Permit 74 . - - CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00645
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2012
Parcel: 2S 101 AA09100
Jurisdiction: Tigard
Site address: 12447 SW 69TH AVE
Project: Capitol One Subdivision: WEST PORTLAND HEIGHTS Lot: A
Project Description: (6) branch circuits and (1) low voltage relocate circuits and data jacks in IT office
Contractor: COCHRAN INC Owner: TIGARD CORPORATE CENTER LP
7550 SW TECH CENTER DR #220 15325 SW BEAVERTON CREEK CT
TIGARD, OR 97223 BEAVERTON, OR 97006
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Limited Energy 11/08/2012 $75.00
Specifics:
6 crt Branch Circuits wo /Purchase 11/08/2012 $93.28
Service or Feeder
Type of Use: COM 1 ea 12% State Surcharge - 11/08/2012 $20.19
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $188.47
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 la w. 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 OA 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2332.1987 or 1.800.332.2344.
Issued By: v'?_ Permittee Signature: Old a-Pe is A-71 O
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.
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Electrical Permit ApplicatRECEIvED FOR OFFICE USE ONLY
City of Tigard A1 8 Received ry® Perm No.: g� /20(3,"- 00 le 'S
/
II
I " 13125 SW Hall Blvd., Tigard, OR 9722i110 0 8 2012 Date/13 : 6
g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 0 DateB : Other Permit
T I G A RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: /iris: El See Page 2 for
Internet: www.tigard -or.gov BUILDING DIVISION Notified/Method: Tic. Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit 2 seta of plans w /items checked below):
ID New construction ., �Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current 0 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 54 Commercial/industrial ❑ Accessory building amps for all oilier installations. buildings.
❑ Multi- family , ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
r^ JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
•
❑ Addition of new motor load of ❑
Job no. yl,ktkiy– ( Job site address: ,'Ll.F4-7 SLR A Six or more more. occupancy.
1 / [� Q' ❑ Six or more residential units. ['Recreational vehicle parks.
City/State/ZIP: .— \ --+ v_ 3 6. 4 –& C 2 ❑ Health facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: C Ll tti ❑ Service or feeder 600 amps or more.
(_,e ` �� FEE SCHEDULE
Cross street/directions to job site: ' Description I Qtv. I Kee 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'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
4144'0+-1 L-1 ' -1 r e...- (,� �t c.:...74--(_ v �S Ilk-• residential (with above sq. ft.)
, Services or feeders Installatlon and/or relocation
A u-.� JU_ <.�S \`rl kT 0 ic vC_,e,' 200 amps or less 100.70 2
❑ PROPERTY OWNER A TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: C `� c. \ 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
relocation Temporary se or feeders installation, alteration, and/or
City/State/ZIP:
Phone: ( ) 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 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
❑ APPLICANT I At CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits without 1
service or feeder fee, first 5,.1
branch circuit 56.18 J 1 2
Contact name:
P J\ C,OC rw� I \ �- • Each add'/ branch circuit 7.42 3'7, 10 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67 84 2
ty 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: COCHRAN INC panel, alteration, or extension. } Page 2 'b • 00 2
Each additional inspection over allowable in any of the above
Address: 7550 SW TECH CENTER DRIVE SUITE 220 Additional inspection (1 hr min) 66/5/hr _
City/ State/ZIP: TIGARD, OREGON 97223 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 234 -6564 Fax: (503) 238 -2098 Inspections for which no fee is 90.00 / hr
specifically listed (Vs hr min)
CCB Lie.: 72942 Electrical Lic.: 36 -546C I Suprv. Lic.: 3447S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: \k – a ' 1..._\ Subtotal: �lA� ' Z- L�
Plan review (25% of permit fee):
Print name: KENNETH KATO Date: ‘x ` s \ l Z State surcharge (12% of permit fee): Z e , ( 9
l TOTAL PERMIT FEE: `� , l. 7
Authorized signature: This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: Date: • Number of inspections allowed per pennit.
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01 11:34:31 11 -08 -2012 2 /3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
•
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
El Other.
COMIVIERCIAL
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
p Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
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