Permit CITY OF TIGARD ELECTRICAL PERMIT
�. C;' COMMUNITY DEVELOPMENT Permit #: ELC2013 -00123
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/28/2013
Parcel: 1 S136DA00100
Jurisdiction: Tigard
Site address: 11308 SW 68TH PKWY
Project: Comcast Tech Ops West Subdivision: PFAFFLE PLAZA CONDO Lot: 2
Project Description: (256) branch circuits and low voltage for fire alarm to convert previous Providence tech office to Comcast Tech Ops
West.
Contractor: COCHRAN INC Owner: BENENSON 68TH PARKWAY KEY LLC, T
7550 SW TECH CENTER DR #220 BY PROVIDENCE HEALTH SYSTEM
TIGARD, OR 97223 ATTN: PROPERTY MANAGEMENT
1235 NE 47TH STE 160
PORTLAND, OR 97213
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
256 crt Branch Circuits wo /Purchase 02/28/2013 $1,948.28
Specifics: Service or Feeder
1 ea Signal circuit or Limited 02/28/2013 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12% State Surcharge - 02/28/2013 $242.79 -�
Electrical
Type of Const:
Occupancy Grp:
Total $2,266.07
•
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 fog • '• OAR
952 - 001 -0010 through OA 9 2- 001 -0090. You may obtain a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � .�AI JAI tit
Permittee Signatur
•
OWNER INSTALLATION O Y •
The installation is being made on properly 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.
Electrical Permit Applicati E� - . F OFFICE USE ONI.Y
tl 9 ° tea ,
City of Tigard R eceived
Date/B : _ - / Permit No.: Ezz izv,2,3
• 13125 SW Hall Blvd., Tigard, OR 9 722 y
IIII
9722 ti, 2 1 2 013 Plan Review Other Permit: / ,00/ 3 -eze.
Phone: 503.718.2439 Fax: 503.598.1960 Date/B :
I ns ection Line: 8 503.639..4175 Date Read /B � Juris. ® See Page 2 for
TIGARD
Internet: www.ti ard or. ov CITY OF TIGARD N. ified/Method: coca Supplemental Information
r k t ' 7 ,rt t 7 v rw I ' sw r : - r
TYPE OF " ` �� . �� II, PLAN REVIEW
ID New construction Addition /alteration/replacement �' • • ' hat apply (submit 2 sets of plans w /items checked below):
■ ce 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
El Emergency system. larger separately' derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1 -3 ",
Job ng ��Job site address: �' /'�/�/] y I ix or or more residential Recreational // `` �r �� '``' ai�� iiQ� ❑S ix or more residential units. ❑ Recreation al vehicle parks.
���/`v�(/
City/State/ZIP: n n , _ 9 7z ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name:6� T �� e,P_0 ❑ 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
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
�/ /A - G ,/J G7 ` ���2, a V s residential (with above sq. ft.)
C-� "' 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
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
Ci /State /ZIP: Temporary services or feeders installation, alteration, and/o
h 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 1 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 above service or feeder fee, 7 42 2
each branch circuit
Business name: / f B. Fee for branch circuits without
l /w / . , service or feeder fee, first / 56.18 ,
� 8 2
Contact name l branch circuit
l Each add'I branch circuit 7.42 f � ' r 2
Addre � zi/ _ � Miscellaneous (service or feeder not included)
Cit /State /ZIP: A/ / — — Each manufactured or modular 67.84 2
y dwelling, service and/or feeder
Phone:, , Fax: ! )�
J —
Reconnect only 67.84 2
, �f > /� � � Pump or irrigation circle 67.84 2
E mail: - � 4 77�5�'/..�F /12As
�j Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: / / panel, alteration, or extension. ! Page 2 Zs" 2
J / r Each additional inspection over allowable in any of the abov
Address:" C '7 � /fj�/ ! f y j �� I �E ) � r �� Additional inspection (I hr min) 66.25/ hr
//''� eei /� ///"" �7`J"7� Investigation (I hr min) 66.25/ hr
City /State /ZIP:
�' / �"� Industrial plant (1 hr min) 78.18/ hr
Phone-„52.3)2041 /��9 I Fa 4 ;4) 2 e Inspections for which no fee is 90.00 / hr
'b'f J specifically listed (V: hr min)
CCB Lic.: 77.E Electrical Lic.. Suprv. Lic.: - yy ELECTRICAL PERMIT FEES
���
Suprv. Electrician signature, required: o Subtotal: 7e,, �/
(...L...4„,__ Plan review (25 /o of permit fee): .5,, SZ
Print name: ■. e ��< k �. L 0 Date ��� State surcharge (12% of permit fee): &4Z.
TOTAL PERMIT FEE: 277/,
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number o inspections allowed per permit.
I:\ Building \Permits\EI- C- PermitApp.doc 07/01 /10 440- 4615T(I I /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
C\ Building \Perntils\ELC- Permi[App.doc 07/01/10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11308 SW 68TH PKWY, TIGARD, OR, 97223
Commercial - Electrical
105 Underground/slab cover
05/17/2013 00:00
ELC2013-00123
PASS
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11308 SW 68TH PKWY, TIGARD, OR, 97223
Commercial - Electrical
125 Wall cover
06/11/2013 00:00
ELC2013-00123
PART
2nd floor bathrooms and mdm wallvrough
Violation Summary:
Inspector Contractor