Permit CITY OF TIGARD REVISED ELECTRICAL PERMIT jig
• COMMUNITY DEVELOPMENT I Permit #: ELC2012 -00635
•
T t G AR L) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/06/2012
Parcel: 1S135DC00200
Jurisdiction: Tigard
Site address: 11825 SW GREENBURG RD 113
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: (4) branch circuits for TI 11/15/12 REPRINT Adding (1) low voltage for phones, computers
Contractor: VAST ELECTRIC Owner: TWO G'S REAL ESTATE LLC
1525 SEATTLE SLEW DR. SE 18395 WOOD THRUSH ST
SALEM, OR 97301 LAKE OSWEGO, OR 97035
PHONE: 503 - 684 -0550
HONE: 503 - 566 -7274
FAX: 503 - 585 -8828
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 11/06/2012 $78.44
Specifics:, • Service or Feeder
1 ea 12% State Surcharge - 11/06/2012 $9.41
Type of Use: COM Electrical
Class of Work: ALT 1 ea Limited Energy 11/15/2012 $75.00
Type of Const: 0 ea 12% -State Surcharge - 11/15/2012 $9.00
Electrical
Occupancy Grp:
Total $171.85
• 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 0 52- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or P,, 1.800.332.2344. r
Issued By: WK £ Permittee Signature: € I �e4 -noiL
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.
CITY OF TIGARD ELECTRICAL PERMIT
s , COMMUNITY DEVELOPMENT Permit #: ELC2012 -00635
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/06/2012
Parcel: 1 S 135DC00200
Jurisdiction: Tigard
Site address: 11825 SW GREENBURG RD 113
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: (4) branch circuits for TI
Contractor: VAST ELECTRIC Owner: TWO G'S REAL ESTATE LLC
1525 SEATTLE SLEW DR. SE 18395 WOOD THRUSH ST
SALEM, OR 97301 LAKE OSWEGO, OR 97035
PHONE: 503 - 566 -7274 PHONE: 503 -684 -0550
FAX: 503 - 585 -8828
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 11/06/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/06/2012 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 9 2- 001 -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: OA( AP PC-10447 Oki
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.
can 503.839.4175 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.
Nov 14 12 03:26p Vast Electric Inc. 503- 585 -8828 p.8
Electrical Permit Applicat EGA `VE®. FFl( 1 0k O t SI 0:\ 1.1
City of Tigard ov 1 4 2012 Received ► ,
b Date/Bv: Permit No.. i O. i
lig 13125 SW Hall Blvd., Tigard, OR 97 Plan Review
C . ' Phone: 503.718.2439 Fax: 503.598.1960 DateB . Other Permit:
I G.a R L Inspection Line: 503.639.4175 CITY OFT*" Date Ready /By: torts: 65 See Page 2 for
Internet: www.tigard-or.gov WILD DW S Alotified/Methad Supplemental Information
TYPE OF WORK 1 � Nt • PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Nl w construction Ex Addition /aleeration /rcplaoemcnt
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other. where the available (Dolt 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 aCommercialtindustria1 ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ '.4 ", "li '. "t - 2', i - 3' .
? , 100111' or more. oac upanq•.
Job no.: Job site addres `� 5 SW !! iR "G� ii i N`Q ❑ Si < or more residential ands. ❑ Rcaratioual vehicle parks.
City /Statc/Z1P: ` V ❑ Health-care facilities. ❑Supply voltage for more than
�j O. [ Haavdoms locations. 600 volts nominal.
Suite/bldg./apL no.: ti roject name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross sl ccl/directions to job site: Description
era- I Filo. ► Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: l.ot no.: 1.00(►sq. ft. or less 168.54 4
Ea. add') 500 sq. ft. or portion 33.92 1
Tax map/parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. H.) 75.01 2
r�j{ Limited energy, multi family 75.00 2
A �1 �t ` / I t V I fi r 1Qf _ Jn 'th ^ Vi i i- residential (with above sq. ft.)
(XY JJJ���^^^ U t` 111 Services or feeders installation, alteration, and/or relocation
tL C - 9'o 1 ? — Ol)b 200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ 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 5936 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 eztension, 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 56.18 2
Contact name: i branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZAP: dwelling, service andlor feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail:
CONTRACTOR Sign or outline lighting 67.'54
( Signal circuit(s) or limited -energy
Business name: 1 1h � I r,L 1 : pane). alteration. orextauion. I Page 2 �,� 2
\Kpl 'ef X i � Ticl� Each additional inspection over allowable in any of the above
Address: 1L
I C� . s s- t �+ 1), S-C Additional inspection (I hr min) ' 6625/ hr
Investigation (1 hr min) 66.25/ 1u
City/State/ZIP: ri � ( & State /ZIP: � 9 73 i 7
Industrial plant (1 hr min) 78.18; hr
Phone: (S« — r 11 '-r Fax: ( ) C Inspections for which no fee is
+ s `� listed (%, hr min 90.00; hr
specifically liste
CCB Lic.: l 7s Electrical Lie.: C —� Sur.' Lie.: S� deS ELECTRICAL PERMIT FEES
t
Suprv. Electrician signature, required: ,� .T ,� Subtotal: 75 v(�
f
i Plan review (25% of permit fee):
Print name: 1.7bAfx / 1 1 U , } S-Det° Date: it ilgf t 2 State surcharge (12%ofpermit fkx): y /06
TOTAL PERMIT FEE: t..) DO I
Authorized signature: This it application e
P� PP spires if a permit is not obtain within 180
•
Print name: Date: r days after it has been accepted as complete.
Number of inspections allowed per permit.
I:1auldagWermia'ELC4'rrmiArrt doe 07.'0 Ii10 610 1615711 /COW'WER
Electrical Permit AL lica oFitt (1
P n EIVED Fi FFII, h: IISl•: ONLY
IN City of Tigard NOV 06 2012 Received t �. 4I( Permit No.: C�taela -opl
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718 2439 FOx:(3 '� A
GD DateB : Other Pcrmit/gip , • 00.D
TIGAR Inspection Line: 503.639J LDINGDNISION DateReady /B.- kris: b m See Page 2for
Internet: Inteel: ww.tl rd - or. Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Additionialteration!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 0 Other: where the available fault current ❑ Mannas and boatyards.
CATEGORY OF CONSTRUCTION eseccis 10,000 amps at 150 volts or ❑ Floating buildings.
less to greund, exceeds 14,000 ❑Commercial -use agricultural
❑ I- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all ether installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separatelyderivedsystem.
❑Addition of new motor loin of ❑ - A "L", 'L -2", "I -3"',
Job no.: j Job site address: 11825 SW Greenburg Rd 1001IPo r
re resi occupancy.
❑ Six or tro residential units. ❑ Recreational vehicle parks
City/State/LIP: Tigard, OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal,
Suite/bldg.!apt no.: 113 1 Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Tatul I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. It. or less 1 168.54 4 '
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited enerpv, residential 1 75.00 2
DESCRIPTION OF WORK (with above sq. F.)
Limited energy, multi- family
Tenant improvement residential (with above sq. ft.) 7"00 1 2
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
1 401 amps to 600 amps 200,34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1.0(X) 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 I 2
Owner installation: This installation is being made on property that I own which is not 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54
Branch circuits— new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or leech fn, 7.42 2
each branch circuit
Business name: Vast Electric, Inc. B. Fee for branch circuits without
service or feeder fee, first 1 56.18 56 18
Contact name: Trung Nguyen branch circuit
Each add'l branch circuit 3 7,42 22.26
Address: 1525 Seattle Slew Dr SE Miscellaneous user ice or feeder not included)
Each manufactured or
City/Stale/7_IP: Salem, OR 97317 dwelling, service and/or fdeeder 67.84 2
Phone: (503) 7934)871 I Fax: : (503) 585 -8828 Reconnect only 67.84 2
E -mail: vastelectrie@Colneast-net Pump or irrigation circle 67.84
Sign or outline lighting 67.84 2 2
CONTRACTOR Signal circuit(s) or limited-energy
Business name: Vast Electric, loc. panel, alteration, or extension. Paget 2
Each additional inspection over allowable in any of the above
Address: 1525 Seattle Slew Dr SE Additional inspection (I hr min) 6625/ hr
City /State /Z1P: Salem, OR 97317 Investigation (I hr min) 6625! hr
Industrial plant (I hr min) 78.18/hr
Phone: (503) 799 -5627 Fax: (503) 585-8828 Inspections for which no fee is
90.00/ hr
specifically listed (S! hr min)
CCI3 Lie.: 175531 Electrical Lie.: C -280 Suprv. Lie.: 5186S ELECTRICAL PERMIT FEES
-..' Subtotal: 78.44
Suprv. Electrician signature, required i %' T _ !ial■ (25% illf Plan review (25/0 of permit fcc):
Print name: Tim Vander Stoep I Date: 1/9/2012 State surcharge (I 2% of permit lie): 9.41
TOTAL. PERMIT FEE: 87.85
Authorized signature: This permit application expires if a permit is not obtained within I80
Print name: I Date: s
clays otter It has been accepted as complete.
Number of inspections allowed per permit. ' /
1 \ Hyildim5 \Permitsnl5t.C- PerrnitApp.doc 07/01:10 W
I:IO 440- 4615u U0SiCOM Ea 3‘/.q-0
9'd 9Z99 'oul ou)oele TSen eLL :01 Z 90 AON
• ,Nov 14 12 03:27p Vast Electric Inc.: . 503- 585 -8828 , p.9
•
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*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 -309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
p Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ I-IVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
0 Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
CO other &La GLu (/ 6
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I:'Buildi, Wermiu%El C- PermitApp.doe 0/01/10