Permit y ,, CITY OF TIGARD ELECTRICAL PERMIT
104 is • COMMUNITY DEVELOPMENT Permit #: ELC2013 -00383
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/10/2013
Parcel: 25101 DB00100
Jurisdiction: Tigard
Site address: 7340 SW HUNZIKER RD 102
Project: Interim Physicians Subdivision: VARNS ACRES Lot: 3
Project Description: (3) branch circuits for TI
Contractor: A C & E ELECTRIC CO Owner: HILLTOP BUSINESS CENTER LLC
3535 DEL WEBB AVE NE #100 HUNZIKER LLC
SALEM, OR 97303 9430 NW KAISER RD
PORTLAND, OR 97231
PHONE: 503 - 363 -2301 PHONE:
FAX: 503 - 363 -2302
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 07/10/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/10/2013 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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. ATTEN a . =!•n law requires you to follow the rules adopted by the Oregon Utility enter. Those rules are( set forth in OAR
952 - 001 -00 r throu h OAR 9 . r r -110 You may obtain a copy of the rules or direct questions to OUNC b = .!87 or 1.800.332. 344.
■ Issued :;y: Permittee Signatur. !
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' - ,4 • /l/ Date:
/aur r C
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.
07/09/2013 08:16 5034850586 AC &E ELECTRIC PAGE 01/02
Electrical Permit ApplicatRECEIVED FOR OFFICE 'Si I ONI.,V
RCCerved �ilm Permit No.: E.CC/tv/J' — O
City of Tigard DMer� ; 7 o g 3
N to 13125 SW Hall Blvd., Tigard, OR 972A J L 9 2 0 1 3 Plan Review �� d '• Phone; 503,718,2439 Fax: 503.598.1900 Datdgy• Ot her Perm `ri
T t r, ,q R D Ins Line: 503.639.4175 Date Ready/By: Jurir. fa See Page 2 for
Werner www,tigard- or.gtry VI I I Vt I IG ARD Notined/Method: Supplemental Information
; :J.. .. :;1'.4:::\ j ;- 4J `' r f' �1-a i V ; � L r - f - �? tit r , 1 k V . !''. / ;.
:.r , .., -. � .� ' r;,;. . •vrn .� ,+:9Li:u l i ... . �,. Y -. , . �. . - . �. r _. ... e'GY.A .rlsd 1 "'1F•ii �i' ! .
❑ New construction El Addition /alteration/replacement pima the* all that apply (submit 2 sets of plans w /items checked below);
0 Service or feeder 400 amps or more ❑ Building over three stories.
❑ Dentobtion ❑ Other: where the available fault current ❑ Marinas and boatyards.
rn ! „ :' �'-' •_1 . ,r .:•- ; '',` L14 " exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
! P B
` a TMr ° "" � ~ '; a �" ` " ` ' " + + 1 ' ^ " is to ground, or exceeds 14,000 ❑ C ommcroinI•t01 agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: pump. Installation 150
[yPirc in not KVA or
]l�Oitf ,i r o ❑Emergency system. larger separately derived system.
r fT k , _ , ' � .. yy -0 1 " Fgt ❑ ❑ Addition of new motor load of °A ", "F••, "1 -2" `•1_3 ",
'%i'r' ,w�. ?„, fir .. "� Ywr M ,.. ,ana.� lane w. %, � ,n,wnn, k"�„1 -. �..� Wl .i:,� '
Job no.: Job site address: 7340 Hun7iker Rd 100141> or more occupancy.
❑ Six or more residential units, d Recreational vehicle parks,
City/State /ZIP: Tigard OR ❑Health -cart facilities. ❑ Supply voltage for more than
El H.vvdous locations. 600 volts nominal.
Suitc/bldg. /apt. no.: 3 I Project name: Interim Physicians ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: n , an NOM/ tree. Total •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. R or less 168.54 4
Ea. add't 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
t:• err 1 r L. t '.tfg,: : :: A (with above sq. R)
Limited energy, multifamily 75.00 2
TI Remodel
restdanga�udt about eq. ft.)
.Y "Rln0.r0a VIl'.Ettitgsi" . :izi mel- ( .rsitikz ' ,,:1A"6., , ,i' y �� t '�, .�':. .,,'i
Services or feeders installation, alteration, and/or relocation
y,
i.9s r r x61. a._ �! fl'A. ,.i fA " 7 L r: „}. t °. 1 „r 200 amps m Ions 100.70 2
:, :� � ; r ..�J ; I�� p ��'�vnf� , , r � s : <�1:15�' Y, � :<.. a _
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 maps 301.04 2
Over 1,000 amps or volts 552.26 2
City /State /ZiP: Temporary services or feeders installation, alteration, and/or
Fax: ( ) relocation
Phone: ( ) 200 amps or less 59,36 l
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 165.54
2
Owner signature: Date: Branch circuits • new, alteration, or extension, per panel
` -;rot ` rr ,i falb,, ,, ., a ' .2. , t • � 0 'r� : Or1V.' .';`wA"e " A. Foe for branch circuits feeder fcc, 2 7.42 14.84
above service or 2
Business name: each branch circuit
B. Fee for branch circuits without
Contact name: service or feeder fcc, first 1 56.18 56.18 2
branch circuit
Address: Each odd'I branch circuit 7.42 2
Ci /Statc/7.IP: Miscellaneous (service or feeder not included)
nr Each manufactured or modular
dwelling, service and /or feeder 67.84 2
Phone: ( ) Fax: ( ) Reconnect only 67.84 2
E - mail: Pump or irrigation circle 67.84 2
` �C
� \ � ;: r V ' * .
1 0: ': ¢ 0..16WAV ';", * R
: ?'j : :7r1 Si or outlmc lighting
1 y
Business name: AC &E Electric Signal circuits) or limited -energy See 2
u' pent/• alteration, tfon, or extension. Pafic 2 _ 2
Address: 3535 Del Webb Ave Each additional inspection over allowable in any of the above
Additional inspection (1 hr min) 66,25/ hr
City/Stat:e/ZTP: Salem OR Investigation (1 hr min) 66.25/ hr
Phone: ( ) 503 - 363 - 2301 I Fax: 03) 363 - 2302 industrial plant (1 hr min) 75,18/ hr
Inspections for which no the is 90.00/ hr
CCB Lie.: 591 i Electrical Lie.: 4 -1C j Suprv. Lie.: 5387S specifically listed y � ( %hr min)
^-MN -' : EysitlT T1 .t ,: ,
y; �-, � . � ����; �. BYM A' /'J��IIYi�1�11'�R "4�:' � vl� ". ld 5 ,
Suprv. Electrician signature, required; / Subtotal: 71.02
r .
• Print. name: Carl Duncan Date: 7 -9 -13 Plan review (25% of permit fee):
— State surcharge (12% of permit fcc): 8.52
Authorized signature: TOTAL PERMIT FEE: 79.54 i
This permit applicadon expires ifs permit Is not ohteined within 18'
Print name: Date: days after it has been accepted as complete.
• Number of in pecttons allowed per permit.
I; \Ridlding \PcrrnitsTLC PermitApp_ELR ERE.dee 50 05/21 /2013 4411.4et5T(tl /0s/COM/W5R