: ci A. Fee for branch circuits with ,4%eogANT .‘ ,. ! . .cr' . ..r .. :„ .. : oii. ' :.: ,..::: ,.,...o.o.s...tAo...tog e ..:: X above bravenh service or feeder fee' 7.42 2 Business name: 0964e/4/1 . . B. Fee for branch circuits without — . — service or feeder fee, first / 56.18 i6 Contact name: ra k... hk ... t. ' u... branch circuit Each add'I branch circuit Address: Miscellaneous (service or feeder not included) Each manufactured or modular City/State/ZIP: dwelling, service and/or feeder 67.84 2 Phone: (T7/ ) 2! ' zi 0,1 Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E Sign or outline lighting 67.84 2 ., ...... . CONTRACTOR . , : • - , Signal circuit(s) or limited Business name: 7 panel, alteration, or extension. Page 2 2 ext,k. .) . Each additional inspection over allowable in any of the above Address: 7 5 50 ,SW ( &I C ,ert , *220 Additional inspection (I hr min) 66/5/ hr Investigation (1 hr min) 66.25/ hr City/State/ZIP: .- Titka_ Ca O 9 72 2- . 1 Industrial plant (I hr min) 78.18/ hr Phone: 91/ z,,,,,,4 9 Z.. yz... Fax: ( 9'21 6/.$ e - / Z‘o.f3' speci Inspe fically eh hr mi ctions for which no fee is 90.00/ hr listed n) CCB Lic.: 1 2_ 4Z Electrical Lic.: 75 L 7 4 c _Suprv. Lic.: 34473 : - -. Suprv. Electrician signature, required: \c■-k Plan review (25% of perm Print name: Ketr.n - On 0. p z') Date: g__/ State surcharge (12% of permit fee): g„z; TOTAL PERMIT FEE: '2 9 , „ Authorized signature: / ,e : cf This - perm it application expires If a permit Is not obtained within 18 days after It has been accepted as complete. Print name: Yg4 fre die Date: 84,3.-/z._ • Number of inspections allowed per permit. t liuildinftPamils•E LC- Perm hApp.doc 07 I 10 440-46157(111.5,COANWEB 01 09:22:55 08 -28 -2012 1/4 t..L� —'t 1'vv 1• Electrical Permit Applicati ,� � Ei$VED FOIt (1PP1('I.: l SI: ()M.\ .\ City of Tigard R,,, }}}//// Received Date/By: Permit No.: �lnl7 rV8�J _ 13125 SW Hall Blvd., Tigard, OR 97223AU G 2 8 2012 Plan Review Ge/ G Gf v l'!J Phone: 503.639.4171 Fax: 503.598.19 Other Permit Inspection Line: 503.639.4175 ± Date/By: e; n It 17 Internet: CITY T OF Tom® Note Rd/ echo: luris Internet: www.ti rd-or ov ' Y !?I See Page 2 for 7 I www.ligard Notified/Method: Supplemental Information 0 New construction r '. dition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Demolition Athei ❑ Service or feeder 400 amps or more ❑ Building over three stories. r . ; ,, where this available fault current ❑ Marinas and boatyards. " i ... ' CAT 'F ;CQNS773UGT101!r, ;• ''" '' exceeds IO,000am sat ISO ..., .r• �'•, ` i.� �` ': ... ..,,: •., ./ i : ' �" s C` - ' . : : _ '� ' �',•` P tsar ❑Floating buildings. ID 1- and 2-family dwelling ommercial/industrial 0 Accesso building less to for orexceed 0 ❑ Commercial -use agricultural ry g amps for all other installations. buildings. ❑ Multi family Master builder Other: ❑F�pump. or ......... . IL $ _30B. INFO ❑ gen em. largerseparat separately D' /fi ,,RRIATI0 AN D .LOCATION . .. Addition 4 system. ❑ mono new motor load of ❑ "A ", "E', "1 -2 ", "1 -3 ", Job no.: L oe Job site addt'ess :` Zg(f7 _54 /f lU Lip 100HP or more. occupancy. ey �e-r ❑Six or more residential units. ❑ Recreational ationion al vehicle parks. City/State/ZIP: - 776,A1 � �� J� !/ ©le 97 2 - 23 - ❑ Health-care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg, /apt. no.: 1 Project name: 4p/ � G ❑ Service or feeder 600 amps or more. Cross street/directions to job site: 50 . ,� -e/An f K , , cF— ': n I Qt cf ; I � ;:; :FEE:.'$CHEDUt;E ee. � T • .. or t _ ] � , ` D ": r, F ee i , , ';,:. Total • I / - -. - family dwelling unit. ..sti.iiiteiCr °�� �/��• �� � New I residential a tta c hed single -or garage multi ,v) �'X ksT.1'� 6 1 t�a' .- 1,000 sq. ft. Or lei 168.54 4 Tax map /parcel no.: Ea, add'I 500 sq. ft. or portion 33.92 1 Limited energy, residential 75.00- DESCRIPTION or WORK (with above sq. R) 2 � Limited energy, multi -family lr DhP9 0 - 3 ! /D 49 - 4P it) 2 7�11 /��, /f ,� 1 a residential (with above sq. ft.) 75.00 2 �t/ �i [ liQ1�lC.r! l S 00 amps or feeders installation alteration, and/ . .... ,' ... 100.70 0 n alteratio or relocation ❑. PROPERTY OWNER• ' . . r �:'.. ; . ,.. �, ®�TENANT�, .. 201 am t 4 00 amps 13156 2 Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less . 2,... 59.36 //f4 7 . t Owner installation: 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: P ❑, A. Fee for branch circuits with APP1IC ANT . above service or fader fee' 7 'I ,. .,i� , ' :' ;��),• CONTACT•, ERON • a ' ` 7.42 777.1) 2 �^� S each branch circuit ` Business name: J�1-me� ciS C _..L _ _ B: Fee for branch circuits without - l � service or feeder fee, first Contact name: brunch circuit 56.18 2 Address: Each add'I branch circuit 7.42 2 Miscellaneous (service or feeder not included) City / State/ZIP: Each manufactured or modular 67 2 dwelling, service and/or feeder Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 ' . . • Signal circuit(s) or limited-energy Business name: h n panel, alteration, or extension. Page 2 2 C C J O � ( , � Each additional inspection over allowable in any of the above Address: J k � n / `(� - # , Z D Additional inspection (I hr min) 66.25/ hr City/ State/ZIP: (t \G- 2l OR q 72. Z �f 2 c71 investigation hr min) 66.25/ hr --- Phone: �f 97/ 2 `� In spect i onsfo t(I hr min) 78.18/hr • 7� �� �� �� Fax: i }sup 8 inspections for which no fee is l-� � + specificallylisted (h hrmin) 90.00 /hr CCB Lic.: 7Z 'jt-/Z I Electrical Lic.: 754/6, CI Suprv. Lic.: jLLLf. /t-J .,..). :.,';"•' ELECTRI. CAL.;PERMIR`' . l9 z , yz„ .F.EE$.. ;•: _ Plan re _ Sub Suprv. Electrician signature, required: ' ''' S -- y Plan revi ... ew (25% of permit fee): Print name: Kenn k I h f • Date: ,.) 40 , State surcharge (12% of pennit fee): , f Authorized signature 6/ /p Q , TOTAL PERMIT FEE: _ This'permlt applicatio expires If a permit is not obtained within 180 Print name: Yo n t° 1 days after It has been accepted as complete. n � / C I \ Date • 63 —` 2' • Number of inspections allowed per permit. R' /,CST A �O us I'Buitdiag -P ' App.doc07,01.10 440- 4615T(11,05.COMrWEB P‘gY/- f EA/ T N� �974 W7 Z C.477 4P. 5/ el& 01 09:23:23 08 -28 -2012 2/4 Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other. COMMERCIAL WORK ONLY: . . . Fee for each commercial $75.00 system (SEE OAR 918 -309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations T RuilelinoPr,. . 1 t-P,s,,,iA,,n n, 07101 nn