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Permit v CITY OF TIGARD ELECTRICAL PERMIT I iiii 11 COMMUNITY DEVELOPMENT Permit #: ELC2013 -00283 T IGAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2013 R Parcel: 1 S136AD04000 Jurisdiction: Tigard Site address: 11507 SW PACIFIC HVVY A Project: Engineering for Kids Subdivision: VILLA RIDGE Lot: 7 Project Description: (2) branch circuits for TI Contractor: RELIANT ELECTRIC OF OREGON LLC Owner: PACIFIC TERRACE COMMERCIAL LLC 20200 SE OLDENBURG LN BY SMITH, EDITA M SANDY, OR 97055 833 NW 170TH DR BEAVERTON, OR 97006 PHONE: 503 - 701 -4562 PHONE: FAX: 503 - 668 -4190 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 05/21/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/21/2013 $7.63 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 Required Items and Reports (Conditions) c "" 1 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 O er g on law requires you to follow the rules adopted by the Oregon Utility •i' enter. Those rules are set forth in OAR 952- 001 -00.10 through OAR 95 1- 0 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. •87 or 1.800.33 .2344. _ �i ems// i Issued rXw r t� 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: ' CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' i �� /% �!, �� Date: LICENSE NO. .. Call 503.639.4175 by 7:00 a.m. for the next available insp 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. r May.20.2013'. 09:15 AM Reliant Electric of Orego 5036684190 PAGE. 2/ 2 Plectrical.Permlt lt,lt1)l I'lt I' I "I tl\l N , City of Ti ai'd MAY 2 0 2013 ' II II g � _ , , 1'ermirNa.: gkCo'to/3- o0�?$3 - " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review II Phone: 503.718,2439 pmt: 503.598.196 OF TIGARD DatmlHy; /� Other Permit; ' Pao/ 3-Oa/ /Q - y 'i ^1� :: f it n Inspection Line: 503.b39 41]5 . .: a Ready/Hy: lode: nl c.r Page tor num MI. www.ugtuuwt.guv BUILDING DIVISION: oaoaewme aupptemenat limn m. on New construction VAdditionfalteration /replacement - Please check all that apply (submit j ems of plans whims checked below); ❑ Service or feeder 400 amps or more ❑ Building over three stories. 0 Demolition 0 Other. where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps -a: !c^ -• ±- ^- ❑•?!cx :•o a-•:a ":::;.:. •- _ less to ground, or ascends 14,000 ❑ Commeroial•use agricultural © 1- and 2- family dwelling Commercial /industrial ❑ Accessory building apps for all other installations, buildings. Multi- family © M11Stcr builder 0 Other: Q Fite pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION CI Emergency system. larger separately derived system. / r f r ) i ❑ Addition of new orator load of ❑ "A^ "E' "1 -2^ "1 -3^ Job no.: Job site address: ' 1 IOOHP or mart. occupancy. ❑ Six or more residential unite. ❑ Recmational vehicle parks. - 0 . 9 Ci /S ` ❑ Health-care facilities, ❑ Supply voltage fm more than ❑ Hazardous locations. 600 volts nominal. nit ldg. /apt. no.: Project name: / / . s , , r� ❑ Service or feeder 600 amps or more � FEE SCHEDULE Cross street/directions to job site: ! -' . 4 neacrtattoa I oq. I Fee 1__Toui "`)" • New residential single- or multi family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq, A. 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 DESCRIPTION OF WORK (with shove sal, n,) ,^ LV �� ' l � ,n � -P 4 rl Limited !era, multi 75.00 2 I Y I � residential (with above sq. R) �� ' Services or feeders installation�slteratloe, satt/or relocation ND 200 amps or leas 100.70 2 itOPERTY OWNER ' 0 TENANT 201 amps to 400 amps r 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: ( ) I Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps ' 123.08 2 Owner Installation: This installation is being made on property that I own which is not 401 amps to 399 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, fi70, and 701. . ..,. Branch circuits - nav or extension, per panel _ Owner signature: _ __ Date: A, Fee for branch cltcull with (] APPLICANT 1 • 0 CONTACT PERSON above service or feeder fee 7.42 2 f each branch circu it Business name: ' 1 I J - �` C-4-71,1 C Dy B. Fee for branch circuits without . ' v service or feeder fee, first Contact name: branch circuit 56 g Ig 2 ''') T Each add'I branch circuit I 7.42 1 f +2 . , 2 0 Address: ! 2t� r3 0 ( d.� l J ''� Miscellaneous istrvlee or feeder not ITIM included) Each manufactured or modular City/State/ZIP: : % 1‘56t L rJ h a dwmlki. serviu: and/or feeder _ 67.84 - 2 , Phone: 3j ♦1 • �`"� L . • Fax:: ( //;;JJ r ) / / _ '" P /T V L / Reconnect only . 67.84 2 , � � ' Pump or irrigation circle 67.84 2 N- mail: _ r Ii1 ; ) ar COYY, Sign 67.84 2 CO ' a' - CTOR Signal circuits) or limited -energy ' Business name: - _panel, alteration, or oxtension, Page 2 2 ...r Each additional inspection over allowable in any of -the above . . Address: Additional inspection (I hr min) _ 66.25/ hr • '. - " ' ""' investigation (1 hr min)' 66.25 / hr • • Ci /S'tatc/ZIP,.' t S 1 11 ' 1 r , A-. industrial plant (1 hr min) 78.18/ hr �' Phone: ( ' - - / • . ( /" ' Inspections for which no fee l9 a � _ specifically fisted (14 hr min .. 90.00/ ' CCB Lie.: I gii(-t!l 2._ Electrical Lie.: ( X75 sup ;C.:44 ,3< - ELECTRICAL PERMIT FEES - ' Suprv. Electrician signature, required: �� _ _ .._� Subtotal: _ -_ l l /9 /�'-= - Plan review (25°x6 of permit fee): Print name: a ukt 4 . i a I - 104( - ,"- ' (L t —. I Date: 5 State surcharge (12% of permit fax): 7 t j4 3 TOTAL PERMIT FE i t 6� 3 signature: g Authorized si is - Lti • fi ` Z' " �'�� ' E: "T i , 1 This permit application expires If a permit is not obtained within 84 �, 'I,' ( � 'l !lays after it bas been accepted as complete. -[ ✓ • Print name: F 5>€ n t ' 4 aryl �'� " Number of inspections allowed per permit. a 2 • imivadiu4W rtnits\ZLC- 1'ermitApp.doe 07/01(10 ll 44046155111 /os/C0M/Wea 7/. �J I/