Permit CITY OF TIGARD ELECTRICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: ELC2012 00567
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/01/2012
TIGARD Parcel: 2S112AA00900
Jurisdiction: Tigard
Site address: 14160 SW 72ND AVE 150
Project: UPS Subdivision: 1992 -007 PARTITION PLAT Lot: 1
Project Description: Replace (1) 200 amp panel.
Contractor: E C COMPANY Owner: WALTON CWOR NELSON 13 LLC
PO BOX 10286 BY CTMT - WALTON RE TAX
PORTLAND, OR 97296 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503 - 224 -3511 PHONE.
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 10/01/2012 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 10/01/2012 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 95 -101 -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: DA/ / /e�"77O�
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.
Sep. 28. 2012 10:44AM No. 1429 P. 2
Electrical Permit Appliicati Received 1.011 OFFICE I S1, (1N1.1 g
City of Tigard RECEIVED
`J Daid0 . /0 / /•Z ■/ Permit No.-62, C .zQ�.2 -OOS(
• II ,.� v 13125 SW H Blvd Tigard, OR 97z2A1� Plan Review
Phone: 503.639.4171 Fax: 503.598,1 qb T 0 1 2012 012 D Other Fermin
T 1 L A t I l Inspection Line: 503.639.4175 !Date Ready/By: Iffra M See Pe
Internet: www.tigard- or.gov CiTY OF "is� Noti
D fed/Me hod: Supplemental Informadoa
TYPE OFD ?i eltik tr a T'''f il, SiO , PLAN REVIEW .
❑ New construction ® Addition /alteration/replacement Please chodc all that apply (submit 7 sets of plans WTtems checked below);
❑ Service or t>:eder400 amps or more 0 Building over three stories.
❑Demolition ❑ Other:
when) the available fault current ❑Marinas and boatyards.
CATEGORY OR CONSTRUCTION exceeds 10,000 amps at ISO volts or ❑ Floating buildings.
1- 2 dwelling lento ground. or exceeds 14,000 ❑ Commercial•use apiculture]
❑ y ng ®Commercial/Indtistrial ❑Accessorybuilding amps for all other installations. buildings.
❑ Multi - family ❑ Master builder 0 Other: Orin pump. Dianlallatioc of 75 KVAor
JOB SITE INFORMATION AND LOCATION
o � �� are°r Iarger separately derived system.
❑ Addition ornery motor load of
Job no.: 74594 - 29 I Job site address: 14160 SW 72 Ave 10014?ormore. occupancy
❑ Six Or MOM residential unite. ❑ Recreational vehicle parka.
City/State/Zip: Tigard OR 97223 0 Health -care facilities, ❑ Supply voltage for more than
['Hazardous locations. 600 volts nominal,
Suite/bldg. /apt,no.: /5.D I Project name: UPS 0 Servioe or ftMv 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: naaspnoe t an. I F4e. I Trial I •
New residential single- or null ti fan dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. fl. or less 168,54 4
Eat addl 500 sq. 11. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OIz Ji'ORK R (wish above sq. ft) 75.00 2
Limited energy, mulli•family
Change out existing 200 amp panel with an residential (with above sq. fl.L 75.00 2
identical new one " Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
d . pf2OPERTY OWNER I.. • . . - I ❑ TBNANT 201 amps to 400 amps 133.56 2
Name: _ 401 gimps to 600 amps 200.34 2
601 amps to 1.000 amps 301.04 2
Address: Over 1,000 amps or volts 55226 2
` Temporary services or feeders installation, altera and/or
City/State/ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 mops 125.08 2 "
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 70!. 401 amps to 599 amps 168.54 2
munch circuits— new, alteration, or extension per panel
Owner signature' - Date: A Fee for blanch circuits w ith
' ® APPLICANT • I ❑ CON'T'ACT PERSON • above service or fend fe e, 7.42 2
each branch circuit
Business name: EC Company R Pee for branch circuits without
- service or feeder fee, first 56.18 2
Contact name: Kathy Kelley branch circuit
Each addl branch circuit 7,42 2
Address: PO Box 10286 Miscellaneous ltT'lTTyain3 not Included)
City/Slate/ZIP: Portland, OR 97296 ���s rf feeder
r dwelling, service and/or feeder 6784 2
Phone: ( 503)224-3511 I Fax: :(503) 295 -3012 Reconneclonly 67.84 2
Pump or irrigation circle 67.84 2
E-mail: kathykage - c - Co . Com signor outline lighting 67.84 2
- CONTRACTOR. Signal circuii(s) "energy —
Business name: EC Company panel, alteration or extension Page 2 2
Each additional inspection over allowable In any of the above
Address: PO Box 10286 Additional inspection (1 hr min) ' 66.25/ hr
City/State/ZIP: Portland, OR 97296 Investigation (lhr min) 66.25/ hr
Industrial plant (l hr min) 78.181 hr
oue;(503) 224-3511 F::. 503) 295 -3012 Irons for which no (cc is
U Specr6rslly listed ('h hr min) 90.00/ hr
colt Lie; 49737 ✓ iElectriciLie.: 6 -4' LY I `S ELECTBICAL. .PERMIT FEES
yc- Suprv. Electrician signature, required: , tti Subtotal: , 3.00 . 7 0
Plan review (25% of pencil fee):
Print acme: Ron Coffman r ' : j; e12 State surcharge (12% of permit fee): , 12.08
Awn;
r TOTAL PERMIT PEE 112. 78 1 Authorized signature: I 1 l +A,
. 'dLI This permit application expires ire permit Is not Owned within 180
Print name: Anna Nett Date: 9/28/2012 • Number ot late
LIO PemoiAppdoo 07/01 /10 440.4615T111/05/COMIWSE
Sep. 28. 2012 10:44AM No. 1429 P. 1
ec 2121 NW Thurman Street
Portland, OR 97210
PO Box 10286
Portland, OR 97296
ELECTRICAL
Telephone (503) 224 -3511
CONSTRUCTION co Fax (503) 224 -6353
CCB #49737
Facsimile
To: City of Tigard
Attn: Permit Department
From: Anna Hett
Date: 9/28/2012
RE: UPS Electrical Permit
Number of Pages (Including this sheet): 3
Message:
Please contact Anna Heft at 503,224.3511 with any questions.
I need the permit today as we are doing work tomorrow. Thanksl
Thanks)
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