Permit CITY OF TIGARD ELECTRICAL PERMIT
I - COMMUNITY DEVELOPMENT Permit #: ELC2013 00213
T f. G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/10/2013
Parcel: 2S101 DD00800
Jurisdiction: Tigard
Site address: 14020 SW 72ND AVE
Project: United Rentals Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: (4) branch circuits for new desk circuits
Contractor: JARMER ELECTRIC INC Owner: I S PROPERTIES LP
5105 SW 45TH AVE #200 ATTN: UNITED RENTALS LEASE ADMIN
PORTLAND, OR 97221 BY FISCHER & COMPANY URI
13455 NOEL RD, STE 1900
DALLAS, TX 75240
PHONE: 503 - 246 -5381 PHONE:
FAX: 503 - 244 -8037
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 04 /10/2013 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/10/2013 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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- 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
/� /9� APP
e-101-774
_f(, -r1oj
Issued By: . �4�' �G(.1 Permittee Signature: U/ul
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 603.839.4175 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.
04/09/2013 11:37 5032448037 JARMERELECTRIC PAGE 01
Electrical Permit Applicati I CE I i ()Ft I< r 1 ` t i■ l
City of Tigard �� ,lc o Id 13 P�rmitxo: /3 - DDS
u 13125 SW rla hall Blvd., Tigard. OR 972 O n 2013 plpp Review
a Phone: 503.718.2439 Fax 503.598,1960' r7 a Other Penult: Penult: Inspection Line: 503.639.4175 Date Ready/By tar -
Internet: www.tigard-or.gov C OF TIGAR I Notified/Metlrod: I &I
e lE hxr Ca V "Mull +t p qy y
. . X +bd ru a ^tii '1141 0%4.4 14tc•trik •'&•Zninitaliri: $l1. * : {,i:),]
lU k ni'�I :j i; . ' '. ' ` ::
et irx
❑ New construction �' ddition/alteration/replacement 1 'p' saes W -
0 Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available lkult current ❑ Marines and boatyards.
. 1� 4.y w�n^A.estrii)r a ' u lr .,`";o,"o° v `"'! " 5. q s1) •: M exceeds 10,000 amps at 130 volts or ID Floating buildings.
:; , . .3 ca t C,'Y,b,: les,;:"G...01
Lr.. r ,s � lk.sr °HS• M.4'.f�"�' ti -'l Iett to Hnwnd, or exceeds 14,000 ❑ Comftteeelelwete 45 ieu0ura1
❑ I - and 2- family dwelling ►•. Commercia l/industrial ❑ Accessory building amp for all other insesllasioes. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fat pump. ❑ Installation of 75 KVA or
Z t ^:. £ IW;1 1 : w•r a r 711 �n.c. 71 t it'7n , cos , r. ❑ Emer'&ency "1":". larger eepecaaely derived ryatero.
t
r•ic l i•li 4 M.� 4.Ia wF .4.4.: rw; Addition of motor load of
� � i ,,� : t ' . � i ` � y ,E4 �� a � ° •>: ' ". T '���S.di' :� �,`^� ❑ ❑ "A", „E,.. "1- Z", "1-3 ",
100111' or more occupancy.
Job no.' Job site address a A ._ Tb II Is • ❑ Six or more residential units units 0 Recreatiwal vehicle parks.
EIM IIErat . `« ' El Health -care facilities. ❑ Sllppty vo>nlge for more than 111. r ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.. Project name �, i� . . ❑ Service or feeder 600 ,..s or yy more
Cross street/directions to job site: D,atrlvncs qty , Par. meal •
"'" New residential single- or multi- family dwelling unit.
Includaa attached garage.
Subdivision: lV~ Lot no.: 1,000 sq. ft. or lass - 161.54 4
Ea. add' l 300 sq. ft. or portion 33.92 I
Tax map /parcel no.:
yr r wiat °"� �''' ! �v•. x a n- ,r, �asap c 1 75.00 2
&r � i 1' r ' r r (wit above sq )
r I. i t q � w r -$.
us.R ]a , 17 � :[ sr _ • ' '1" -
"_ Limited energy, ab S
family 75.00 Z
t 111114115 . •• . ■ . residential (with ith a bove sq. ]
Services or feeders installatloe, *lterntion, and/or relocation
200 amps or lets 100.70 J 2
, .as ^' .i
Tk✓ .r, �,�.' , �yyr - , ..r.S': . g I u p q r 1 1. :�
am. . f i a t '.: vm ,,T.,e.e,ii zs ,tmttFt �4.'r e "' • ¢ ` ha > ;t1 ,
� „ 201 amps 1a 400 amps 133.36 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/o
City/State/ZIP:
Phone: ( )
• Fax: ( ) 200 amps or lees 59.36 I
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 salt, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuhts new alteration or citensio . tint
Owner signature: Date: A. Fee for branch c with
A: - x ..._.. ..., ..... -
se.' r' ., ,,. -, .. .r,,.,.,.,.2r . -�; � gsrgu.; #a - :^^' : rz�• :-.� i � above service or feeder foe,
•r1., *n >.. , . ,,y,� - �' . ... r '^v arm r.q ■
7x. , 33'. + 4:.. , .aloi. � rox3s III
: t,•; . f ? d4.1,05
I . b Pi:, a • .e++,,,ix nra iaatirKCts < x �... each branch circuit ; 7.42
Business name: B. Fee for breech circuits without
_ service or Reeder fbe. Ent 56.18 % )C)
branch circuit
Contact name: Each add'I branch circuit 7.42 111.
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: - - Each manutbctured or modular 6714 2
dwelling, service and/or feeder ,
Phone: ( ) f Fax:: ( ) RecOanect Only 67.84 2
Pump or irriydon circle 67.14 2
E -mail Sign or outline lighting 2
y. A. 1 ,f.`vFMFr+1�'*'*'C /`w y Q.'�[' . y .,p�I ■ ry.�}ya�'r�, M. }y Olt r "I..: �? > ..f G ) Yi1 7i, t. 1',�F ^fir •TT^"# °Y'6. $N'.C5°.$M''�M I�"4GV."�AA.'!O�"�('tC. Cl
I i v 4r :0,., ll..... Signal CicY' Or (1t1kltEd^efilUQy
sumac ,.i. s panel, alteration, or erdensiwt, Page 2 2
Busutore tl
✓ 1 e F 0-Ae0 A. r e 1 . - - Each additional inspection over allowable In any of the above
Address: .. e '3 - - fit,: e , ,: ✓) 1 4 -1". J-7-e 2 . er4• Addlpmal inspection (l hr mitt) 66.25/ hr
City/State/ZIP: e -') 2, Investigation (I hr min) 66.25/ hr
City/State/ZIP:
, do, 4 �¢4- 4 oft' Industrial plant (1 bx min) 78.18/ hr
Phone: (Se 3 ) 2 fL. ' y 3 f F ox: ( ) 4j .�f �'- 'rr f Inspections for which no fee Is 90.00! fu
..cificalty listed S/, hr mint
CCB Llc.: 4, q1. 4 / Ele ctrical Lic.:2L, it/ . Suprv. ic.: Lic '/4 5 4,1„
Subtotals
Sup'v. Electrician signature, required: - . t Plan review (25% of permit fee):
Print name: ,5 ! •P tt+f / 1' . :b.\ 1 \e State surcharge (12% of permit fee):
- TOTAL PERMIT FEE:
Authorized. signature: The pe 'is k application 'apices If a permit V not obtsiaa within Ado
- days after It has been accepted as complete.
Print name: Date: • Number of inspections allowed par permit.
1: 1Buiidinswennks16t•GPnadta p.dae 07511/10 - M0. I57(11/OS,COM/WEB