Permit rt CITY OF TIGARD ®� ELECTRICAL PERMIT
= COMMUNITY DEVELOPMENT Permit #: ELC2013 -00306
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2013
Parcel: 2S 110AB00200
• Jurisdiction: Tigard
Site address: 14385 SW PACIFIC HWY
Project: Harbor Freight Subdivision: CANTERBURY PLACE, AMENDED Lot: PTS 1-4
Project Description: TI 6/13/2013: REPRINT permit to correct site address from:1_4389 to 14385 SW Pacific Hwy. DLH
Contractor: THE POWER WORKS Owner: BULL MOUNTAIN INVESTMENTS LLC
4233 SE 182ND #202 ATTN JERRY KOLVE
GRESHAM, OR 97030 • 14389 SW PACIFIC - HWY
TIGARD,- OR 97224 - •
•
PHONE: 503- 310 -9745 PHONE:
FAX: 503 - 622 -6612
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 06/04/2013 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/04/2013 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
•
•
Total $104.47
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 0 9 - 01 -0090. 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: ,14/ /97 (° 48
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 603.639.4176 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 uirtll completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
CITY OF TIGARD ELECTRICAL PERMIT
1111 a • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00306
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2013
Parcel: 2S110AB00200
Jurisdiction: Tigard
Site address: 14389 SW PACIFIC HWY
Project: Harbor Freight Subdivision: CANTERBURY PLACE, AMENDED Lot: PTS 1 -4
Project Description: TI
Contractor: THE POWER WORKS Owner: BULL MOUNTAIN INVESTMENTS LLC
4233 SE 182ND #202 ATTN JERRY KOLVE
GRESHAM, OR 97030 14389 SW PACIFIC HWY
TIGARD, OR 97224
•
PHONE 503 - 310 -9745 PHONE:
FAX: 503 - 622 -6612
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 06/04/2013 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 06/04/2013 $11 19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 OAR 952- 001 -0090 You may obtain a copy • or direct questions to OUNC by calling 503.232 1987 or 1.800.3322344
Issued By: - -- ` _ 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' 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.
05/29/2013 22:28 5036226612 SANDY RIVER ACCTG PAGE 02/02
Electrical Permit Application RECEIVED 14112 ()1•h1( I. I SF: ()NI.)
14 City of Tigard oatci By: d P ermit No , L
Date/ 5q/,3 A 6,7- �9 - el3= a53 t
•
w 13125 SW Hall Blvd., Tigard, OR 97223 MAY 3 0 2013 Plan Re,7 Other Permit.
503.718.2439 Fax: 503.598.1960 Date/By
'1' I (.■ A R D l rispccdon Line: 503.639.4175 Dare RcaayBy. An is El see Page 2 for '
Internet: www.ligard- or.gov CITY OFTIGARD Notified/Method: ' A Supplemental Information
. • TYPE OF AJAPING DI PLAN REVIEW
❑ New construction ® Addition/ alteration /replacement Please check all that apply (submit a, sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
El Demolition ❑Other
where the available fault current ❑ Marinas and boatyards
CATEGORY OF' CONSTRUCTION • • exceeds 10,000 amps at 150 volts or ❑ Floating buildings
❑ 1 ttttd 2 dwelling ess to ground, or exceeds 14.000 ❑ Commercial -use agricedhrrnl
y g Si ® Commercial /industrial ❑ Accessory building amps for all other lr$talla/rorLe, buildings
❑ Multi - tamily ❑ Master builder 0 Other. ❑ Feu pump. ❑ huannaeivi. yr I:10 KVA v.
• ' JOB SITE INFORMATION AND LOCATION . '• CI t'""m"`7 system. larger separately derived system.
. O Addition of new motor load of ❑ "A ". "E". "1 2" "1 -3"
Jul, icy.. 13 - 14389 Jul) bite :Rhirs. - sa. 14389 SW Pacific Hwy i00HPormore. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks,
City/State/ZIP: Tigard, OR 0 Health-care facilities. ❑ Supply voltage for more than
❑ Harrrdous locations 600 volts nominal
Suite/bldg. /apt no.: Project name: dza ,/b e - 5..,„ t ❑ Service or feeder 60u amps Or more,
Cross street/directions to job site: FEE S(.HEI I
1 t]euiPtion I (Pty. Fee. 1 Tam I •
New residential single- yr multi - ramify dwelling :,nit.
Includes attached garage.
Subdivision: Lot no.: 1.000 sq ft or less 168.54 4
Ea, ao0'I 500 sq. ft, or ponton 33.92 1
Tax map /parcel no.: Limited energy, residential 75,00 2
DESCRIPTION OF WORK (with above sq. R,)
Limited energy, multi family 75.00 2
Six Branch Circuits residential (with above sq. ft )
Renewable Energy Q Ste Page 2
Services or feeders installation, alteration, and /or relocation
❑ PROPERTY' OWNER • • ❑ • TENANT • • 200 amps or less , 100.70 2
' 201 amps to 400 amps 133 56 _ 2
Name: 4n1 amps trt kin amps 200.34 2
Address: 601 amps to 1,000 amps 301,04 2
w
' Over 1.000 amps or volts 552 26 2
City /State/ZiP: Temporary services or feeders Installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or Icss 59.36 1
Owner installation: 'this installation is being made on property that I awn which i< not 201 snips 20 400 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, alteration, or extension, per panel
' 0 APPLICANT I 0 CONTACT PERSON A. Pee for branch mains with
above service or feeder fee.
7,47 2
Business name: each branch circuit
' 13. Fee for branch circuits without '
Contact name: service or feeder fee, first 1 56.18 56 18 2
branch circuit
Address: Each add'l branch circuit 5 7.42 37.10 2
• City/State/7.1P: _ Miscellaneous ( service or feeder not Included)
Each manufactured or modular 67 84 2
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
Reconnect only 0'184 2
E - mail: -
Pump or Irrigation circle _ 67.84 2
. CONTRACTOR ' Sign or outline lighting 67.84 2
Business name: The Power Works /f4 in, rfrrr 1 LL Signal circurt(s) orlimhed- energy Scc
panel, alteration, or extension. Page 2 2
Address: 4233 SE 182nd Ave, #202 Each additional inspection over allowable in any of the above
Additional inspection (I hr mm) 6615/ ter
City /State/ZIP: Gresham, OR 97030
Investigation (1 hr min) 6625/ hr
Phone: (503) 310 -9745 Fax: (503) 622 -6612 industrial plant (1 hr mm) 78.18/ hr
/ inspcatons for which no fee is
CCB Lie.: 184278 Electrical Lic.: C444 Suprv. Lic.: 5389S ✓ specifically listed (Y: hr mint) 90.00/ hr •
Okra/ il - -i/+ l/N • • ELECTRICAL. PERMIT FEES
Suprv. Electrician sign e, required:
Subtotal: 93.28
Print name: Fric C. Martin Date: 5/30/13 Plan review (25% of permit fcc):
State surcharge (12% of permit fee): 11.19
Authorized signature: F.., / TOTAL PERMIT FEE: 104.47
� / � This permit application expires it a permit Is not obtained within 180
Print name: Date: days after it his beets accepted m, complete.
• • Number of inspections allowed per permit,
I lauldingWermid18LC cm nApp_PLR Faai,doc Rev 05/2)2011 440.461ST(11/OS/COM / wt;n