Permit •
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CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00114
T i G AR a 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13560 SW PACIFIC HWY
Project: Starbucks Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: (1) branch circuit for future equipment
Contractor: LIN R ROGERS ELECTRICAL CONTRACTORS Owner: MK EP TIGARD LLC
2050 MARCONI DRIVE SUITE 200 623 5TH AVE, 18TH FLR
ALPHARETTA, GA 30005 NEW YORK, NY 10022
PHONE: 770 - 772 -3472 PHONE:
FAX: 866 -496 -7839
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FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 02/14/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/14/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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.
Issued By: Permittee Signature: D APPUC/ -1
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 Applic EC EiV F . P I- I: U t 1 1(1 1 .I . (I \ I 1
City or Tigard 1 4 2013 P c m i r N o . : E I S ' x01 -c0/14
: / 13125 SW Hall Blvd, Tigard OR 7
Phone: 503.718.2439 Fax: 503.598.1960 r .., . : Other Permit
I 1 \, i, 1 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By. EMI 61 See Page 2 for
Internet: www.tigard-or.gov • \ , ' , a , 1 Notified/Method: Supplemental Information
❑ New construction [3 Addition /alteration/replacement Please check all that apply (submit 2 seta of plans w /items checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Other where the available fault current ❑ Marinas and boatyards.
exceeds 10,000 amps at 150 votes or ❑ Floal'ng bmldiugs.
teas to ground, or exceeds 14,000 ❑ Commercial-se agricultural
❑ 1- and 2- family dwelling ` ommercial/industrial ❑ Accessory building amps for an other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
- • , . _.,, — - - - g cac y s larger separesely derived system
' ... ❑ Addition of new motor load of ❑ "A", "E', "1-2", "1-3 ",
Job no.: Job site address: 13560 SW Pacific Hwy 100HP or more. Recreational Recr
❑ Sae or more residential units. ❑ eational vehicle parka.
City/State/ZIP: Tigard, OR 97223 ❑ eealmtare facilities_ ❑ Supply voltage for mom than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name:Starbucks LaBoulange ❑ Service or feeder 600 amps or more.
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Cross street/directions to job site: D Qty. Fee. y Tp
Starbucks 1 •
SW McDonald Street 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'1500 sq. ft. or portion 33.92 1
Tax map/parcel no.: 2S102CC00500 Limited energy, residential
. $ (with above sq. ft) 75.OD 2
- limited energy, multi- family
Install (1) 120V 20A circuit for future equipment and (1) 208V 30A circuit residential (with above sq. R) 75.00 2
for an oven. Services or feeders instailation and/or relocation
200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Starbucks Corporation 601 amts to 1,000 amps 301.04 2
Address: 2401 Utah Avenue South Over 1.000 amps or volts 552.26 2
City/State/ZIP: Seattle, WA 98134 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( 206 ) 318 -1575 Fax: ( ) 200 amps or less 5936 I I 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
i .'-- . - abo service or feeder fee
K '':...,11_• his r 7.42 2
,' .G. _ . t ; ,.. .- -r each branch circuit •
Business name: Lin R. Rogers Electrical Contractors, Inc. B. Fee for branch circuits w!lhout
• service or fader fee, first 1 56.18 2
Contact name: Alyssa Coursey branch circuit
Each add'I branch circuit 1 7.42 2
Address: 2050 Marconi Drive Suite 200 Mi celanem (service or feeder not included)
City/Stale/ZIP: Alpharetta, GA 30005 d > h ° an
67.84 2
Phone: ( 770 ) 772 - 3472 F ax: : ( 86p 496 - 7839 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: - I ti„ ' , ' �!'I I _ gn or outline l ighting 67.84 2
Si '
_. ;•':. ;-; :. > 1 -= _ _ . :/ ,:tfL 6-:c#'4ir'a . F - ::;k; i" r: Signal circuit(s) -energy I
Business ltame. panel, alteration, or extension. Page 2 2
Lin R R R. era Electrical Contractors, Inc. Each additional inspection over allowable in any of the above
Address: 2050 Marconi Drive Suite 200 Additional inspection (1 hr min) 6625/ hr
Investigation (1 hr min) 6625 / In
City/State/ZIP: Alpharetta, GA 30005
Industrial plant 0 hr min) 78.18/ hr
Phone: ( 770 ) 772 -3400 Fax: ( 86§ 496 -7839 Inspections for which no fee is
ecifi listed ii hr min 90.00! hr
CCB Lic. :118038 Electrical Lic.: 37 - 727C Suprv. Lic.: 4292S &N: _ _..,., ., _. - . .:".'i',:- . %.'..,.: . '''.: . -
Subtotal: $83.60
Suprv. Electrician signature, re Plan review (25% of permit fee):
Print name: Paul Howell Date: 2 -13 -13 State surcharge (12% of permit fee): $7 -63 ■ / / � TOTAL PERMIT FEE: $71.23
Authorized signature: I i �M
This permit application expires if a permit not obtained within 180
days after It has been accepted as complete. I
Print name: Date: • Number of inspections allowed pee permit. I
ItauitinglPcnnti ELC- Pu®itAppdoe 07/01/10 440.6l5Tp 1/05/COM/wEa
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