Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00142
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/04/2013
Parcel: 25101 DD00101
Jurisdiction: Tigard
Site address: 6975 SW SANDBURG ST
Project: Verizon Wireless Subdivision: TECH CENTER BUSINESS PARK Lot: C
Project Description: (1) service and (2) branch circuits for Installation of back -up generator at existing site
Contractor: RED HILLS ELECTRIC & TOWER SERVICES Owner: WESTON INVESTMENT CO LLC
PO BOX 490 2154 NE BROADWAY, STE 200
DUNDEE, OR 97115 PORTLAND, OR 97232
PHONE: 503 - 554 -8244 PHONE:
FAX: 503 - 554 -1735
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 03/04/2013 $100.70
Specifics: amps or less
2 crt Branch Circuits w /Purchase 03/04/2013 $14.84
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 03/04/2013 $13.86
Electrical
Type of Const:
Occupancy Grp:
Total $129.40
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 i - 0.r•an - 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. ENTION: Oregon -w r- •• -s y• - o follow the rules adopted by the Oregon Utility Notification Center. Those as are set forth in OAR
952 -0 -0010 through OAR 952 -0' -0090 o may obtain a copy of the rule or direct questions to OUNC by callin 503.232.198 r .80 32.2
Issu d By: / /� / �� -' � Permittee Signature:
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:
CONTRA TOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' A t/ 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 Application QQ FOR OFFICE USE ONLY
II City of Tigard plv
Re SEW Permit No.: ��I i 3��/
° 13125 SW Hall Blvd., Tigard , R R Plan Review
Phone: 503.718.2439 Fax: 503.598.11 960 Date/By: Other Permit:
Inspection Line: 503.639.4175 MAR 4 2013 Date Ready/By: Juris: ® See Page 2 for
l I G A R D p Notified/Method: Supplemental www.tigard- or.gov PP lemental Information
TYPE I j f ^ Qf�& Waage PLAN REVIEW
XNew construction 11 Additi n clte 98nTr� e 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 ", "1 - ", "1 - ",
1001-11 or more. occupancy.
Job no.: d/ e c' Job site address: 97 , See) Sd ,p KJ,e46-Sp ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: -- ❑ Health -care facilities. ❑ Supply voltage for more than
Qt�Ie ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: tine, 2 d i(.J ,,,,,.. er 2 Z/_ ❑ Service or feeder 600 amps or more.
�b'�'G� FEE SCHEDULE
Cross street/directions to job site: / 72 -. Description I Qty. I Fee. 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 I
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi-family 75.00 2
.._7:43.1 #tJd'W adrdd/s./ /�L `& 45644.7 residential (with above s ft.)
f Services or feeders installation, alteration, and/or relocation
Lvea- g ` 7� 200 amps or less / 100.70 /0/9. 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
each branch circuit 7 /y 9 2
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)
City/State/ZIP: Each manufactured or modular 67.84 2
ty 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
Business name: 1e:17 1,/,///‘ E panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 5D6 o o y y iU Additional inspection (I hr min) 66.25/ hr
Ci City/State/ZIP: Investigation (1 hr min) 66.25/ hr
ty D OA/ DEr1 (€ Q 97//
Industrial plant (1 hr min) 78.18/ hr
Phone: (3O ? ),57.5 82 44 1 Fax: (S6 �Sy 3) 7 '�� Inspections for which no fee is
' k e b 3 specifically liste (V: hr min) 90.00 / hr
CCB Lic.: 1346-4'3 Electrical Lic.: Suprv. Lic.: y,rI 5 ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: C - r 87 �i by i%h 3 Subtotal: // 5 . 5q
p g �� 4� 41 Plan review (25% of permit fee): ----_____.
Print name: / J , j/; , • ��� Date: 3 /� J ! y State surcharge (12% of permit fee): Lig • gb
K / TOTAL PERMIT FEE: /A 9 • S/ O
Authorized signature: This permit application expires if a permit is not obtained wi 180
Print name: Date: days after it has been accepted as complete.
N um b er of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 07/01 /10 440.4615T(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
1: \ Building \Permits\ELC- PermitApp.doo 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
6975 SW SANDBURG ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
05/14/2013 00:00
ELC2013-00142
PASS - No C of O
Remove jumper
Violation Summary:
Inspector Contractor