Permit , CITY OF TIGARD ELECTRICAL PERMIT
11111 COMMU DEVELOPMENT Permit #: ELC2013 -00338
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2013
Parcel: 2S113AA00700
Jurisdiction: Tigard
Site address: 16436 SW 72ND AVE B5
Project: Tesla Subdivision: ROSEWOOD ACRE TRACTS Lot: D
Project Description: (1) 200 amp service and (10) branch circuits.
Contractor: COCHRAN INC Owner: PACIFIC REALTY TRUST
7550 SW TECH CENTER DR #220 ATTN: N PIVEN
TIGARD, OR 97223 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/18/2013 $100.70
Specifics: amps or less
10 crt Branch Circuits w /Purchase 06/18/2013 $74.20
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/18/2013 $20.99
Electrical
Type of Const:
Occupancy Grp:
Total $195.89
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 -00 . 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: /t/ /0G/e�/7O_/
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 503.639.4176 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 until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
01 09:24:11 06 -18 -2013 1/2
Electrical Permit Applicatil E roi orricr USE ONLY `
City of Tigard Received j Permit No. � n �
13125 SW Hall Blvd., Tigard, OR 97223 " 1 1 S 2013
Date/B
a Review w��3 '7��.3e7�
= Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Other Permit:
Inspection Line: 503.639.4175 DateReady /By:
TIGARD 0 SeePage2
Internet: www.tigard- or.gov CITY OFTIGARD Notified/Method: Supplemental Information
TYPE o � DIVISION , . • PLAN REVIEW
❑ New construction XAdditi0n /alterati0n/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current
❑ marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
1- and 2-family less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
El mily dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
/7 ❑ Addition of new motor load of El "A", "E ", "1 -2 ", "1 -3 ",
Job no./0Z e Job site address: /6 [{.? 4 .5107z It 4Y pc,. lixHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/ State/ZIP: - r " , p O a e . 9 7 z zq ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: -r $ ` I f i _ ❑ Service or feeder 600 amps or more.
o /t � FEE SCHEDULE
Cross street/directions to job site: So) aO�er -winc / 014- Description I Qty. I Fee. I Total I •
y y 40-e_. New residential single- or multi - family dwelling unit,
�r�
9— S tO ` Zj n Includes attached garage.
Subdivision: 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
DESCRIPTION OF WORK (with above sq. ft.)
• Limited energy, multi - family 75.00 2
1 wsrIGC 6o) Atafi n d/t/.'ads 001,1 0 Cn ia tap residential (with above sq. ft.)
�� z���� ���� T Services or feeders installation, alteration, and/or relocation
IX-�'de4' 200 amps or less + 100.70 Joo,7O, 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 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 circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I above service or feede fee,
CONTACT PERSON I D 7.42 7 20 2
each branch circuit
Business name: (19e1c.004 -//l B. Fee for branch circuits wirhou/
service or feeder fee, first
Contact name: m 6 ,�i >✓.Q . branch circuit 56.18 2
�`
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City / State/ZIP: dwelling, service and/or feeder 67.84 2
Phonele3) ( ICI— 0000 Fax: : 67) )2es LIz,g Reconnect only 67.84 2
E - mail: y Q� �I ( fa il ra R i n �, Co m Pump or irrigation circle 67 2
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited -energy
Business name: COCHRAN INC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 7550 SW TECH CENTER DR. SUITE #220 _ Additional inspection (I hr min) 66.25/ hr
Investigation (I hr min) 66.25/ hr
City/ State/ZIP: TIGARD OR 97223 Industrial plant (I hr min) 78.18/ hr
Phone: (971) 205 -4242 Fax: (971) 205 -4268 Inspections for which no fee is
specifically listed (%r hr min) 90.00 / hr
CCB Lic.: 72942 Electrical Lie.: 37546C uprv. Lie.: 3447S ELECTRICAL PERMIT FEES
f j Subtotal: / '7 ¢, 90
Suprv. Electrician signature, required: \� "'� , Plan review (25% of permit fee): '
Print name: KENNETH O Date: 6 _`8 ./4 State surcharge (12% of permit fee): i
TOTAL PERMIT FEE: /
G �/�t& /1�/ f/
✓
This permit application expires if a permit is not obtain within Authorized signature: / .
days after It has been accepted as complete.
Print name: 0_444- Date: _46./4_ + Number of inspections allowed per permit / e l e `e ,t
1BuildingWermitslELC- Permit pp.doc 07/01/10 440.4615T(11/05/COMlWEB J .••
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