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Permit Iii CITY OF TIGARD ELECTRICAL PERMIT III a,. _ COMMUNITY DEVELOPMENT Permit# ELC2013 00440 Date Issued 07/29/2013 TIGARD 13125 SW Hall Blvd Tigard OR 97223 503 718 2439 Parcel 2S101 DA00102 Jurisdiction Tigard Site address 13221 SW 68TH PKWY 120 Project Precoa Subdivision VARNS ACRES Lot 9 Project Description (10)branch circuits for TI Contractor R C COSTELLO ELECTRICAL CONT INC Owner GK TRIANGLE CORPORATE PARK III L PO BOX 336 BY THOMSON REUTERS INC AURORA OR 97002 ATTN MEGAN DOWLING PO BOX 130174 CARLSBAD CA 92013 PHONE 503 982 7400 PHONE FAX 503 982 7400 FEES Quantity Description Date Amount 10 crt Branch Circuits wo/Purchase 07/29/2013 $122 96 Specifics Service or Feeder 1 ea 12°/ State Surcharge 07/29/2013 $14 76 Type of Use COM Electrical Class of Work ALT Type of Const Occupancy Grp Total $137 72 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 a • -- -- . th approved plans This permit will expire rf work is not started within 180 days of issuance or if work is suspended for more the 180 days A NTION Oregon -w re•- -s you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952 001 0010 thr•ugh OAR 952 Or 1090 ou :y obtain a copy of the rules or direct questions to OUNC by calling 03 232 1987 or 332 2344 J ' � � . Issued = , /��/ i Permittee Signature 00.—, 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 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 Electrical Permit A licati E1 V ED rUR(11 11( 1: (HSI:ONLY City of Tigard Received Permit No g y Datem 7 e s tai go/3�O qLf v :� • 13125 SW HaII Blvd Tigard OR 97223H1 D 9 ( i13 Plan Review Phone 503 718 2439 Fax 503 598 1 Date/B Other Permit T I G A R D Inspection Line 503 639 4175 .�/o�TIGARD Date Ready/By loos ® See Page 2 for Internet www tigard-or gov p�C�]ra �ISD Notified/Method Supplemental Information TYPE OIBWEJ�INGD l PLAN REVIEW ['New construction [IAddit ion/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below) ❑Demolition Other ❑Service or feeder 400 amps or more ❑Building over three stones ❑ where the available fault current ❑Marinas and boatyards CATEGORY OF CONSTRUCTION exceeds 10 000 amps at 150 volts or ❑Floating buildings less to ground,or exceeds 14 000 ❑Commercial use agricultural ❑ 1 and 2 family dwelling 121CommerciaUtndustrial ❑Accessory building amps for all other installations buildings ❑Multi family ❑Master builder ❑Other ❑Fire pump ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived system ❑Addition of new motor load of ❑ A E 12 13 Job no Job site address /322_ 1 Su/ 6B14 1 Six► or more occupancy Ga��IUI►.y 0 or more residential units ❑Recreational vehicle parks City/State/ZIP ❑Health-care f a c I t es ❑Supply voltage for more than ❑Hazardous locations 600 volts nominal Suit ldg/apt no 1 LO) Project name ?r sE.CoA ❑Service or feeder 600 amps or more Cross street/directions to job site FEE SCHEDULE J Ddcnpno I Qty I Fee. I Total New residential single or multi family dwelling unit. Includes attached garage Subdivision Lot no 1000 sq ft or less 168 54 4 Ea add 1500 sq ft or portion 33 92 1 Tax map/parcel no Limited energy residential 75 00 2 DESCRIPTION OF WORK (with above sq ft) Limited energy multi family 75 00 2 residential(with above sq ft) Renewable Energy ❑ See Page 2 Services or feeders installation alteration and/or relocation ❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100 70 2 201 amps to 400 amps 133 56 2 Name 401 amps to 600 amps 200 34 2 Address 601 amps to 1 000 amps 301 04 2 Over 1 000 amps or volts 552 26 2 City/State/ZIP Temporary services or feeders installation alteration and/or Phone ( ) Fax ( ) relocation 200 amps or less 59 36 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 ❑ APPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with above service or feeder fee 7 42 2 Business name each branch circuit B Fee for branch circuits without / Contact name service or feeder fee first / 56 18 sif ((/ 2 branch circuit Address Each add 1 branch circuit q 7 42 b6' 7e6 2 City/State/ZIP Miscellaneous(service or feeder not included) Each manufactured or modular 67 84 2 Phone ( ) Fax ( ) dwelling,service and/or feeder Reconnect only 67 84 2 E mail Pump or imgation circle 67 84 2 CONTRACTOR Sign or outline lighting 67 84 2 Business name C /y Signal circuit(s)or limited-energy See "R a C os��1k E 1 p_c f rl�s� I Ct,n4 rtt c+n 5 J A C panel alteration,or extension Page 2 2 Address O 3o x MG Each additional inspection over allowable in any of the above City/State/ZIP ,Q R Additional inspection(I hr mm) 6625/hr /7O to POt O R q)OO 2- Investigation(I hr min) 66 25/hr Phone (SQ3) C/SZ —WO Fax (503) qs2,.-14d J Industrial plant(I hr mm) 78 18/hr Inspections for which no fee is 00/hr CCB Lic g'pyV Z Electrical Lic 3-3 LjLiC Supry Lic 3C///,,/ 5 specifically listed(I hr mm) Supry Electrician signature required ELECTRICAL PERMIT FEES G �� — Subtotal f�. I /,n Plan review(25/of permit fee) �' Pont name 5 Date /�'1 State surcharge(12/of permit fee) / q 7 v t2t C Cu��Q ��u /J l Authorized signature TOTAL PERMIT FEE .j 7 7- Print name Date This permit application e pires f a perm t is not obtained within la0 days after it has been accepted as complete. Number of inspections allowed per permit i\B Id ngTPerm t\ELC_PemutApp_ELR ERE doc Rev 05/21/2013 440-4615T(I 1/05/COM/WEB