Permit •
1/p • CITY OF TIGARD ELECTRICAL PERMIT
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2 =-- COMMUNITY DEVELOPMENT Permit 4: ELC2013 -00265
T j G AR D 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Date Issued: 05/09/2013
Parcel: 2S102AA03901
Jurisdiction: Tigard
Site address: 8905 SW COMMERCIAL ST
Project: Razz Ma Tau Subdivision: TIGARD HIGHWAY TRACTS Lot: 23
Project Description: (2) reconnect only
Contractor: BOB'S ELECTRIC Owner: PENNY CONNOR INVESTMENTS LLC
2700 NE BURTON ROAD STE A 8905 SW COMMERCIAL #A
VANCOUVER, WA 98662 TIGARD, OR 97223
PHONE: 360- 254 -7200 PHONE:
FAX: 360 - 254 -8219
FEES .
Quantity Description Date Amount
2 ea Reconnect Only 05/09/2013 $135 68
Specifics:
1 ea 12% State Surcharge - 05/09/2013 $16 28
Electrical
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $151.96
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 -0090 You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344. -
// .e a.- Oki PPLic��
Issued By: �4i� Permittee Signature:
OWNER INSTALLATION ONLY
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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. u
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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PROM (WED)MAY 8 2013 2:50/57. 2:43/N..9302825583 P 1
' ; 'CEIVED
Electrical Permit Application r(lz uri• ICI: t 'i1. 0\1 1
City of Tigard MAY 0 8 2013 Received eived s °, Permit No.: / 3 •�)�
l
13125 SW Hall Blvd., Tigard, OR 972 �.� +� Plan Review
e Phone: 503.718.2434 Fax: so3.s98. l OF TI GARD p : Other Permit:
'f I , .; :_ 1, inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By: rubs. & RI See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
Please check all that apply (submit a sets of plans w /items checked below):
❑ New construction ® Addition/alteration/replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
-2,-,-.7---,,_,-==-,--=====-= _
>✓ `� �"�" -z•> < "`""` -
.'...._-...S r • "r. - � � Sa - xc in 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
, r .4 ❑ Emergency system. larger separately derived system.
` z_ _ _ :-.12..:,:-,:::47:: . _' „ '' r bl'; t „ ;., ;. -= ❑ Addition of new motor load of ❑
Job no.: 13 -523 I Job site address: 8905 SW Commercial St. 100HP or more. R c re arrcy
❑ Six or more residential units ❑ Recreational vehicle parks
City/State/ZIP: Tigard, OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: II ` ZZ 14. t4 (ft 22- ❑ Service or feeder 600 amps or more.
1 - _ T._--- - = � -
Cross street/directions to job site: ocsosptinn i otv. I Fee. I Tota
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft or less 168.54 4
• Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
�s _
:i.."4. - . 5 - - --- : . 1 = _`^ .§- _. �. --`'' (with above sq. ft)
� 3 Limited energy, multi - family
Repair 2 existing meter bases. residential (with above sq. ft.) 75'00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
`� x -_4 9g :4n fl_ '- - -r 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: Penny 601 amps to 1,000 amps 301.04 2
Address: 8905 SW Commercial St. Over 1,000 amps or volts 552.26 2
City/ State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)639 I Fax: ( ) 200 amps or less 1 59.36 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
Owner signature: Date: Fce for branch circuits w ' i6 mdon, or extension, er panel
s , { -0r above service or feeder fee, 742 2
each branch circuit
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)
Each manufactured or modular
City/State/ZIP: 67 84 2
dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 2 67.84 135.68 2
Pump or irrigation circle 67.84 2
E -mail: .
• � 'r �•s
or outline lighting 67.84 2
a�A _ ,s. - �'� St � ` - ' � Signal circuit(s) or limited-energy
Business name: Bob's Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 2700 NE Burton Rd., Ste. A Additional inspection (I hr min) 66 25/ hr
City/ State/ZIP: Vancouver, WA 98662 _ Investigation (I hr min) 66 25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (360) 254 - 7200 I Fax: (360) 4 Inspections for which no fee is 90 00/ hr
specifically listed %r hr min
CCB Lic.: 53136 Electrical Lic.: 37 lc Suprv. Lic.: 4322S '— .:�;
Suprv. Electrician signature, required: `z
Subtotal: 135.68
Plan review (25% of permit fee):
Print name: Kevin Broselle Date: 5/8/13 State surcharge (12% of permit fee): 16.28
Authorized signature: - TOTAL PERMIT FEE: 151.96
This permit application expires if a permit Is not obtained within 180
Print name: Date: • days after it has been accepted as complete.
Number of inspections allowed per permit.
1`.Building'Permits\El.C- PmnitApp doe 07/01/10 44046I5T( I I /05 /COM/WEB
FROM < WED )MAV 8 2013 2:50/ST. 2: 48 /No. 8302825503 P 2
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for aaa residential systems combined ... $75.00
Check Type of Work Involved:
El Audio and Stereo Systems*
❑ Burglar Alarm
p Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
Fee for each commercial $75.00
system
(SEE OAR 91S-309 -0000)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
1 \Bcilding\Pamits\ELC-PamdApp dnc 07!01/10