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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2012 00483 T t GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/15/2012 Parcel: 2S102AC01704 • Jurisdiction: Tigard Site address: 12720 SW PACIFIC HWY Project: Tigard Plaza Subdivision: BURNHAM TRACT Lot: 1 Project Description: (6) branch circuits - replace receptacles and make repairs to grounding in panels. Contractor: E C COMPANY Owner: LARAWAY, JOSEPH CHARLES TR PO BOX 10286 3370 RACHEL WAY PORTLAND, OR 97296 HOOD RIVER, OR 97031 PHONE: 503 - 224 -3511 PHONE: FAX: 503 - 295 -3012 FEES Quantity Description Date Amount 6 crt Branch Circuits wo /Purchase 08/15/2012 $93.28 Specifics: Service or Feeder 1 ea 12% State Surcharge - 08/15/2012 $11.19 Type of Use: COM . Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $104.47 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: ©� I'TPGLlGA id )1/41 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. Aug. 13. 2012 3:56PM No. 1133 P. 1 • Electrical Permit Apnlicat►wlFi E suit orrit:a: I'SI. ONLY City of Tigard moved •�� •' ,� -- 13125 SW Rah Blvd., Tigard, OR 99zi31 2 0 12 Da,. Q FemtitNd.ZL47'4 P-'004 Phone: 503.639.4171 Fax: 503,598.1960 3 D at Review Other Perrni,: I' 1 d A It 0 Inspection Line: 503.639.4175 CFfY G /y Dare y Ready/B r• RI See page 2 for Internet: www.tigerd•or.gov i d ®�IVl71IiD NoriilediMemod ■ Po Supplemealallnforntalbn TYPE OFF ~ 1'if1lltlr 11 �'' • . PLAN REVIEW ❑ New construction RI Addition/alteration/replacement Please check all that apply (submit 2 sets ofplans wf terns checked below): ❑ Demolition 0 Other: ❑ Service or feeder 400 amps or more 13 Building overstate stories. whets the available fault aernal 0 Marinas and boatyards. ' CATEGORY .OF CONSTRUCTION . exceeds 10.000 amps allsOvontor ❑ Floating buildings. El 1 artd2•faniil dtvellin less to ground, or exceeds 14.000 ❑Commercial-use agricultural Y g n Comniercial/industrial ❑ Accessory building amps (orall ether installations. buildings. ❑ Multi- family ❑ Master builder [] Other: ❑ Fire pump. Jrnstalletionof75 KVAor JOB SITE INFORMATI AND LOCATION ❑ Emergency system. Itagcsepar separately derived system. • ❑ Addition or new motor load of ❑ "A ^, "o', "1.2r. "1 -3" fob no,: 74659 -01 I Job site address: 12720 SW Pacific Highway 10OHPormom. occupancy. Six or more residential unln, ❑ Recreational vehicle parka. City/State/ZIP: Tigard OR 97223 IJ Health -care facilities. ❑ Supply veltase for mnre than ❑ ffererdous locations. 600 volts nominal Suite/bldg. /apt. no.: I Project name: Tigard Plaza ❑ Service orreeder600 amps ormom. FEE SCHED ' Cross street/directions to job site: mama.. I err. I Prw I 'raw I • New residential single- or multl.famlly dwelling unit. Includes attached garage. Subdivision: Lot no.: 1 .000 sq. ft or less 168,54 I 14 Tax ma Ea. add'l 500 sq. R. or portion 33.92 1 p/parcel no.: Limited energy, residential ' ' " DESCRIPTION OF WORK . - Swith above sq. ft) 75.00 2 — Limited energy, multi- family 75.00 2 Replace receptacles and make repairs to residential (with above sq. � • grounding in panels Services or feeders installation, alteration, antler relocation 200 amps or less 100.70 2 . ❑ PROPERTY OWNER • I • . .: ❑ TENANT " . 201 amps to 400 amps 133.56 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 55226 2 City/State/ZIP: — Temporary services or feeders installation, alteration, aod!or relocation Phone: ( ) I Fax; ( ) 200 amps or less 59.36 _ II Owner installation; This installation is being made on property that I own which is not 201 amps (0 400 amps 125.08 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to $99 amps 168.54 2 Branch circuits- new, alteration, or exlenaton, per panel Owner signature: Date: A. Fee for branch circuits with ' ® APPLICANT : l . ❑ CONTACT PERSON .. . . ' • above service or feeder fee. • each bdaach circuit 7.42 2 Business name: EC Company B. Fee for branch circuits without $56.18 service or feeder fee, firsi 1 Contact name: Kathy Kelley branch circuit 56.18 2 Each add') branch circuit S 7.42 $37.10 2 Address: PO Box 10286 Miscellaneous (service or feeder not included) City/State/ZIP: Portland OR 97296 d wenin ,serv or 67.84 2 � tlwelliog, service a atilor feeder Phone:( 503) 224 -3511 I Fax: : (503) 295 -3012 Reconnect only 67.8, 2 - r Pump or irrigation circle 61 2 E - mail: kathyk ®e••c- co.com Sign or ouiiine lighting 67.84 2 CONTRACTOR Signal circuil(s) or limited energy Business name: EC Company panel, alteration, or extension. Page 2 , 2 Each additional Inspection over allowable In any of the abov Address: PO Box 10286 Additional inspection (I hr min) - - 66.25/ hr City/State/21P: Portland, OR 97296 ' mvasligarion(1 hr min) 66.2$/h Industrial plant (I hr rein) 78.181 hr • Phone:(503) 224 -3511 I Fax: (503) 295 -3012 inspections for which no !leis - mcifically listed (S5 hr min) , 90.001 hr ►B Lie.: 49737 I " 6 - Suprv. Lic.:ss gLgCIRIrrAL PERMIT •I?EFS . Suprv. Electrician signature, req[Iired: r Subtotal: $93 .2 8 Plan review (25% of permit fee): Print name: Ron Cj aman 1 1 Date: 8 /13 / 2 012 State surcharge (12% of permit fee): $11.19 Authorized signature: jJ) ! °I ' I f _ TOTAL PERMI FEE $104 7 A/ 6 This permit application expires It permit is not obtained within 180 Print name: Anna et t Date: 8/13/2012 days after it has been accepted as complete. Number of inspections allowed per permit. 11Bald'w57e it3V/C.Fe, nitAppdoo 07/01 /10 440.4615T(r1105 /COM/NEB Oct. 12. 2012 8:58AM PGE -TCC QUAD A No. 4571 P. 1 EmergencjRe- connection Authorization E OO ‘41S Rate : To : Portland General Electric Attn: _ Fax No. This authorizes Portland General Electric to make an emergency service connection at the following address: Name f} FF4CLD et ir4Atl- Gc.I'Mc..5 Address / 2 7z 3c .,o • ai NW S • -L City _ /6 4gp of authorized "Si iit Supervisor": 1(. --� Signature g� . g p Name of Electrical contracting firm: t CO • Phone Number: _5/7t' • • Attach Copy of the Permit Application Note: TI is `is nom fo be used for non - emergency I new connections. • F