Permit CITY OF TIGARD ELECTRICAL PERMIT
II I • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00268
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2013
Parcel: 1 S135BD00100
Jurisdiction: Tigard
Site address: 9600 SW OAK ST 525
Project: Suite 525 Subdivision: ASHBROOK FARM Lot: PTS 5 &
Project Description: (2) branch circuits for TI
Contractor: DYNALECTRIC Owner: SUN LIFE ASSURANCE CO OF CANADA
5711 SW HOOD AVE BY NORRIS BEGGS & SIMPSON
PORTLAND, OR 97239 121 SW MORRISON ST #200
PORTLAND, OR 97204
PHONE: 503 - 226 -6771 PHONE:
FAX: 503 - 226 -7720
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/13/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/13/2013 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 O 2 -001- 090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: ON iPPU ` e I /oC.
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 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.
May. 8. 2013 9:37AM . . No. 1284 P. 2
' Electrical Permit ApplicatiRECEIVED FOR OFFICE USE ONLY
City of Tigard Received / 3 I cf Permit No.ei.C., . 3_
I 419A4,08"
I g 13125 SW Hll a Blvd., Tigard. OR 972A AY 0 8 2013 Date/E :
P on Review
:. •• Phone; 503.718.2439 Pax: 503,598.1960 Date/B : Other Pertnittuf,
TiCrAILD Inspection Line: 503.639.4175 CITY oF TIGARD Date Ready/By: ,rut . El See Page 2 for
WWW.tigard V Notified/Method! Supplemental information
Buiwinui nivistoN
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O New construction 0 Addition/alteration/replacement Please check ell trial apply (submit a sets of piens w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 0 Other: , where the available fault current ['Marinas and boatyards,
7 .' :;. !: ' f .:',.1 . :::
0
.-- 1. , '..•41ii' i ,. 0 : ; ' . ' i.F. : ; .: :.'!!' . i : -, - ;: -1: ..' '':
9911 exceeds 10,000 amps at 150 volts or 0 Raving buildings.
less to ground, or exceeds 14,000, El commercial-me agricultural
ID 1- and 2-family dwelling VCommercial/indusirial 0 Accessory building amps for all other installations. buildings.
El Multi-family El Master builder El Other: El Fire pump. 0 Installotion of 75 KVA or
. 0 Emergency system. • larger separately derived sysiem.
--'—''-r--- • . ''':l'":'s4: s.. :''' . :.- :.'' :,-::.,., ..:::'-!:': -.-• o Addilion of new motor to of 1:1 "1.2" "1-3",
Job no.: /4 site address: 5''aeltIt k5a.) e2a_15 100HP or more, occupancy.
['Six or more residential units, 0 Recreational vehicle parks.
...-•'-':
City/State/ZIP: , —
eer,A 0 Heahh-care facitilies, • CI Supply opine for morn than
['Harwell:10s locaiions. 600 volts nominal.
Suite/bldg./apt. no.: xe:5 Project name: je„)//e 5 — 71 E) Service or feeder 600 amps or more.
.. ' . ,.,•.• •• • .. ..-;,: • . .A:', !t.'i•;.;; ,..
Cross street/directions to job site: Littieigut 1 my. I Pee. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: - Lot no.: 1000 sq, R. or less 1 168.54 4
Ea. adril 500 sq. R. or portion 33.92 1
Tax map/parcel no.: . Limited energy, residential 75.00 2
.. ' : ',^:4 . (with above s q . (1.3
Limited energy, multi-family 75.00 2
77 iele774. G 6›-ei../._,-/s residential (with above sq. I)
.ReneWalile:Energy ' : • . '. • ,: 0 'lee l'tii :' : : ., • :'•
, Services or feeders installation, altera ion, and/or relocation
100.70 2
. ...... ": :. : •:! - tUT gr 'A ,./i9w.I41,p,W:i. . ...3.piig •,..,... • , 4 ,,,•,::....;,; .. TAT' '''.:.,, s _ .
201 amps to 400 amps 133,56 2
Name: . . atnps 10 600 amps 200.34 2
Address: • 601 amps to 1,000 amps 301.04 - 2
• Over 1,000 amps or volts ' 552.26 . 2_
City/State/ZIP: . Temporary services or feeders installation, alteraiion, and/or
Phone: ( ) { Fax: ( . ) relocation
200 amps or less 59.36 1
Owner InstalIntion: 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
Owner signature: _Date: Branch circuits - new, Micro hot!, or extension, er panel
— .- • "-- •
'' ' :.' ••:''.-': ;';;;•', .:,*:; IA ht: Ir;':;?. :'.' Igtrujwaiis..kitok: ..,: A...:,.., . Fee for branch circuits with
above service or feeder fee,
• 742 2
Business name: 4... ,,ez.4„ _ )//7 -c each branch circuit *
. B. Fee for branch circuits *dour
Contact name: — Sec:h i Ca fri1/45c5/0 • service or feeder fee, first / 56.18 5643 2
branch circuit
, —
Address: Each add'I branch circuit " / 7,42 7 2
Miscellaneous (service or feeder not included)
CO/State/ZIP: . Each manufactured or modular 67.84 2
dwellin:. service and/or fbcder
Pilo"' (cow ,e, - 77 Fax: : ( )
Reconnect only 67.84 2
E , or irrigation circle 67.84 2
;.;,:.1.,. .'::.•;.:;:*.,....,;:.:::•:.,:•;;....:::',.....•:. ' CTIOLCt0i:(•, .... ':.‘,; ..i . ,. i .i :. ., .:': ;„ :..:'.. .:- Sign or outline lighting 67.84 2
signal circuit(s) Or limited.cnergy
Business name: ' 4C- ct_ 6.X.,___(,..._1____ panel. alteration, or extension. Page 2 2
Address: ,57// Liu.) /760e2x2iigi-we., Each additional inspection over allowable in any of the above
'Additional inspection (i hr min) 66.25/hr
City/Slate/ZIP: c d eNi 9 72,3 Investigation (1 lir min) , 66.25/hr
Phone: (so) 1.,E 6 Fax, (52 ) ,9,z .. 7 7 ac9 Indusirial plant (1 hr min) inspections fw 78.18/ hr
Inspectioor hich eels Is no f
CCB Lic.: / 6 f Electrical Lie.: R • -5? Suprv. Lie.: specifically listed OS hr min) 90.00/ hr
' -
/fir . . • .•
— .'. -''.: .:•.,••:,':-. '..tLECTRIt4410 FEES
.. '.'.';'.:`..'-.,..:.•
. . . .. .
Suprv. Electrician signature, required: ' i " Subtotal: /J
Print name: Rokg(.-1- - il ° D a t e : f1 — Plan review (25% of permit fee);
State surcharge (12% of permit fee); '7 4
.......-...i--
Authorized signature: j opP- . 1 .. TOTAL PERMIT FEE: 7 J.,,,2 ?:,
• . .;
This permit application expires Ir permit in not obtained within 180
Print name: ei ' Date: 3 g
•S e i 4 eizA • days after It has been accepted as complete. •
. Number of inspections allowed per permit.
1:VisuildingetrmiskELC_Permnapp_o40917.doe 440-46t57(1 tam/COM/WEB
May 8. 2013 9: 37AM .No. 1284 P. 1
Dynalectric Company
Dynalectric 5711 SW Hood Avenue
Portland, OR 97239
An EMCOR Company Phone: 503.226.6771
Fax: 503.226.7818
ccb: 66793
Faxsimile
Number of pages Including this cover sheet: 3
Date: 05/8/13
To: Electrical Permit Dept Tel:
• Company: City of Tigard Fax: 503 - 598 - 1960
From: Lynne McEachern
Message:
Following is an Electrical Permit Application to be processed.
Thank you.
Dyna -019 Rev. 02/17/04
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
9600 SW OAK ST 525, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
05/22/2013 00:00
ELC2013-00268
PASS - No C of O
Violation Summary:
Inspector Contractor