Permit lig p CITY OF TIGARD
°A6 ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Per
COMMUNITY ELC2012 -00687
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/06/2012
Parcel: 2S112AB00300
Jurisdiction: Tigard
Site address: 7350 SW LANDMARK LN 110
Project: Cambridge Precision Subdivision: 1992 -007 PARTITION PLAT Lot: 2
Project Description: (4) branch circuits for TI. 12/26/2012: REPRINTED to add (2) 200 amp service and (11) branch circuits.
r
Contractor: VISION POWER & LIGHT Owner: B -1 LANDMARK LLC
3809 W 39TH ST BY PRENTISS C HICKS TR
WASHOUGAL, WA 98671 429 A NW SKYLINE BLVD
PORTLAND, OR 97229
PHONE: 503 - 209 -8808 PHONE:
FAX: 503 - 926 -9384
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 12/26/2012 $201.40
Specifics: amps or less
15 crt Branch Circuits w /Purchase 12/26/2012 $111.30
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/26/2012 $37.52
Electrical
Type of Const:
Occupancy Grp:
Total $350.22
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 . 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 issuan -, or if wor is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifica enter. Th•=e 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 0 : .1987 or 1. 0 .332.2344.
Issued By: TZP Permittee Signature:
a. � /,i' `I ( t
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
$ . COMMUNITY DEVELOPMENT Permit #: ELC2012 -00687
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/06/2012
Parcel: 2S 112AB00300
Jurisdiction: Tigard
Site address: 7350 SW LANDMARK LN 110
Project: Cambridge Precision Subdivision: 1992 -007 PARTITION PLAT Lot: 2
Project Description: (4) branch circuits for TI
Contractor: VISION POWER & LIGHT Owner: B -1 LANDMARK LLC
3809 W ST BY PRENTISS C HICKS TR
WASHOUGAL, WA 98671 429 A NW SKYLINE BLVD
PORTLAND, OR 97229
PHONE: 503 - 951 -0415 PHONE:
FAX: 503 - 926 -9384
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 12/06/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/06/2012 $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. Spec • Codes • •d al 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 • uance or if •rk is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N. ' Cen -r. T ose rules are set forth in OAR
952 - 001 -0010 through OAR 95 -001 -0 90. You may obtain a cop of the rules or direct questions to OUNC by calli • S 32.1987 •r 1,8 0.332.2344.
•
Issued By: L1 ` Permittee Signature: 1 :IL
OWNER INSTALLATION ONLY or"
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.
REeEIVE.
Electrical Permit Application FOR OFI. WE t SE 0y1.1
of Tigard DEC 2 6 2012 Received
City g DateBy: /4/24/.44) ‹grAil •' emit Nooz /l0/a � /_ L �J
, • 13125 SW Hall Blvd., Tigard,OR 97223 Plan Review C 100
111
P 503.718.2439 Fax: 503.598. l9 I TIGARD Date/By: Other Permit:
I , r t� Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: brio: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ddition/alteration/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 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 agricultural
❑ 1- 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 INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "l -3 ",
Job no.: Job site address: • `) 100HP or more. occupancy.
S(,�J ^� * ! X� 0 or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: ,F—d Q r et? 2.2. 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: Cep— It, r ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: 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 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 I
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.) .
Limited energy, multi - family
n � �� P t t / C4 c + ZDI Z --6/54g 7 residential (with above sq. ft.) 75.00 2
� I � Services or feeders installation, alteration, and/or relocation
--'= 200 amps or less 2. 100.70 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: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State /ZIP: relocation
Phone: ( ) Fax: ( ) 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
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, er panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, I l 7.42 2
each branch circuit 1
Business name: B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
City/State /ZIP: dwelling, service and/or feeder
Phone: ( )
Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
N panel, alteration, or extension. Pa e 2 2
Business name:
U rs I r ig f2Lc)e t ` -4 Iv Each additional inspection over allowable in any of the above
Address: 3 0 7 475 Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: ,, 1 e (A,� t 6 Ca 7 l _ Investigation (1 hr min) 66.25/ hr
W��k44/ v Q Industrial plant (1 hr min) 78.18/ hr
Phone: le ) ` -1 09jl / Fax: ( ,Q,$ ff s (3p� Inspections for which no fee is 90.00 / hr
specifically listed ('h hr min)
CCB Lic.: /6,7Sro91 Electrical Lic.L' , / 1/t2 Suprv. Lic. ELECTRICAL PERMIT FEES
P signature, required: �/1'// - , o Subtotal:
Suprv. Electrician si nature, r uired:
_ ,t � f. Plan review (25% of permit fee):
Print name: r - I ' 2 r
, DS' iC 1 ' S7j State surcharge (12% of permit fee):
TOTAL PERMIT FEE:
Authorized signature: `k This permit application expires if a permit is not obtained within 180
��`_ days after it has been accepted as complete.
Print name: 5 . 4D 'e l( - / e...ert- Date: • Number of inspections allowed per permit.
I: \ Building \Permits\ELLC- PermitApp.doc 07/01 /10 440- 4615T(I /COM/WEB
Electrical Permit Applicati fiEC FOR OFFICE USE ONLY
1L,�� !!lI Received
City of Tigard Date/By: i te, l _I Permit No.: (iL .J ) _ g, • 13125 SW Hall Blvd., Tigard, OR 9722} 0 6 2012 Plan Review
' I ' Phone: 503.718.2439 Fax: 503.598.195 `` Date/By: Permit: p7pr _ (j 013 $�
TI G A R D
Inspection Line: 503.639 CITY �' /� T� p Dat Ready/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov VI t 1 V // i �� 1 f�,I Notified/Method: 1 � Supplemental Information
TYPE OF� DIVISION PLAN REVIEW
❑ New construction Addition /alteration/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 ❑ 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 agricultural
❑ l- and 2- family dwelling I CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
El Multi- family ❑ Master builder ❑ Other: ['Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "I - ",
Job site address: 100HP or more. occupancy.
Job no.:
�3 S� � �12oi ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bld /a t. no.: Pro ect name: ! i ❑ Service or feeder 600 amps or more.
g' p it
�_D77�(('1/`1 �J �°_ �GG FEE SCHEDULE
Cross street/directions to job site: / Description I Qty. I Fee. I •
I Total
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'I 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
CP a i d__-e_ di 1 ) D r k residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
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
Temporary services or feeders installation, alteration, and/or
City/State /ZIP: relocation
Phone: ( ) Fax: ( ) 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 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
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 fee, 7 42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first
Contact name: branch circu 56.18 2
Each add'I branch circuit ? 7.42 2a, 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
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
panel, alteration, or extension. Page 2 2
Business name: V I s , / e .,� p a j e V c i _< 7 1—
/ Each additional inspection over allowable in any of the abov
Address: . S"..--. 7` / Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: , JJxd�d� r- Investigation (1 hr min) 66.25/ hr
=T B Industrial plant (1 hr min) 78.18 / hr
Phone: () ' 9 Fax: ) Inspections for which no fee is
�� Z specifically listed (V2 hr min) 90.00/ hr
CCB Lic.: Electrical Lic.: i'a SS Lic.:L`Sf S ELECTRICAL PERMIT FEES
Suprv. Electr s ature, required: I /`( ' / ► ' ' — (of( (1.3 Subtotal:
V �' Plan review (25% of permit fee): _
m
Print name: /I ,/ t l d 1\ r A , Date: I 0 1 State surcharge (12% of permit fee):
��l/ i� ! TOTAL PERMIT FEE: 7.,
Authorized signature:
This permit application expires if a permit is not obtained within 180
\ days after it has been accepted as complete.
6 Q Print name: - ri�l Date: 1 Z.,...1, • Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 07/01/10 440 -46t5T(11 /05 /COM/WEB
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
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC•PermitApp.doc 07/01/10