Permit CITY OF TIGARD ELECTRICAL PERMIT
III * • COMMUNITY DEVELOPMENT Permit#: ELC2013-00559
T f GARO 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2013
Parcel: 2S101DC03800
Jurisdiction: TIGARD
Site address: 7190 SW SANDBURG ST 10
Project: Spec Space Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Electrical for TI. (5)branch circuits for demo and lighting.
Contractor: CURRENT ELECTRICAL CONST CO Owner: MCCORMACK PROPERTIES LP
PO BOX 19652 7190 SW SANDBURG ST
PORTLAND,OR 97280 TIGARD,OR 97223
PHONE: 503-245-5997
PHONE: 503-624-4649
FAX: 503-245-2919
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 09/23/2013 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/23/2013 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 160 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. Tho • - are set forth in OAR
952-001-0010 through OAR 952-001-0090, You ma •• -'• - • irect questions to OUNC by calling 503.232.1987 or 1.8••.33 • 4.
Issued By: Permittee Signat �% ::_
NIP%
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.
Electrical Permit Application �9 FOR OFFICE USE ONLY
Received
City of Tigard �+ Date/B : iJ Permit No.: _� , .SS"
III 0 13125 SW Hall Blvd.,Tigard, sjt �3 Plan Review z
^ Other Permit:
Phone: 503.718.2439 Fax: 5i;e':,-:,1960 c3 L Date/B : Oia..ataI
TIGARD Inspection Line: 503.639.4175 r �j C� Date Ready/By: See'age 2 for
Internet: Line: gard-or.gov C3 cfc0 xe^� Notified Method: /� Supplemental Information
��`` C
TYPE OF G0ly a PLAN REVIEW
❑New construction IZ Addition/altertOacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: 115 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
❑ I-and 2-family dwelling Commercial/industrial ❑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 "I-2","l-3".
Job no.: 100 13 C L Job site address:7190 SW SANDBURG ST 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:TIGARD OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: /0 Project name: MCCORMACK ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'I 500 sq.ft.or portion 33.92 I
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.)
�1 Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ 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 ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: S��, �J7a4..1 each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first l
56.18 56.18 2
branch circuit
Address: Each add'!branch circuit 4 7.42 i 29.68 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 irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:CURRENT ELECTRICAL Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: PO BOX 19652 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
_
City/State/ZIP: PORTLAND,OR 97280 Investigation(1 hr min) 66.25/hr
Phone:(503)2455997 Fax:(503)2452919 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 46994 Electrical Lic.: • 71-" Suprv.Lic.: 5232S specifically listed(/:hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,requi -..
Subtotal: 85.86
fee):f
review(25%of permit name: Jason Jacobucci Date: 09/17/13 Plan re -
State surcharge(12%of permit fee): 10.30
Authorized signature: 10--- / TOTAL PERMIT FEE: 96.16 ,../
Print name: David Thompson Date: 09/17/13 This permit application expires if a permit is not obtained within 180
p days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(II/05/COM/WEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7190 SW SANDBURG ST 10, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-11-04 00:00:00
ELC2013-00559
PASS - No C of O
Violation Summary:
Inspector Contractor