Permit n CITY OF TIGARD ELECTRICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit #: ELC2013 00419
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/24/2013
Parcel: 1 S134DC12700
Jurisdiction: Tigard
Site address: 11365 SW TIGARD ST
Project: BAPS Temple Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: (3) branch circuits for addition of restroom to 2nd floor
Contractor: INFINITY ELECTRIC LLC Owner: BAPS PORTLAND LLC
PO BOX 1635 ATTN CORPORATE AFFAIRS DEPT
BRUSH PRAIRIE, WA 98604 81 SUTTONS LN
PISCATAWAY, NJ 08854
PHONE: 503 - 209 -0533 PHONE: 503 - 597 -3030
FAX: 360- 256 -8516
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 07/24/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/24/2013 $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 accord 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 •N: Ore! 'n law requires you to follow the rules adopted by the Oregon Utility Not Center. Those rules are set forth in OAR
952 - 001 -00 d through OAR • • 11 - r 9 r You may obtain a copy of the rules or direct questions to OUNC by .1987 or 1.800
Issued :y: — ► j Perm ittee Signature: /
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:
n C�ONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' T— C�--�Ge- 4--__ Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
Thls 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.22.2013 04:36 PM Jack Brown 360 256 8516 PAGE. 1
Electric!!! Permit Aniplic i • C IV
pip City of Tigard 8e�� ived
_ -" 1311) SW Hall Blva,'ligard, UK 9 U 2 2 2013 . na 7 3 - ) .�• ermitNO `7�/3 e7
Phone: 503.718.2439 Fax: 503.598.1960 Plea Rev
'
T.iGn Ci Tne�grfirtn.T,inr• �njl7Q�17S CITYOFTIGARD Date/13 . °ty ��p' / .9�
Internet: www.tigard -or. oV r D �..R,,•, n NJ �!/ f/
+ V , : silted: l77
. �._ r _ _ Suppier: a In formation
TYPE air 'wivaxi;. _
❑New construction ddition/alteration/replacement Please check all that :: .
LJ Demolition apply (submit j sea of plans w /items checked below
I I - z — U Other: r i Service or feeder 400 arms or rem 11 Ruj(dinu over three stories. )
CATS • RY OF CONSTRUCTION where the available fault current ❑ Marinas and boatyards.
t xaeds 10,000 amps at 150 vole or ID Floating buildings.
❑ 1- and 2- family dwelling f4 Commercial/industrial w gto Dati, m cxr xa.is'iv,i iti
❑ Acce ssory building u wwnrcrciai -uac agnwuunu
( l f._Iti fam:l.. n Adaara. {,._Ian amps for all other installations. buildings.
l � l n ❑Fire Dumb. E JOB SITE INFORMATION AND LOCATION l Emergency system. "tenon of 150 derived system.
or
_ I ❑ Addiooa of "A", separately derived )
Job no.: I Job site address: it J Olo t— 5 0 - 1. :::::::r..„,.-....„,.. motor load of ❑ - A -.. E . , „ - 1.3 „
('its /State /7.iP• _ — J lord ❑ Six or more residential units. ❑ Recreational vehicle parts.
___ l - Q D r ❑ Health-care facilities. 0 voltage for more than
J
S name:
❑ Harardo locations. 600 volts nominal.
Suite/bldg./apt. no.: Project a
e ❑ Service or feeder 600 amps or more. • Cross street/directions to job site: i 5 1
•• G u
' Dweri •
New residential single- or multi - family dwelling unit
Subdivision: -. Includes attached g arage .
t Lot no.: 1.000 sq. R or less 168.54
Tax map /parcel no.: + Fa edd'1500 sq. ft or portion 4
1 1 33.92 1
ur itiiirriuio vi - wiiiu� . Limited energy, residential aw• tw. ;�) 5.00
L 2
Limited energy, multi - family
residential (with above sq. R) 75.00 2
�._._„„ Renewable Energy I ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
ROPERTY OWNER I ❑ TENANT uxr
amps or irss L
Name: i —
Ai ,4111 201 amps to 400 amps 133.56 — ,k ail
Address: C 401 amps to 600 amps 2
200.34 r 2
� _ 5 1 /1+ 601 turps to 1,000 amps 301.04 2
City/State/ZIP: 1 (/ (j O Over 1,000 amps or volts 11111 552.26
2
Phone: ( Temporary services or feeders instapation, alteration and/or
D 3 -- 3 0 3 Q I Fax: ( ) relocation '
Owner instillation: I Ins installation ts'oemg made on property that I own wtuch is net 200 amps or less 55
intended for sale, lease, rent, or exchange, according to OILS 447, 449, 670, and 701. 1
201 am t o 400 amps 125.08 2
Owner signature: 401 amps to 599 amps 168.54 2
Date: Branch tine tdts -new, alteration, or extension
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with extension, per Panel
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: B. Fee for branch circuits without .
service or feeder fee, first
/
Address: branch circuit 56.18 2
Each add'i branch circuit A_ 7.42 - , 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Each n.n+•r+fart,... -.: or modular
Fax: : ( ) aweum service anaror teener I Rd I 1 7
E -mail: Reconnect only 6 7.84 2
CONTRACTOR Finn or itrioatinn circle. h7 R4
2
Business name: / sign or outline lighting 67.84 2
rrycl 0 C e ( y�.l 4..4 / `-F � // \ signal circuil(s) or limited - energy
panel, alteration see
Address: P a ` r , or extension. Page 2
I 2
�i ' c o - E ach additional inspection over allowable in any of the above
City /State/ZIP: ►� I _ n � ^ g� Additional inspection (1 hr min) 66.25/1a
Ph e: Goa, z G, 2 Fax: ` - ( Investigation (1 hr m 66.25/ hr
in)
I o S 3 7 ( ) Industrial plant (1 hr min) 78.18/hr
C$ Lic.: 1 5 3 . Electrical Lic.. • Teq;+w•ti�.+a fnr ,vhirh ,,,, 0._;
7 Su prv. Li c. i I I yu.wr nr 1
ELECTRICAL PERMIT FEES I
. _ .. specifically fisted (Si hr min)
'
uprv. Electric' . � . e, requit i �� / , /j/
�
- Subtotal: 74 °a
Print name: c� / (.J 0G r / 41 �/ � I Date -.-.- Plan review (25% of permit fee):
authorized signature: r State surcharge (12 %ofpermit fee): 9 '5'2
'tint name:
I Date: TOTAL PERMIT FEE: 9 e t //
Thb permit application expires if a permit is not obtaine within 180
days after It has been accepted as complete .
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