Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit ft: ELC2013 00429
Date Issued: 07/24/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: SEG1189
Jurisdiction:
Site address: SW NO ADDRESS
Project: Walmart Subdivision: Lot:
Project Description: (1) branch circuit for existing service at NE comer of 72nd Ave at Hwy 217 northbound ramps.
Contractor: E C COMPANY Owner:
PO BOX 10286
PORTLAND, OR 97296
PHONE:
PHONE: 503 - 224 -3511
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 07/24/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/24/2013 $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. 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 OA - • 5090. ou may obtain a copy of the rules or direct uestio te t S OUNC b calling 503.232.1987 or 1.800.332.2344. /�
�%
Issued By: �� 2 oN L /C 70/
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 until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Jul, 19. 2013 3:37PM RECEIVE!' No. 0946 P. 1/1
Electrical Permit Application I ( 1 1 2 ( 1 1 1 I ( 1 . , ti l. O L 1
11 1 -2 11 City of Tigard JUL 2 2 2013 a 3 /3 •: f r a . t N ° � � . . 4 3 - ) %
13125 SW Hall Blvd, Tigard OR 97223
Phone: 503.718.2439 Fax. 503.598.196
ti „ inspection Line: 503.639.4175 CI OF I IG Date Ready/By: rent El Sec Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO Nom: 6- Supplemental Information • TYPE OF WORK .PLAN *yaw ''.:' .
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit a sets of plans whams checked below):
❑ Service or fboder 400 amps or more Q Building over three stories.
❑ Demolition
q Other: where the available built current CI Marinas and boatyards.
CATEGORY OF copsn1Uci'{oN exceeds 10.000 amps at 150 volts or 0 Floating buddings.
1 -and 2-family dwelling
[] ® Commercialrmdustrial less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other Prim pap. ❑ Installation of 150 KVA or
JOB STIR INFORMATION' AND LOCATION . . Addition ❑ larger separately derived system
anew motor load of 0 A ", "E , 1 -2 ", 1 -3 ",
Job no.: 65469 Job site address: 72° Ave @ OIt217 — 1-10 r j - h 'b c . m n cl ramps O six or resdentiai w it,. ❑ Recreational vehicle parrs.
City/State/ZIP: Tigard, OR ['Health facilities. ❑ Supply voltage for more than
i] Hazardous locations. 600 volts nominal.
Suite/bldgJapt. no.: Project name: Tigard Walmart ❑ Service or feeder 600 amps OT more.
'FEE:SCHEffilLE :- ..., :z' ` .'
palmation street/directions to job site: palmation I oar. (. pee. I Taal I * . '
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: I,000 sq. tt. or less 168.54 4
Tax map /parcel no.: 5 TC JiF 9 Ea. add'1 500 sq. ft or portion 33.92 1
Limited energy, residential 75.00 2
DESCR1PT1oN o f WORK (with above s ft)
Limited energy, multi-fhmily 73.00 2
Modifications to existing traffic signal A-7 /I le ('Q residential (with above sq. ft)
Renewable Energy CI See Page 2
Services or feeders installation, alteration, and/or relocation
•
❑ PROPERTY OWNER ❑ .TEN
200 amps ra less 100.70 2 •
- 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 20034 2
Address: 601 amps to 1,000 amps 301.04 2
City/State/ZIP: ' Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
Phone: ( ) Fax: ( ) relocation
200 amps or leas 5936 1
Owner installation: This installation is being made on property that I own which is not 201 to 400
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, panel • El APPIdCANT ! A Fee for branch circuits w ith
I . [] CON!'ACF:1!'ERSQN
Business name: E C Company above service t eller fee, 742 2
B. Fee for branch circuits without
Contact name: Shanna Fullbright service or feeder fee. first 1 5618 56.18 2
branch circuit .
Address: P 0 Box 925 Each add'I branch circuit 7.42 _ 2
City/State/ZIP: Albany, OIi 9?32l
Miscellaneous (service or feeder not included)
Each ma ufactared or modular 67.84 2
Phone: (541) 926-4266 Fax:: ( 541) 926 -0165 dwelling, service and/or fixdcr
Reconnect only 67.84 2
E - mail: shannafta .e- c -caeom Pump or irrigation circle 67.84 2
`CONTRACTOR . Sign or outline lighting 67.84 2
Business name: E C Company Signal circuit(s) or limited - energy See
panel, alteration, or extension. _� c 2 2
Address: P O Box 925 Each additional inspection over allowable in any of the above
Additional inspection (l In min) 6625/ hr
— City/State/ZIP: Albany, OR 97321 lnvestigetiort hr min) 6625/ hr
Phone: (541) 926266 Fax: (541) 926 -0165 Industrial plant (l hr min) 78.18/ hr
Inspections fbr which no fee is
CCB Lic.: 49737 Electrical Lic.: 22 5c Suprv. 'c.: 3 specifically listed CA hr min) 90'00/ hr
iM CITCICAL ,PIfa.RMP)C;FJi '> .;
Suprv. Electrician signature, required: '
Subtotal: 56.18
Print name: William R. Coburn ` Date: 07.19.13 Plan review (25% of permit fee): -
Stttre surcharge (12% of permit fox): 6.74
Authorized signature: TOTAL PERMIT FEE: 62.92 t� '
Print name: Date:
This permit application expires if a permit is sot obtained within 180
ass after it has been aoeeplod as complete. •
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
SW NO ADDRESS, TIGARD, OR
Commercial - Electrical
199 Electrical final
PASS - No C of O
June 4, 2014 at 7:53:02 AM
ELC2013-00429
Jeff Grove
Violation Summary:
Inspector Contractor