Permit CITY OF TIGARD Eg SED ELECTRICAL PERMIT
'COMMUNITY DEVELOPMENT 1 Permit #: ELC2012 -00636
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 i2 I Date Issued: 11/06/2012
Parcel: 1 S 135DC00200
Jurisdiction: Tigard •
Site address: 11825 SW GREENBURG RD 112
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 - 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 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 OAR 952- 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. I'
Issued By: Atka&if e Permittee Signature: f//L n ► I1 e., 2. f 1Od.
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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CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00636
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 112
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 0 952- 001 -0090. You may
� LJ .8
obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2334 �7 /'
Issued By: ` )' .Q i1 K Lt Q Permittee Signature: & 4 r Jc4 f , .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.
Nov 14 12 03:26p Vast Electric Inc. 503- 585 -8828 p.6
Electrical Permit Applic.i - 1,: EVED FOR 0F1 lc e (s1_ ONLY
Received
City of Tigard Permit No.: ELC2012 -00636
I II • 1.3125 SW Hall Blvd., Tigard, OR 9V 14 2012 Plan Review
C ' Phone: 503.718.2439 Fax: 503.59 .1960 pye/B . Other Permit:
T I G A R U Inspcaion Line: 503.639 C� 1 1 OF TIGOQ (1 ) r �� Information
Internet: www.tigard- or.gov WILING (( 1�1w , a+
nvE WILL l'G DISIO►'t PLAN REVIEW
❑ New construction ® Addition /alteration/replacement cam` all that apply (submit 2 sees of plans w:items checked below):
❑ Service or feeder 400 amps or more 0 Budding over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts of ❑ 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. ❑Fie pump. ❑ Installation of 75 KVA or
JOB SITE LV FORI►tATIOV AND LOCATION El Etnergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "E'. I -2 °1 -3 ^.
lob no.: I lob site address: 11825 SW Granburg Rd 100HPor more. occupancy.
❑ Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard. OR ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Haardous locations. 600 volts nominal.
nal.
Suite/bldg./apt. no.: 112 I Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: DescriptionDescriptionI Qty. 'I
l Fee. ► Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.92
Limited energy, residential 75.00 2
! DESCRIPTION OF WORK (with above sq. It)
Limited energy, m ulti - family
Adding low voltage to permit /mELC2012 -00636 residcrmat (with above sq. R) 75.00 2
Services or feeders installation, alteration, and/or relocation '
200 amps or less 100.70 2
0 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 20034 2
601 amps to 1 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /StateJZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) I 2o0 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 1 above service or feeder fee, j each branch circuit 7.42 2
Business name: Vast Electric, Inc I B. Fee for branch circuits without
service or feeder fee, frr t 56.18 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not induded)
City/StatcIZ1P: Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) Fax:: ( ) Reconnect only i 67.84 2
E - mail: Pump or irrigation circle 67.84 2
Sign or outline fighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy j
Business name: Vast Electric, Inc panel, alteration. or extension. I Page 2 75.00 ; 2
Each additional inspection over allowable in any of the above
Address: 1525 Seattle Slew Dr Se Additional inspection (1 hr mm) 6625/ hr
City: State/71P: Salem, OR 97317 investigation (1 hr min) 66.25! hr
Industrial plant (I hr min) 78.181 hr
Phone: (503) 799 - 5627 I Fax: (503) 585 - 8828 Inspections for which no fee is
90.00/ hr
specifically listed CA hr min)
CCB Lic.: 175531 Electrical Lie.: C -280 I Suprv. Lie.: 5186S ELECTRICAL PERMIT FEES
Supra. Electrician signature. require
Subtotal: 75.00
V(1-4
G Plan review (25% of permit fee):
Print name: Tim Vander Stoep Date: 11/14/2012 State surcharge (I2 %of permit fee): 9.00
TOTAL PERMIT FEE: 84.00
Authorized signature: This permit application expires if a permit is nos obtained within 180
Print name: days after it has been accepted as complete.
Date: • Number of inspections allowed pm permit.
1:t Evading\PcrmimELC•PermitApp.doc 07 :01/10 440- 16I5t(1I/05/COMAVEB
Electrical Permit Application RECEIV II
1:01Z 01:FIC E l SE.O l 1
Ph m City of Tigard NOV 6 20 e""`d Pena; 4o_
13125 SW Hall Blvd., Tigard, OR 97223 `Datc[i : �- L.�idD/d`' O�
Phone: 503.7182439 Fax: 503.598.1960 �� OF T �t ; Other �;t: �8 u Paote_ op ."
I
T I e,t R 0
Inspection Lane: 503.639.4175 Bl See Page 2 for
( U
CITY V� a • . • y ., .
Internet: www•.tigard- or.gov BILDING DWI ~�ii r. Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Z Addition/alteration /replacement Please check all that apply (submit 2 sets of plans wlitcros checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and bootyerds.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14.000 ❑ Commuoial -use agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder [] Other. ['File pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separatelyderisalsystem.
i
❑ Addil ion of new motor load of ❑ "A ","[ ",`l -2 "I -3',
Job no.: I Job site address: 11825 SW Greenburg Rd I OOHPor more. ■ccupantyy.
❑ Six or more residential units_ ['Recreational vehicle parks.
City /StatciZlP: Tigard, OR ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 112 Project name: 0 Service or feeder 600 amps ar more.
FEE SCHEDULE
Cross street/directions to job site: Description
I Qtr. I Fee. I Total I •
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq. ft. or less 168.54 4
fax map /parcel no.: Ea. add'I 500 sq. It. or portion I 33.92 I
Limited energy, residential
75.00
DESCRIPTION OF WORK (with above sq. ft)
Limited energy, multi- family 75.00 2
Tenant improvement residential (with above sq. R.)
Services or feeders installation, alteration, and/or relocation
200 amps or less • 100/0 ; 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: I Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
CityJState./Y..IP: : relocation
Phone: ( ) Fax: ( ) I 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 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 feeder fix. 7 42 2
each branch circuit
Business name: Vast Electric, Inc. B. Fee for branch circuits wi boor
service or feeder fee. firm I 56.18 `
56.18 .,
Contact name: Trung Nguyen branch circuit
Each add'I branch circuit 3 7.42 22.26
Addr 1525 Seattle Slew Dr SE Miscellaneous (service or feeder not included)
CityiStatelZlP: Salem, OR 97317 Each manufactures or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 793 - 0871 I Fax: : (503) 585 - 8828 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: vastelectric@comcast.net
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Vast Electric, lac. pond, alteration. or extension. Paget 2
Each additional inspection over allowable in any of the above
Address: 1525 Seattle Slew Dr SE Additional inspection (1 hr min) 6625/ hr
City/State/ZIP: Salem, OR 97317 Investigation (I hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: (503) 799 -5627 Fax: (503) 585 - 8828 Inspections for which no fee is 90.00 / hr
specifically listed (t4 hr min)
CCB Lie.: 175531 I Electrical Lie.: C -280 Suprv. Lic.: 5186S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, r uircd:CC�� /�� r — =- Subtotal: 7P+.44
Su
P � !(.GlAA :reg .e Plan review (25% of permit fee):
x
Print name: Tim Vander Stoep Dale. 11/9/2012 State surcharge (12%ofpermit fee): 9.41
TOTAL PERMIT FEE: 87.85
Authorized signature: This permit application expires if a permit is not obtained Filhin 180
Print name: Date: • days after it has been accepted as complete
Number of inspections allowed per permit.
1 :'Ruddir.g1Pamits',FIC- 4.emitApp doe 07,01!10 440- 16;STt l I l0SCOblAF,s
b'd 8299 ' o!Ipal3 iSen e9l :Ol Zl 90 noN
Nov 14 12 03:26p Vast Electric Inc. 503- 585 -8828 .. p:7
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*
•
El Burglar Alarm
• ❑ Garage Door Opener*
El 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
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other Phone_ computer
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
1:•. Build'urtePermhs\ELCi4rmilApp.doe C7 /01 /10
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