Permit I
CITY OF TIGARD ELECTRICAL PERMIT
q
a: -'- COMMUNITY DEVELOPMENT Permit #: ELC2009 -00080
Date Issued: 03/16/2009
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639.4171 Parcel: 1S135B600501
Jurisdiction: TIG
Site address: 10575 SW CASCADE AVE 130
Subdivision: Lot:
Project: HEMCON
Project Description: TI
Owner: FEES
AMB PROPERTY L P Quantity Description Date Amount
BY TRAMELL CROW NW INC, 8930 SW GEMINI
DR 3 ea Services or Feeders - 200 03/16/2009 $240.90
amps or less
PHONE 3 ea Services or Feeders - 201 to 03/16/2009 $320.55
400 amps
87 crt Branch Circuits w /Purchase 03/16/2009 $578.55
Contractor: Service or Feeder
BOONES FERRY ELECTRIC INC 2 ea Signal circuit or Limited 03/16/2009 $150.00
PO BOX 628 Energy Panel
WILSONVILLE, OR 97070 1 ea Plan Review Electricial 03/16/2009 $322.50
PHONE: 503 - 682 -4936 1 ea 12% State Surcharge - 03/16/2009 $154 80
FAX: 503 - 682 -7946 Electrical
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $1,767 30
Required Items and Reports (Conditions)
This permit • ect to the regulations contained in the Tigard Municipal Code. State of OR Specialty Codes and all other applicable law All work will
be don in accordance with = •prove• • ans 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 la • require- ou to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 01 -0010 thr•ugh OAR 95 101 -c 101 may obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1 800 332 2344
Is ued By: _ Permittee Signature. �� /1
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' �, , iiii/���E Date: / *�9
LICENSE NO. q (/ g5
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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 ApplicationRECE VE )1 FOR OFFICE USE ONLY
City of Tigard Received
Date/B tt. • .0
1 - q Permit No — ± iii `+ + `
13125 SW Hall Blvd., Tigard, OR 97223 FEB 2 6 2009
Phone: 503 639 4171 Fax: 503.598 1960 Plan Review
_ Date/B . Other Permit
TIGARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By- ® See Page 2 for
Internet: www.tigard- or.gov BUILn�{�1/� DIVISION Notified/Method Supplemental Information
- ' TYPE OF WORK DING IV * - DIVISION . . - . P LAN REVIEW -
❑ New construction _, Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Demolition
El Service or feeder 400 amps or more ❑ Building over three stones
❑ 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 agncultural
❑ I- 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. INFORMA AND LOCATION- ❑ Emergency system larger separately denved system
- . ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "l - ",
Job no.: Job site address: _+ lrn occupancy
V S 7 s S W ` i t4 v C y ❑ix Si fo or more or re sidential units ❑ Recreational vehicle parks
City/State /ZIP: 7, J o e 4 0 g ❑ Health -care facilities ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: H C".l ( Q 0 ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: BEE SCHEDULES
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 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft or portion 33 40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq ft.)
Limited energy, multi - family
T r , residential (with above sq. ft ) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 3 80 30 24Q . 7 0 2
- = ❑. PROPERTY OWNER - ❑ - TENANT 201 amps to 400 amps 3 106.85 .21: , sr 2
Name: 401 amps to 600 amps 160.60 2
idress:
601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454 65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133 75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑; APPLICANT I - 0 CONTACT PERSON above service or feeder fee, z 7 6 65 s 7 $, S J 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'l branch circuit 6 65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) 90.90 2
Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53 40 2
-.: `= , , ^h�= .. _ : ,CONTRACTOR = - • ; ' • - ' Sign or outline lighting 53 40 2
Business name: Boones Ferry Electric Signal circuit(s) or limited -
energy panel, alteration, or
Address: P.O. Box 628 extension. Describe: 2 Page 2 150 2
City/State /ZIP: Wilsonville OR 97070 Each additional inspection over allowable in any of the above
Phone: (503) 682 -0936 Fax: (503) 682 - 7946 Per inspection 62.50
Investigation per hour (I hr min) 62 50
CCB Lie.: 88482 Electrical Lie.: 3 -223C Suprv. Lie.: 47 / S C Industnal plant per hour I 73.75
� ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: //V(/*`' Subtotal: j� .2 ` - 0 , 0 (t
int name: S-to. IA c 0.4,,, Date: Plan review (25% of permit fee) 32 Z • r 7 0
State surcharge (12% of permit fee). /S $ p
Authorized signature: TOTAL PERMIT FEE: t
i
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted as c mplete.
• Number of inspections allowed per permit 1 ; 0 76 -1. 3 n
I \Buildingt'ermns\ELC- PermitApp doc 05/23/06 440-4615T(11/05/COM/WEB v