Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 -00204
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2013
Parcel: 2S110DCO2400
Jurisdiction: Tigard
Site address: 11565 SW DURHAM RD 100
Project: Dr Auzins Subdivision: 1998 -128 PARTITION PLAT Lot: 2
Project Description: (3) branch circuits for TI.
Contractor: PRECISION ELECTRIC OF WA INC Owner: DRT PROPERTIES LLC
PO BOX 2353 9805 SW CHOCTAW ST
BATTLEGROUND, WA 98604 TUALATIN, OR 97062
PHONE: 360 - 260 -4544 PHONE.
FAX: 360 - 260 -4833
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 04/03/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/03/2013 $8 52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79 54
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: • - .. - law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952- 001 -0010 thro OAR 952 -c01 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 5 2.1987 or 1.800 32.2344.
Issued By: • /...• Permittee Signatu l c.0 -
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' — rJ 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 REcEIV i l OR OI Fit ( ti l' 0\1.1
1.1
Sli City of Tigard ° / ?. / A AerntitNo. E.4-C&°/3-z)-2° l3125 sw Hall Blvd_, Tigard, OR 97223 APR 0 2 2013 rt.n Rcvic
Phone 503.718.2439 Fax: 503.598.1960 Mi ether Permit: Q - /7� 2, O � 2
Inspection Lair. 503.639.4175 CITY 4FTIGARD D . t c Ready /By: f ury ; �[ ® see tea: J
Internet: YAW!. ngard -orgov , Tin, Notittcarntrttwd; Supplemental
y . k Information : _ ,. � ..t4^ a ryl. <' :' ; �,,,'... ig t el 'tl..i:.., . __ K _ : :. r ; (rp � :V : P.` ; 'ii:r ,' ,,al. • r,e.:a SL 4.i. R. �. ` t6, . r„ :C i ',, . • - ` ., Lk ► .r. , 1 A�s -. �
q New Construction It Addition/alteration/replacement Please Check all that apply (submit j sets orptun w /items clmekcd below):
❑ Service or feoder 400 amps or man ❑ Building over three storks
❑ DCmolitiOn ■ Other: ;
the e ava4tb,e fault current Mari
� � � qy4 a r�+ s ^r n fist CI Marinas ° boatyards
r�'t:'* .,,s eat a <w ' .. f k, 1„,LI . .w.:.. 't ":',1 r , : •�.rj :;f rJ'•- .% /,�.i` exceeds 10,000 amps at 130 vole. or ❑ Floating buildings.
u less to rou.d, or exceeds 14,000
0 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building s ❑ Ge ldin g s l -use agricultural
� ampt for all other it�tellatior.s. buildin
0 Multifamily ❑ Master builder rim um
Ce, t'+'3F i , t+ en,. x n;.."vat_ -. __ ❑ O t h er: ❑ rim pump. ❑ Installation rger $spa i ly 75 KVA or
r �t `�a' + • >• _ _ ; ❑ Emergency system, ew larger sepamkly derived system.
° ..r ` r,iY' a. .i;at +� Addition
-; .� ":" ❑ of new motor load of ❑'•A" "E" "I -2" "1.3 ",
Job no.: Job site address: 100HP or more. oecrpancy.
/ ��� ��� �U�G, rt iu l ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: a Li`A 04 - 7 0 0 Health - arc facilities.
0 Supply voltage for more than
❑ H°rardoua locations. 600 voles nominal.
Suite/bldg. /apt, no,: Project name: A - // C OS ervite or feeder 600 amps or more.
Cross street/dire tioxis to job site: t
Demrlotl
i - "'''' ` {' � ix� i :F• '�� - .. Qty. I tae. 1 rant l
New residential tingle- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1 ,0o0 sq. ft. or less 168.54 - 4
Tax map/parcel no.: Ea. add'1500 sq. R- or portion 33.92 1
+y _, �n , Limited energy, residential
2
Z.5:7?-i 14. 1 r• s• 7 ,1 : " 7, -- r., 1 :sSc m ,4-it . s o with ab ove 75.00
Limited energy, multi - family 75.00 2
1 r/ L / O r Z /, 'r I G , 3 P/66 residential (with above sq. ft.)
Services
�{t - or feeders installation, alteration, and/or relocation
"'� ri r zxw'ri a .- �T,x -, r ,_ r 200 amps or less 100-70 - Z.
S.' ..... ..�, u._.uu,,__StY° ry ;. :: ,..,ri ; � E 41, i ..�.�... t Y : - \ k or..i• ma •, ti 201 amps to 400 amps 133 -56 '. •
ri
Name: 401 amps to 600 amps 200.3.4 2
601 amps to 1,000 amps 301.04 2
Address: 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 59.36 1
Owner installation: This installation is being made on property
201 amps to 400 amps 125.08 2
g p petty that I own which is not 401 imps to 399 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 F ce F or branch circuits with
t�7 . "-- n . ., : ter. 7 34 ; n y 'ti _ ntt above service or feeder fee,
.- , ....: .e__ .
...ir ��.., ....., 1, ¢4 , ate each branch circuit 7,4 2
r
Business name: prc c / ... / o y) f 1 :_7 ( / ( 0 ' n. Fee for branch circuits without
Contact name: l� p �� /, Ln� ^ a service or feeds fee, first 56.18 s( 2
J branch circuit
Each add'I branch circ 7.42 r G 2
Address: PU 9 x f— 3 Miscellaneous (service at feeder not Included)
City /State/ZIP: ‘,5, //Z-,1, 6,--6...o � 1,-,4 /J o t) Each
dwelling, sense and/or feeder 67.84 2
Phone: () 6 p) O [7/5-4/4/ Fax: : ( 766. ) ZG O 4/ g - -3 Reconnect only 67.84 2 Zg
E-mail: �4 r -- e° t L • C4.)--• Pump or irrigation circle 6, - g4 2
a t a i r etail: t .''';',..,...1.---,'", , _ „ J Sign or outline lighting 67.84 2
tifi .s�rri; +...'7W Yl I i .�.� :.._ ....m. wl J `
..�.,.. � +ate °a, =w . � - •, \ Signal circuits) ts) or Ilmiledtncrgy
Business name: . G ,,,, C C)7 t „ panel, alteration, or extension. Page 2 2
Each additional Inspection over allowable In any of the above
Address: / O X . 3 Additional inspection (I hr min) _ 66 25/ hr
City /State/ZIP: "1, 7 6,2 f A. (/4 C��d L 1 Investigation (1 hr min) 66.25! hr
Industrial plant (I hr min) 78.18 / hr
—
Phone: (Vo) Z‘,0 .//5 Fax: ( 34 a ( Inspections for which no fee is
ap �nficelly listed (/m hr min) 90.00/ hr
CCB Lic.: t: �fj Electrical Lic.: G Suprv. Lic.: s s,.ttarrroar rx _ -.
Suprv. Electrician signature, trrquires / Pr _ Subtotal: 7 / .O-
`� /(� Plan review (25% of permit fee):
Print Her
nt ne:
I , , �✓ Date: ' -� / 5tate surcharge (12 °6 of permit foe): $. 5
Authorized signature: . TOTAI PERMIT FEE: 7 [ ' $1
This permit ■ 1lcadon e>r lret if a
Pe ay p cc pub, complete.
srttMln I>!9 n
Print name; ]+.�C p(�n l /1_9 Date; 4 �--i • days after k has d been accepted (4 �/
, vim ' Number of inepeetio.b allowed per Permit,
t: iB. IldinjPcrminl fil.c'.Pen..itwpp 071111!10
41 5Th lroslcont/wt:o
T 0' d 3 I 210 NO I S I O32id S T: Z0 £ T 0Z— E0 —eldU
Z0 'd 14101
. Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for $u resIdendal systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
p Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other
�
Fee for b 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
lAlk ld'mtP 4:LC- PefmilAOb.dos 07/01/10
Z0 ' d O I ?110313 NO I S I 03dd S ti: ZO E Z OZ- ZO -ddt1
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
11565 SW DURHAM RD 100, TIGARD, OR,
97224
Commercial - Electrical
199 Electrical final
06/04/2013 00:00
ELC2013-00204
FAIL
Locked 12:50 pm
Construction or work for a permit is required to be accessible R109.1
Violation Summary:
Inspector Contractor