Permit 11 p CITY OF TIGARD ELECTRICAL PERMIT
1, • COMMUNITY DEVELOPMENT Permit #: ELC2012 -00615
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/29/2012
Parcel: 25101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Triangle Pointe Subdivision: VARNS ACRES Lot: 9
Project Description: (12) branch circuits for E -Mon meters in basement, 3rd and 4th floors
Contractor: COCHRAN INC Owner: TRIANGLE POINTE LLC
7550 SW TECH CENTER DR #220 901 NE GLISAN ST, #100
TIGARD, OR 97223 PORTLAND, OR 97232
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
12 crt Branch Circuits wo /Purchase 10/29/2012 $137.80
Specifics: Service or Feeder
1 ea 12% State Surcharge - 10/29/2012 $16.54
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $154.34
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 l kt 1 4..b./. f 952- 0001 -0090. You mm a copy of the rules or direct questions to OUNC by calling 5003 or 1.800.332.234
T' Issued By: C>�'fiC Wt Permittee Signature: D/L /PuG4-.r 34 /e&L
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.
01 09:30:35 10-26-2012 1 /2
Electrical Permit ApplicatRECEivED FOR 011.1U1.: USE ONEY
City of Tigard . Received
- Date/By: ID ag re- sit Permit No.0.,... C06 I
al 13125 SW Hall Blvd., Tigard, OR 97224 fs.e . Plan Review
lig • Phone: 503.639.4171 Fax: 503.598.11R, I 292012 Date/By: Other Permit:
See Page 2 for
inspection Line: 503.639.4175 Date Ready/By: El
Iii;Alt1)
Internet: www.tigard CITY OF TIGARD Notified/Method: I 7 Supplemental Information
t :.
0 New construction IR' Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other where the available fault current (J Marinas and boatyards.
'cATOPRY69.Fc-CY:i.§TRUPPO 7 -;,-.0i: ;:. ....,;',: ' ' exceeds 10,000 amps at ISO volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial agricultural
EI I- and 2-family dwelling Rt Commercial/industrial 0 Accessory building amps for an other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
0 Emergency system. larger separately derived system.
• qop SITE fiso000o. 001 • . . •. '. ! 0 Addition of new motor load of 0"A". "E". "1 -2", "1-3",
t)-- '
Job no.:4/e/ site address: /A5..51(ibg / .)/ /0 if9 100HP or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: 7),, ale. 97zo 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locatiom. 600 volts nominal.
Suite/bldg./apt. no.: 1 Project name: . 7e m4 4,zi,.. .. 0 Service or feeder 600 amps or more
. ...,.::,,' 7 .:,..::.... 7 i!l! . r.1*E.: $0.0.0.04 , ::_::!:;'' , ,..:',•-.1-.:. ' ....
Cross street/directions to job site:
oeuription . I Qty. I Fee. 1 Total - 1 .
' New residential single- or multi-family dwelling unit.
Includes attached garage.
•
Subdivision: i Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. addl 500 sq. ft. or portion 33.92 . I
Tax map/parcel no.:
Limited energy, residential
75.00 DESCRIPTION OF WORK (with above sq. ft.) 2
Limited energy, multi-family
75.00
V/#1 Visi Fin
. - - en i217 z)-4 residential (with above sq. ft.) 2
Services or feeders installation, alteration, and/or relocation
gfri j ?--3 1—. 7 bi— . /. 5 /J,e----S-- 200 aimis or less . 100.70 2
0 .PAOPgirrY OWNER ' ,:: s ,' I" : ' ';'. d ' . ' '. 201 amps 10 400 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 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation
Phone: ( ) I Fax: ( ) 200 amps or less • 59.36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
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
' la APPLICANT : . 1 :: . . .0.4AC.T. PERSON .• above service or feeder fee,
742 2
each branch circuit
Business name: ,) . ,. -- e ...., B. Fee for branch circuits without
service or feeder fee, first
• 2
„ icsiic 44/IS64 branch circuit / 56.18 Zo7
Contact name:
Each addl branch circuit ii 7.42
Address:
Miscellaneous (service or feeder not included)
• Each manufactured or modular
City/State/ZIP:
dwelling, service and/or feeder 67.84 2
2 -
Phone: 14n773 sz&L I Fax: : ( 9 zz -(124 0 Reconnect only 67.84
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 . 2
. .
. CONTRACTOR .. .
. . • • Signal circuit(s) or limited
Business name:
panel, alteration, or extension. Page 2 2
Caj ca ...nc_..
Each additional inspection over allowable in any of the above
Address: 1 550 5kA ( e C ( 4. K .- *22D Additional inspection (I hr min) 66.25/hr
investigation (1 hr min) 66.25/ hr
City/State/ZIP: 77 (A op, R722_ _
_____ Industrial plant (I hr min) 78.18/ hr
Phone: 971_,(p. vzvz_. Far fag . (Z- &i3 Inspections for which no fee is
specifically listed eh hr min) 90.01)/ hr
CCB Lie.: "1 2:71-12 1 Electrical Lic.: r'7 5% e, Suprv. Lic.: 3141473 ',::'.;::;.!;-:::.i.Y..•:-.;::,..7.1.p.:gentieAL:ifgamrr.rEgs.:,,,,,.
Subtotal: - 457 bi6
Suprv. Electrician signature, required: \(.3<k
Plan review (25% of pennit fee):
Print name: Ke ‘ , - N n -i K 1, 9 I Date: /0 ....g& —/Z State surcharge (12% of pennit fee): I/,, 415 / 4 4 471 'sr
Authorized signature:
TOTAL PEFLM IT FEE: 4.1V,,
A(z ' b i de ,_>-_._
This 'permit ap r
plle
days h ex h tres If within 180
Print name: t-q) n • e . roci+ Date: /..-7i, .--/7 .. * Number of inspections allowed per perrnit. IS* 3( t
klautdinocmitsELC-PennitApp.doc 074:11•Io 440 I 115.COMAVES