Permit CITY OF TIGARD ELECTRICAL PERMIT
1 11 1 1- COMMUNITY DEVELOPMENT Permlt#: ELC2013 -00372
Date Issued: 07/03/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7236 SW DURHAM RD 600
Project: 1 -5 Trucking Subdivision: COUNCIL VIEW ACRES (LOTS 21-44) Lot: 25 -27,2:
Project Description: (2) branch circuits for fork lift plugs.
Contractor: A TO Z ELECTRIC Owner: PACIFIC REALTY ASSOCIATES
10117 SE SUNNYSIDE RD, F36 ATTN: N PIVEN
CLACKAMAS, OR 97015 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 -481 -5061 PHONE:
FAX: 503 - 907 -5483
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 07/03/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/03/2013 $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 OAR 9 -001- B Yo 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: /OW 79 7 70 N
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 plane are required on the job site at the time of each Inspection.
Electrical Permit A lice , 1:01: tl l F l t : I. t ..:1-. ( ) L \
City of Tigard I I 2013 Received 2 43 Permit No. LC 4i3 -Do 3 7 .2. , 13125 SW hall Blvd., Tigard, OR 9723' Plan Review
a Phone: 503.718.2439 Fax: 503.598. 6 Other Permit
o6 ®F i l iflil® D a le R y:
11 , ; \ xi - , Inspection Line: 503.639.4175 pm Reedy/13y: runs: 121 See Page 2 for
Internet www.tigard- or.gpv nu Irm o W Notified/method: fie' Supplemental Information
E XI'J OF
'PLAN ,ltEVI�W
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit A sets of plans whims checked below):
❑ Oem011tion El Other: 0 Service a feeder 400 amps or more 0 Dwlding over three stories-
where the available fault current ❑ Mmieas and boards,
CATEGORY .01 . COI!IS7E RUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
El 1 - and 2 family dwelling ® Commercial/industrial 1=1 Accessory building
less to ;or od, or exceeds iin ❑ Commercial agricultural
ry S amps fbr all other kiwi-aims. . buildings.
❑ Multi-family El Master builder El Other: ❑ fins pwnp. ❑ Installation of 150 K VA or
C] Emergency system. hunger aepatately derived system.
-
. . ' 3011 •SITE INFORMATION AND "LOCATION: ; " .
' � ❑ Addition of new motor load of D "A ", "E ^, "1 - 2 ^, "1 - 3",
Job no_: Job site address: 7236 SW Durham, #600 10011P or more. occupancy.
0 Six or more residential units_ ❑ ]recreational vehicle parks.
City/ State/ZIP: Tigard, Oregon 97224 ❑ Health-care facilities. ❑ Suppiy voltage for more than
/
El Hazardous Locations. NO volts nominal.
I uiteJ dg. /apt no_: 600 Project name: I-5 Trucking ❑ Spice or fender 600 amps or more. _
Cross Street/directions to job site: FEE SCkT)8bt1L
DdSri tine 1 Pte. I tree f_ Tour 1 •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: [Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft or portion 33.92 1
Tax map /parcel CO.:
Limited - _
ed , residential 500 2
Il energy, 7 .
10NrOF W[>rltt>i� . ' - • , (with above sq. R)
Limited energy, multi - family 75.00 2
20 -amp and 50-amp fork lift plugs residential (with above sq. ft) ,
Renewable Energy ❑ See Page 2
Services or feeders instaliatioa and/or relocation
l': *PM.* OWN ... I . '. 0 . TENANT-H : 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:
401 amps to 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 iastaitatioet, alteration, and /o
Phone: ( ) I Fax: ( ) relocation
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
Owner Signature: Date: Branch circuits — new, alteration, or extension er panel
�'. APPI.ICrAIVT ..' A Fee for brdmch ucuie, with
I .' , ... ❑ C'Qlrfl#CF'PER4ON .. above service or feeder t
Business name: each branch circuit
742 2
B. Fee for branch circuits wlthow
Contact name: service or feeder fee, first I 56.18 56 2
^ branch circuit
Address: Each ad in branch circuit 1 7.42 742 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Each manufactured W modul8f 67.84 2
Phone: ( ) - Fax :: ( ) dwelling, service and/or feeder
E-mail:
Reconnect only 67 -84 2
_ or Pump o irrigation circle 67.84 2
Sign or outline luting 67.84 . 2
Business name: A to Z Group, LLC dba A to Z Electric Signal circuit(s) or limited Sea
panel, alteration, or extension Page 2 2
Address: 10117 SE Sunnyside Road, F36 Each additional inspection over allowable in any of the above
Additional inspection (I hr min) 66.25/hr
City/ State/ZIP: Clackamas, Oregon 97015 Investigation (I hr min) 66.25 / lu
Phone: (503) 481 -$061 Fax: (503) 907-5483 Industrial plant (1 hr min) 78.18/ hr
Inspections for which no fee is 90.00/ hr
CB Lie.: 156615 /�� Electrical Lic.: 24-499c Su
CB ic,: ;6 5 specifically listed (AA hr min)
Suprv. Electrician signature, required: 7 / / // /3 Subtotal: 63.60
Print name: Jonathan L. Pays Date: 07 -01 -2013 Plan review (25 % ofemit fee): 0
„ � State surcharge fee): .23
Authorized signature; wi � . i — TOTAL PERMIT ERM]T FEE: 71.23
Print name: Kenne IGris-rt pate: 07 -0i -2013 This permit applkatiu expires do permit la not obtained within 180
days after it has been accepted as complete.
]:18u0JlaeU mair+rEr C?emveA EI.R ' Number of inspections allowed per permit.
pp_ ,)rRE.aoc Re' 05/2tno13 446- 4615TO 1/05/COMIWEs
TO 2 &me
CCB# 156615
503.235 -9393 —Telephone
503.481.5061 - Telephone
503- 907.5483 — Facsimile
ATOZKEN@ATT.NET - Email
W W W.ATOZELECTRICLLC.COM
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Attention: City of Tigard
Fax. Number: 503.598 -1960
Telephone Number: 503.718 -2439
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Date: JULY 01, 2013
Electrical permit for 7236 SW Durham, Tigard, Oregon 97224