Permit CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2013 00393
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013
Parcel: 1 S 134AA01800
Jurisdiction: Tigard
Site address: 10220 SW NIMBUS AVE K10
Project: Scholls Business Park Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: (1) branch circuit for HVAC disconnect
Contractor: CAPITOL ELECTRIC CO INC Owner: HANSON, RONALD D
11401 NE MARX STREET ROBINSON, CONSTANCE A
PORTLAND, OR 97220 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 07/11/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/11/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 : Orego aw requires you to follow the rules adopted by the Oregon Utility Notifica�tio tenter. Those rules are set forth in OAR
952 - 001 -001 through OAR 952 -0. -r: -. / Yo ay obtain a copy of the rules or direct questions to OUNC by callin. 503.232.1987 or 1.800.332.2.44.
r �
Issued B — Z adL -• L / Permittee Signature: \, %� � �� %/,k#'
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.
07/10/2013 09:15 5032551966 CAPITOL ELECTRIC PAGE 01
Electrical Permit Application ... � FoR owlet. tls' °NEN .
City of Tigard U J3 C EI d J�D Received 7 // / 3 CAP, ,trout No. ELe 0 013— Dc 3'
• 13125 SW Hall Blvd., Tigard, OR 97223 pion Review Other Permit MEC',0/3 3 77
i ' Phone: 503, 718.2439 1' aM; 503. 598.1969 U l 7 DateB :
1 I. +. R D'
Inspection Line: 503.639.4175 0 , 013 Dale Ready/By: a. E.1 S Supplemental Information
P f o
Interact; www.tigard- or,gov Notificd/Method:
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ry hi , ..sN? , a c" . mr : ' �' r ., , ''Kd r4 ;e.,EA 'Y 1 : -'4i .
, ;{, .� = x r� t.• r»� 1<.rr�+t - l`^w,+� C, •1;, � o x �^ � � , �; ,., . , � } " T , + ..,i,:ac�, �r_ -, r . • s ..,
' +e, . ,.,, : ,e,t.= a+, ..:,i: ' L�#."...",. :�� r,v_�r•, . _ 6s . w 4 , • , r i.. . , �. .tfi .,y.,., , s , : SI: s 'o. �L _
r ation /1
• nJ Please check all that apply (sohmlt 2 acts or plans w /Items checked below):
❑ New construction El Addition /alte
❑ Service or feeder 400 amps or more ❑ Building over duce stories,
❑ Demolition ❑ Other whore the available fault current ❑ Marinas and boatyards.
" � „ • " •` exceeds 10,000 amps nt 150 volts or CI Floating buildings,
i1, 7a.,�ita�u "',�e 3.1m+. ay.W B ' / , " 1rl T %r' ' +:, n Mrs ' ,', `!
x } , � ° 4�++ ( . �ahc ,�et� a >,.,. , R r�2� T,�tk. TF htio-" ' loss to Rround, or exceeds 14.000 ❑ Commercial agricultural
❑ 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building amps for nil other Installations, buildings,
Q Multi -film 1 y ❑ Master builder Other: CI Fire pump. ❑ Installation of 150 KVA or
p r ". " vw .. w „, •�., ❑ Ltncr�Cncy system larger separately derived system.
I ` '
p�"lll , ° 7 @ �
l rt , � , » iu.1 1 r, 171 ,.
❑ Addition of new motor load of A "`P "1-2 I.i ",
", t h i ?a t G n 1 I • a e k"
1f
fl more. or more residential mils, Rec reational vehicle P OHP or are. occupancy.
Job no,: 131249 Job site address: 10220 SW Nimbus Ave [] arks.
City /State /ZIP: Tigard, Or 97223 ❑ Hcnllh•aare Facilities. ❑ Supply voltage for more than
❑ Hazardous locotiott_a 600 volts nominal
Suite/bldg. /apt. no.: K 10 l Project name: B ❑ Service or feeder 600 amps or more
Y{
: .7 " 4 k a . .Ply .+' •rfi%: �' p .,.> t o ..i/'.ri y {.. W r ' ',
� ef.vu•a &LI6/, .)s:s6 /°�e � - _..,.f,
Cross street /directions to job site: Do_ .edm Oily. p «. Total •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Scholls Business Center Lot no.: 1,000 sq. ft . or loss - 168.54 4
Ea, add's 500 sq. ft. or portion 33,92 I
Tax map /parcel no.: Limited energy, residential
C y aT14 ,4 Y .. a r i 1 " }b , r t i , h., � °" (with above sg, R.) 75.00 2
W
.A t j p h T.'7 ' r�,^ ' � ._. A «. 1 ' �; s ; n ` .
, 1 . ,, , .a.,, { t' u w ,� ra.,, + rye. a 1 L imited energy, multi- 1:lmily
Replace HVAC Disconnect Bldg K Suite 10 residential (with above sq. ft) 75.00 2
- Rent'wable Energy .. D .See Page 2
Services or feeders installation, alteration, and /or relocation
i
a�
- +r , .•Z ' t :
r . 200 amps or lass 100.70 2
,. .""'•ft,°,'r A � � le °, � - .. -, ..`,e
r.r , "�'r2;`,�t. Ni; :�'—' :.1.•,...
201 amps to 400 amps 133,56 2
Name: T 401 amps t o 600 amps 200.34 2
Address; 601 amps to 1.000 amps 301,04 2
Over 1,000 amps or volts J 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) I Pax: ( ) relocation,
200 amps or less 59,36 1 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, per panel
p n+i I r iM r ^T tt y" <rr � a1 "eta '+ - . �s. A. Fee for branch circuits wish
+ 1 . 1 r4 4 , , .. - _ ' • • ••i above service Or feeder fcc. 7.42 2
Business name: cook 1 r�,_�_l -
tal-w co. aj (-' each branch circuit
� B . Fee for branch circuits withour I
Contact name: Ga ert.k service or feeder fee, first 56,18 2
branch circuit
Address: 1k \ E Ahfle&-4. Each add'I branch circuit 7,42 2
Miscellaneous (service or feeder not included)
City/5tale/T_.1P:
%Q\ Q % 4 112 2- Each manufactured or modular
67,84 2
_ dwelling, service and /or feeder
Phone: (50) 255 94 c lax:: (5)3 ) ZS$ - !q(pto Reconnect only 67.84 + 2
E - mail: • OM - • cc. •dK - Gulfs . Pump or irrigation circle 67.84 2
y
iu6 ! 7`, t ,< •1, r!w. L174,,i 1 . n . `"rt H!'.. `^ ' '+'4;ki.4
�Mr.e _ ,.. _ , �'�s•.. SX h�t i`4�', ���ti�j!�a _, r,'�`^ = :;.�Ari� :,C.„„�, Sign or outline lighting 67,84 2
Business name: Capitol Electric Co., Inc Signal circuit(s) or limited See
0 )
panel, alteration. or extension, Pag 2 2
Address: 11401 NE Marx Each additional inspection over allowable in any of the abov
Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Portland, Or 97220 Investigation (1 hr min) 66,25/ hr
Phone: (503) 255 -9488 Fax: (503) 255 -1966 industrial plant (1 hr min) 78.18/ hr
inspection for which no fee is 90.001 hr
CCB Lie.: 48748 Electrical Lie.: 26 -496C Suprv. Lie.: 3132 -S specifically lived V2 hr min)
= aa ;
air 72: y _it tr7..ld'ij', :it'. ryu,,t'r"': �`
Suprv. Electrician signature. required: p g 9 -0'7 -"A4. Subtotal: 56.18
Print name: Darrell McNccl Dale: 7/1 /13 Plan review (25% of permit fee): 0
State surcharge (12Re of permit fee): 6.74 Authorized signature: a TOTAL PERMIT FEE: 62,92 dii ` �' `'�� `' Thia permit application expires if a permit is not obtained within 180
Print name: Darrell McNeal — Date: 7/10113 _ days after it has been accepted as complete.
• Number of inspections allowed per permit.
I: \Building\n mii5'Bi.C_PermitApp_aLR E1tE.doe Rev 03/21/201i 140 5 7(11 /n5 /COM/Wi2