Permit o CITY OF TIGARD ELECTRICAL PERMIT
' "-- COMMUNITY DEVELOPMENT Permit #: ELC2012 -00584
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 10/08/2012
Parcel: 25101 DCO3800
Jurisdiction: Tigard
Site address: 7190 SW SANDBURG ST 5
Project: McCormack Properties Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: (21) branch circuits for TI
Contractor: CURRENT ELECTRICAL CONST CO Owner: MCCORMACK PROPERTIES LP
PO BOX 19652 7190 SW SANDBURG ST
PORTLAND, OR 97280 TIGARD, OR 97223
PHONE 503 - 245 -5997 PHONE 503 624 -4649
FAX 503 - 245 -2919
FEES
Quantity Description Date Amount
21 crt Branch Circuits wo /Purchase 10/08/2012 $204.58
Specifics: Service or Feeder
25 12% State Surcharge - 10/08/2012 $24 54
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $229.12
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 • - 95 -111 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 5 .1987 or 800 332 2344
�
Issued By: I , A Permittee Signature:
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.
Electrical Permit A licatio NED FOR OFFICE USE ONLY
City of Tigard Received 7f►� /�r
Date /B • /d v Vi ' emit No . cL t� p20I„2 -e SQ I
13125 SW Hall Blvd., Tigard, OR 972230�' / 10 8 2012 Plan Review D � �
0 ` Phone: 503.718.2439 Fax: 503.598.1960 Date /B Other Permite(�(, ova
TI G A K D Inspection Line: 503 639.4175 CITY O 'it Date Ready /By Juns ® See Page 2 for
Internet: www tigard- or.gov gl111 DING �D�IIQ i► pNJrIISII Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below).
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Al2129 1 Job site address: 7190 SW SANDBURG 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks
City/State/ZIP: 97223 ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: MCCORMACK PROPERTIES ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I *
New residential single- or multi - family dwelling unit.
includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
ADD CIRUITS residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
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 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
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: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 20 7.42 148.40 _ 2
Address: Miscellaneous (service or feeder not included)
City/ State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( )
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: CURRENT ELECTRICAL panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: PO BOX 19652 Additional inspection (1 hr min) 66.25/ hr
City/ State/ZIP: PORTLAND, OR 97280 \Investigation (1 hr min) 66.25/ hr
, Industrial plant (I hr min) 78.18/ hr
Phone: (503) 2455997 Fax: (503) 2452919 Inspections for which no fee is 90 00/ hr
specifically listed ('A hr mm)
CCB Lic.: 46994 Electrica ' *a`ern C Sup . Lic.: 5232S ELECTRICAL PERMIT FEES
t
Subtotal. 204.58
Suprv. Electrician signature, r ' .' - I .
,'L.•••_� Plan review (25% of permit fee):
Print name: JASON JACOBUCCI Date: 10/04/12 State surcharge (12% of permit fee): 24.54
TOTAL PERMIT FEE: 229.12
Authorized Signature: T his permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: DAVID THOMPSON Date: 10/04/12 * Number of inspections allowed per permit
1 \ Building \ Permits \ELC- PennitApp doc 07/01/10 440 -4615T(11 /05 /COM/WEB