Permit TI GARB,
City of Tigard
August 1, 2013
E C Company
Attn: Anna Hett
PO Box 10286
Portland, OR 97296
Re: Permit No. ELC2013 -00410
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 7330 SW Landmark Ln.
Project Name: TVT Die Casting
Job No.: N/A
Refund Method: ❑ Check # in the amount of $
® Credit card "return" receipt in the amount of $50.33.
Note: Please allow 2 -5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit" receipt in the amount of $
Cornment(s): Per applicant's request as job was cancelled. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
/
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard- or.gov
City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the RequestforPermitAction form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: E C Company DATE: 8/1/2013
Attn: Anna Hett
PO Box 10286 REQUESTED BY: Dianna Howse
Portland, OR 97296
TRANSACTION INFORMATION:
Receipt #: 192339 Case #: ELC2013 -00410
Date: 7/23/2013 Address /Parcel: 7330 SW Landmark Ln
Pay Method: CreditCard Project Name: TVT Die Casting
EXPLANATION: Per applicant's request as job was cacelled. Refund 80% of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000 -43104 $ Amount
Restricted Energy Permit 220- 0000 -43103 $44.94
12% State Surcharge 100 - 0000- 43.1.El .2 Y00/ 5.39
R , /
TOTAL REFUND: $50.33
APPROVALS: SIGNAT R —11 ATE:
If under $5,000 Professional Staff
If under $12,500 Division Manager
If under $25,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: Date: IY /A I By:
1: \Buildin \ Refunds \RefundRequest.doc x 09/01/2010
Jul. 24. 2013 2:23PM No. 2999 P. 1 e (/
RECEIVED
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ,JUL 2 4 2013
I� ° Request Permit Action q CInoFTIGARD
l I u A (z D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigadd#dnd. G DIVISIOP
TO: CITY OF TIGARD V Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223 /i 4 ,s
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard- or.gov
FROM: ❑ Owner ® Applicant ❑ Contractor ❑ City Staff
(check one)
RE}UND OR Name: E C Company
INVOICE TO: (Business "l"ivid") Please reference Job # 74963 -18
Mailing Address: PO Box 10286
City /State /Zip: Portland OR 97296
Phone No.: 503.224.3511
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (r):
❑ CANCEL/VOID PERMIT APPLICATION.
® REFUND PERMIT FEES (attach copy of original receipt and provide explanation below)
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: ELC- 2013 -0041 ELC,o20/3 — 0 0 V/0 X95
Site Address or Parcel #: 7330 SW Landmark Ln
Project Name: TVT Die Casting
Subdivision Name: Lot #:
EXPLANATION: Job was canceled
14
Signature: - FINgi a Date: 7 -24 -2013
a Nett
Print Name: 5G / 7V
5'y 9y --573p .ems .v,
1. The Director or Building Official may authorize the refund 05 f�• a .7J ,e,--7-,4,../6-2)
a) any fee which was erroneously paid or collected
b) not more than 80% of the land use Application fee when an application is withdrawn or canceled before any review effort has been expended
c) not more dean 80% of the land use application fee for issued pennies.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior co any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds.
1 (71.1 OFFICE USE ON
Rte to S s Admin: Date Rte to Bid: Admin: Date , 0 AM B . ��
Refund Processed: Date PQ e� B. ,i%i Invoice Processed: Date ' �•. ".
Permit Canceled: Date , Q® B �% Parcel Ta_ Added: Date By
Receipt # Date Method Amount
CITY OF TIGARD ELECTRICAL PERMIT
ati 11 1 c COMMUNITY DEVELOPMEN Permit #: ELC2013 -00410
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2013
Parcel: 2S112AB00100
Jurisdiction: Tigard
Site address: 7330 SW LANDMARK LN
Project: TVT Die Casting Subdivision: 1992 -007 PARTITION PLAT Lot: 2
Project Description: (1) branch circuit for new lathe
Contractor: E C COMPANY Owner: SUMMIT PROPERTIES INC
PO BOX 10286 5550 SW MACADAM BLVD STE 205
PORTLAND, OR 97296 PORTLAND, OR 97201
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 07/23/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge -, 07/23/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OA' • 5 -0 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
issued By: / V / Permittee Signature: o '! f z-• � D
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 603.639.4176 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept In a conspicuous place on the Job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
Jul. 18. 2013 3:20PM No. 2973 P. 1
Electrical Permit A ' F
• '' I o IN
F. �i•.rl<•1•. 1 tic c)N
City of Tigard JUL 1 g R —
13125 SW Hall Blvd, Ti OR 97223 2O �3 Da1em • ez3 f% PeemirNo.: (-LCo /3 60 WO ■ Plan Review
-' -. Phone: 503.639.4171 g A .pAy9 Date/8 : Other
G A I D Inspection Line: 5 s ; :.e. 1 Sy� IRA Date Reedy/By: 7 .' See Page 2 foe
Internet: www.tign'' P IIV oo cd/Mehod: Supplemental Vr N I1 Supple In formation
SWIM - ° •'r.$ , :: .: ;, {' - - a . - tC_: = Matra _410g:=_, .. , - • y:. ' - -.� ...: _, �:...,
,....... - ,,t.,:- .- ::::,. � ._._.....�..,,:1�.:�,_::_� - -- -,_- �'�` —. ,�'2 ..���?:��.�1�.,�h ';,,,�` -= -'ice -
❑ New construction ® Addition/alteration/replacement Please check all dun apply (submit 1 iris of plans iv/items checked below):
❑ Service or (ceder 400 amps or more ❑ Building over three stories,
❑ Demolition ❑ Other:
-. whsle the available faun current ❑ Marinas and boatyards.
.:F u ' =
ATF, " o Q tt= _ _ lit _fxf: exceeds 10.000 amps ar 1So volts or ❑ Fleecing buildings.
= ''; less to ground, r exceeds t4
1:1 1 - and 2 dwelling Commercial/industrial 0 Commercial -use ogricuiswral
Y g ® ❑Accessorybuilding amps tar all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ tee pump. ❑ Inslallauon ot75 KVA or
K` A,.,=-..t _.`%. - �BaRI ''; - i! �l 7C a` , • .: A.' : ' ? - _�e,`Y_ OMdi larger sepuar system.
_ { . v, . __ .�. day_: � ;
- <••m...._.__.. ,,,.,,- .: ;. -. ,.-•__ , -: :��: ..�., OAddtdoaofncw motor load of ❑ "A °,°E°, "1- 2 ", "1 -3°,
Job no.: 7496 3 - 181 Job site address: 7330 SW Landmark Lane roOUP or mere. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard OR ❑neata,..0 faciitie,. ❑ Supply voltage for more than
❑ Hazardous locations. 600 voles nominal.
Suite/bldg./apt. no.: ' Project name: TVT Die Cast ing ❑ Servka or feeder 600 amps or more.
Cross screel/direclions to job site: ' -Y � F = —`>i
Peacripdon ` 1 olv. I rue. I Tow I • _
- New- resideoltai single - or multi- family dwelling unit. -- - - - - - -- --
Includes attached garage.
Subdivision: - I Lotno.: 1.000 sq. It. orless _ 168.54 4
Tax map /parcel no.:
Fa edd'i 500 sq. R. or ponion 33.92 1
,, __. � Limited energy, residmtial • = ; aAle s. gY •._. .-=--- -_.. M - (with above sq. 0.) 75.00 2
one new circuit for a new lathe Limited energy. multi-family 75.00 2
residemial (wills above eq. fl.)
Services or feeders Installatlonotteralion, and/or relocation
-
q _ ON 200 amps or less 100.70 2
'.tOP'�; _.— ° = ®, ' , P. ' .. 201 ampato400amps 13336 2
Name: 401 amps to 600 amps 200.34 2
'°' 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/Staterim. Temporary es or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or loss 59.36 I 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 snips to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, , er panel
Owner signature: Date: _ A. Fee for branch circuits with
_ `".' ; Ac`- - i - . r a Pk:'�`U ;E°�_� above service or feeder fee,
- y'^ each branch circuit 7A2 2
Business name: EC Company e. Foe for branch circuits without
service or feeder fee. first 1 56.1 8 5 6.18 2
Contact name: Kat Kelley branch circuit
Each add'I branch circuit 7.42 2
Address; PO Box 10286 Miscellaneous (service or feeder not Included)
Each City/State/ZIP: Portland, OR 97296 dwelling. 6784 2 • r dwelling, service and/or feeder
Phone: ( 5 0 3 ) 224-3513. 1 c ; 1 5 0 3 ) 295-3012 Reconnect onl 67.84 2
E - mail: kathyk ®e - c - co . corn
Pump or irrigation circle 67.84 2
..L_CE• i-`Q' <., ,.� � . _r(� - - q ��. Sign 0 time lighting
e - n =r - w C t A= " .= �. - : 4- 1r`; —ms s,,. rou " 67.84 2
'- - - - - -- �• Sign c or ' w i led- energy
Business name: EC Company panel. alteration or extension. Page 2 2
Each additional Inspection over allowable in any of the abov
_ Address: PO Box 10286 Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Portland, OR 97296 fnvesti hrmin) ` 66,25/ hr
tndustrial plant (1 hr min) 78.18/ hr
/Phone: (503) '
5 0 3) - 224-3511 , 03) 29- lnspections for which no feo is
: 4 9 7 3 7 trica s� V .i &call lislea I, he min 90.00/ hr
0 ,.....,,,,
Sup rv_ LIc. I?ectricion signature, requiredElecl Lie.: 2 _ . , C : Subtotal: 5 6.18
� , . 1 : .--*-7 Plan review (25% of permit fPe):
Print name: Ron it .IE �1 1 1' /'18/2013 - State surcharge(12 %ofpermir 6.74
r rims"— �l� -
Authorized signofr i N � '+., _
This permit application expires TOTAL PERMIT F lo c oh % 6
ire permit Is not tthin 180
Print name: 7 18 2 013 days on.. it has been accepted a. complete.
Anna Hett _ Date: I / - Number ofiaspecdonsallowedperpermit. / n 9
ecaardinerc,�t 1.C- prmuupp loc 07/01/10 4 40- 461310 1ro5xtwm (P O �
a