Permit CITY OF TIGARD ELECTRICAL PERMIT
III >e COMMUNITY DEVELOPMENT Permit #: ELC2012 -00731
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/24/2012
Parcel: 2S 101 DC04000
Jurisdiction: Tigard
Site address: 7550 SW TECH CENTER DR 250
Project: Cochran Subdivision: TECH CENTER BUSINESS PARK Lot: A
Project Description: (4) branch circuits and (1) low voltage for TI to enlarge (3) offices.
Contractor: COCHRAN INC Owner: WALTON CWOR SOUTHWEST 12 LLC
7550 SW TECH CENTER DR #220 BY CTMT - WALTON RE TAX
TIGARD, OR 97223 4678 WORLD PARKWAY CIR
ST LOUIS, MO 63134
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Limited Energy 12/24/2012 $75.00
Specifics:
4 crt Branch Circuits wo /Purchase 12/24/2012 $78.44
Service or Feeder
Type of Use: COM 1 ea 12% State Surcharge - 12/24/2012 $18.41
Class of Work: ALT Electrical
Type of Const:
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 OA 9 2 -001- - 090. You
�/ may obtain a copy of the rules or direct questions to OUNC by calking 503.232.1987 or 1.800.3
Issued By: JGty I+YU al Permittee Signature: D� A 1.
\ Y '' u ti C 14-77 O0
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.
RECEIVED 15:01:02 12 -21 -2012 1 /3
Electrical Permit Application I (1R 01.11(1 11 SF O \I.1
Ci of Ti and D 2 4 2012 Received
g
D
• at
Permit Noei_c . _ 007 3
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: I ��4
Phone: 503.639.4171 Fax: 503s98.1 OFTIG Plan Review Other Permi d 9, _ co 3
I I c; A It I Inspection Line: 503.639.4175 BUILDING DIVISIO Date Ready /By: Jana: el See Page 2 for
Internet: www.tigard Notified/Method: -n Supplemental Information
TYPE OF WORK PLAN -. REVIEW
Please check all that apply (submit 2 sets plans w /items checked below):
❑ New construction XAddition /alteration /replacement
❑ 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 n Master builder ❑ Other: ❑ Fire Pump. ❑ Installation of75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION
Q Additionofitew motor load of ❑"A ", "E ". "1- 2 ". "l -3 ",
Job no.: /g the i Job site address: �' • S � - f /) ()eider Jr x or or more. occupancy.
l ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: _91.2.Z _ ❑ Health -care facilities. ❑ Supply voltage for 'none than
y lv/ r1L� �/� ❑ Hazardous locations. 600 volts nominal.
��
Suite/bldg./apt. n o.: Z Project name: C / ['Service or feeder 600 amps or more.
• /',� • - !,1.1 : * FEE SCHEDULE
Cross street/directions to job site: ,5 P I - --i-- nacrIpti°n I Qty. I Fee. I Total I •
�j' New residential single- or multi - family dwelling unit.
/�1� - L "J�II L _ Includes attached garage,
• Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /parcel no.: Ea. add'I 500 sq. fl. or portion 33.92 I
Limited energy, resident ial 75.00 2
hedd DESCRIPTION ( O " F WORK / � (with above sq. f.)
o ;y �x a-r/t1 pl�da `Q n / 1 i e ( esi energy, mu o v e y Y � , l y f J residential (with above fl. ) 7500 2
C D t - /, Services or feeders installation, alteration, and/or relocation
J /" f f e_C-..5 200 amps or less 100.70 2
❑ PROPERTY OWNER 11 ❑ TENANT 201 amps to 400 amps _ 133.56 • 2
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: y 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 J 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
Brandt circuits - new, alteration, or extension, g panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT • ,' :: 11 • ` ONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
Business name: Me Cl S C fir, a. (:_k---0.{." B. Fee for branch circuits without
service or feeder fee, first
Contact name: e Rte/ %i branch circuit ) 56.18 //� 2
Address: Each add'I branch circuit 7 1 Z,u 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and /or feeder
Phone: ( ) ( F ax: ;
�Z/ Zvi �z fZ ( /71 ) ZD. yz�B Reconnect only 67.84 2
L (� I1 1 Pump or irrigation circle 67.84 2
E-mail: • . rc c (l CO l / O • 7
601
vl a Sign or outline lighting 67.84 2
(�� �,, Signal circuit(s) or limited- energy
8 .
CONTRACTOR
Business name: ``-LLi� can panel, alteration, or extension. ( f Pa e 2 DD
2
Each additional inspection over allowable in any of the above
Address: - 1 5 50 i. { �h e11 r' *2,20 Additional inspection (I hr min) 66.25/ hr
City /State/ZIP: (F l G O R 7Z Z Investigation (1 hr min) 66.25 / hr
Industrial plant (1 hr min) 78 18/ hr
Phone:97/ i''6 41Z9 . Fax: , 9 '7 ,r;..
Inspections for which no fee is
I
/ [�L� specifically listed ('h hr min) 90.00 / hr
CCB 2 , . . . . / Lie.: .1 Z L/ Z Electrical Lie.: .2 5Gk C, Suprv. Lie.: 3i-ii-I.7 .' "'ELECTRICAL PERMIT' FEES
_
Suprv. Electrician signature, required: 0,\--_, /e
Vert'
Plan review (25% of perm feebtotal:}: .
Print name: KP �l . --tit K% ,, Date: / z- Z/ . State surcharge (12% of pennit fee): to, y I
Authorized signature: gg TOTAL PERMIT FEE: / 7/ 1
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: L1D�t° _>♦ y C , � Data J�_ Z i_ /�
1 < N umber of inspections allowed per permit
I:'Building App.doc 07'01'10 440- u615T(11'05,COMAVE6
01 15:01:31 12 -21 -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*
❑ Other:
•. COMMERCIAL WORK.ONL
Fee for each, commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
p 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*
❑ P rotective Signaling
❑ O ther
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I: 1Building \PamitslELC- PamitApp.doo 07/01/10