Permit Q CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: ELC2012 -00496
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/23/2012
Parcel: 25101 DA00101
Jurisdiction: TIGARD
Site address: 13190 SW 68TH PKWY 110
Project: Stearns Lending Subdivision: VARNS ACRES Lot: 9
Project Description: (10) branch circuits for additional TI electrical work
Contractor: THREE PHASE ELECTRIC Owner: PACIFIC NW PROPERTIES LIMITED PA
493 NE 3RD AVE SUITE B200 STERN FAMILY LIMITED PARTNERSHIP
CANBY, OR 97013 STERN, HELEN R REVOCABLE TRUST
6600 SW 105TH AVE #175
BEAVERTON, OR 97008
PHONE: 503 - 889 -6615 PHONE:
FAX: 503 - 651 -3540
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo /Purchase 08/23/2012 $122.96
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/23/2012 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 �i orr180
Issued By: ..) Sli t L,Ikl ( Permittee Signature: 013 i 1 LiC 477 D&i
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.
2012 -08 -22 12: . 503 - 651 -3540 h -- ..r - _ • .
Electrical Permit A r t TOR 01..ru.'1 t sr•. ONI.
� * � Dutc y: Permit N o.
City of Tigarr' Rec S ?.311,x,..
_-00
° 13125 SW Hall Blvd., TigarA 1 � 20'12 Plan ]review e 0101,1- D (41 O' �
' a' Plume: 503.718.2439 Fax: Sb3:5 1 Datc/ay: Other Fermis: Q j i
1 1 t'. n :t r1 Inspection Line: 503,6_ /1F TIGARD Date Ready/By: r A - a See Page 2 for
Internet: www.tighntl- M1..
OF Notified/Method: _ fl t Supplemental information
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Please check all that apply (submit a sera of plans wfitems checked below):
❑ New ocn etrvet :An ® Addition /alterntion/roploeetnant
I_I Service or feeder eta) amps or mute D nuuuu>x uvcl !MCC gut R{..
El Demolition ❑ Other: wt.. the available fault current D Mariic ants Imat
l N� r, 1 � ilil � i � � q r 1 i Hid � n l�us4+ uurq l if x l i i B l t ' rf+ l�{� �{ l+li i 1 it �fi I' er cect ln ,
10000 amp at 150 volts or D 11 tlat ing buil+Gngn.
iLlltfi, ,:st [t, , .i .� :lffliiI li� rlitr+6�wairgitl r 1 utdim /mutr(io i.r.11niomp a i : f l +. 11?� al }i 1 iy ``HIE)filL� a to ground, or exceeds 14.000 D C :ummerClid -ow agricultural
❑ 1 - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installatiuru, buildings.
❑ Multi- family ❑ Master builder ❑ Other' ❑ Fav pump. ❑ Installation of 75 KVA or
1 t J1 11 1'i, i I i 1 'lY q lrlypwu,lrunll iruraa{ ri;rnl pggl sl>fer :c r t Ih' } ula,le11 rtrrw; IJMI , I, ilf' .' {1+} 1 ` 1fi'{1 iii , r El Emerge s larger acpatatcly derived system, • ai Ifli�f� l i11 d+ . 4.6 d; ,iraa igthit ,iii: :ttarslil:rillfihm lot o+ utai lit l 11 ,, , „lli11I 1 :{i�l�`�I j ❑Addllion • of • new molar load of D ' L'" "I "1 4'
1 a l l 11 a+ 4 ( , +
ualh � •
Job no.; B232402 Soh site address: 13190 SW 68 Ave., Suite 110 Six o r' nr more. uP�Y
El SIX or more residential unit... D Recrea)iunal vehicle ru)rka.
City /State/ZIP: Tigard, OR Dliralth -cpe fscilitiea. ❑ Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: Sterns Lending 0 Servic:0 Ur feeder 600 amps or more. 17
is ifir'i'�Lii i fi1i'i��, I E 1� :!1''e : °w ;a"� 'ffili<iII>l !IIERCI N € I
Cross street/directions to job site: nwcriplion Qty. Fee. Total
New residential single- or multi- family dwelling unit.
_Includes attached garage.
Subdivision: 1 Lot no.: 1,000 so, ft, or less 168.54 4
Ea. add'1500 sq. ft. or portion 33.92 1
Tax map/parccl no. Limited energy, residential 75.00 2
f III {Ii t c•�n' mraaAwt } 1 rnt trf y p 1 ;; i i 111 71
(with above s . IL)
t Ft � i I ASI( nth h 1r b .1...t.1.1,�e 16 „ v,.ttstl}' Illlh4l "ll'SIIi11� ;. 1 E 1 t v�� ( 4
) 713�98iGllfq�i��l ��,lU o6usdu 1��1+1r r 1 r 1 Limited energy, multi-faintly -
Additional tenant electrical work subsequent to final aproval on our last residential (with above sq. ft.) i 75.00 z
Services or feeders installation, alteration, and/or relocation
permit (if ELC2012- 00429). zoo amps or less 100.70 2
(( a nr i n11sr ti Tito rsaj +4 i�6ltwn 1 , I ( Fpp }l {�+ M Il+� } f 1 , ,Ti..., 1' +1 } tl i I +� 1 (! f il �tf I I I l i z p I am to 40(1 am s 133.56 2
'f1�Il�l�lf) i}h�} 1>;,,.�r�tsi xt i', lax °Gksia )f�.IlllilliiliftilSL'&tG6 fNrl�i(rililNK 1• o�il 4 'xii' 1 f ' N ' Ii t. ! te'�s�'r �ll P
Name: Pacific NW Properties LP, Stern Family LP 401 amps to 6011 amps 200.34 2
601 amps to 1.000 amps 301.04 2
Address: 6600 SW 105 Ave. #175 Over 1,000 amps or volts 552.26 2
C- ily /Slite/71P: Beaverton, OR 97008
Temporary services or feeders Installation, alteration, and/or
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 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new alteration, or extension, er panel
Owner signature: Dale: A, Fcc for branch circuits with
f,, n cr vu Na r y�,y, r p ; , r" r Y i C" w5t i r9 pm ,ras c1 N ❑1dr 1 above service or feeder fee.
J'f r E � E n r iar :∎ li`'!' 45 1 y y y i if + t 4f i 1 � , { L ' if 1 n ' t art p 'F' ., t rcili 1 1 � M ? ail 7.42 2
li lltxd. 11 YtYUU1+ a11i,m1sonr I,.t I.Yai14 1 f lat r ig..rvumill I1di,.. each bra nchCi rCtllt
Business name: 6. Fcc for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each atd'l branch circuit 9 7.42 66.78 2
Address: Miscellaneous (service or feeder not Included)
Ci /State/Lll': Each manufactured or modular G7,84 2
tY dwelling. service and/or feeder
Phone: ( ) I Fax:: ( j
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
IREI'i l :: ;, L 1 '1L6 lll:l IIII1fi�Gl }fir R '' ;��in�;: ,'.Cps fl f�" ENEIi6 iRIII Gi!i 1 i f Ifillif;�G Sign a' dr lighting 67.84 67.,14 z
Business name: Three Phase Electric panel, alteration. or extension. Page 2 2
Each additional Inspection over allowable in any of the above
Address: 493 NE 3' Ave., Suite B200 Additional inspersion (1 hr min) 65.25/ hr
City /State/'ZII': Canby, OR 97013 Investigation (1 hr min) 66.25 / hr
industrial plant (I hr min) 78.18/ hr
Phone: (503) 263 - 2558 Fax: (503) 651 - 3540 Inspections for which no fee is 90.00/ hr
s+ cilicall listed (34 hr min)
33d r r r f ur i, 1 i q w 1 r I r ."r.' 1 1 1'l
CCB Lic.: 162368 Electrical Lic.: 3332C S Lie.: 33985 •(1 -i 1.111 i i f � `,111: @ �„C;,' / �Gf.. � w' iiil.l.i,il�i,t
i3 {."!i!' i, i T
Suprv. Electrician signature, required: fl.. a...••� &ala ' / Subtotal: J
Plan review (25% of permit fee):
Print name: Dennis Welch Date: 8/22/2012 State surcharge (12% of permit fee): 14.75
TOTAL PERMIT FEE: u.7.'7-1
Authorized signature: This permit application expires If a permit is not obtained within IRO
. days after n has been accepted as complete.
Print name: — Dale: • Number of inspections allowed per permit. t 31.12
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