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Permit CITY OF TIGARD ELECTRICAL PERMIT 11 4 s COMMUNITY DEVELOPMENT Permit #: ELC2013 -00742 TI G A R O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2013 Parcel: 2S1 01 DA00102 Jurisdiction: Tigard Site address: 13221 SW 68TH PKWY 410 Project: NWCUA Subdivision: VARNS ACRES Lot: 9 Project Description: (7) branch circuits for TI on fourth and fifth floor. 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 7 crt Branch Circuits wo /Purchase 12/17/2013 $100.70 Specifics: Service or Feeder 1 ea 12% State Surcharge - 12/17/2013 $12.08 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 Required Items and Reports (Conditions) This permit is 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 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. TTENTION: Oregon law ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -0 1 -0010 thro gh OAR 952- 1- 00,90. u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 0.332.2344. Iss d By: Permittee 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: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Ar � 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 A licatio FOR OFFI('F l SF () \ I ■ E CEIVED R eceived i - Ci}y of Ti a nd , 1 Permit No.: e; (!;.0/5--650 7412 �J g Date1B 7 / � 13 SW Hall Blvd. Tigard, OR 9 Plan Review Phone: 503.718.2439 Fax: 503.598.19 Date/B : Other Permit / 0 , ;,2, 6 ,7 7, .��Z� T I G A R D Inspection Line: 503.639.4175 E C 17 2 0 13 Date Ready/By: Innis 0 See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information OF FIGAR© TYPE OF �In fit t PLAN REVIEW El New construction []Addition /alte /rep 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 El Other: where the available fault current ❑ Marinas and boatyards. CATEGORY O 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. El 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 ", "1 -2 ", "1 -3 ", Job no.: Job site address: / 3 z 2 I s uj G 1` ') r Six or or more residential Recreational 1 1 f � tat � ❑ Six or more residential units. ❑ R vehicle parks. City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: Ai IA C u H ❑ Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE J Description I Qty. I Fee. I Total New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add'I 500 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 - b(' 1 . 1(. k C 1 rGVr4 s -f ) . 1 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 ❑ 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 1 �/ O 2 branch circuit Address: Each add'I branch circuit to 7.42 _ ` ti Z. 2 City /State /Z[P: 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 I Sign or outline lighting 67.84 2 Business name: C C o s -/e / l J E le e - t - r i s c I Cuedfa.+i Signal circuit(s) ena or limited- energy See panel, alteration, or extension. Page 2 _ 2 Address: -- , Box i -,, 6 Each additional inspection over allowable in any of the above City/State /ZIP: q r� 'Z'>" Additional inspection (1 hr min) 66.25/ hr I' f - 0 rU ( - 1100 7— Investigation (1 hr min) 66.25/ hr Phone: (50)) 9�1 y Fax: 3 Industrial plant (1 hr min) 78.18/ hr q �` V q � �� i Inspections for which no fee is CCB Lie.: 89/. L /0Z El (� J Electrical Lic.: 3 -31 ! > I Suprv, Lic.: 3c - Li S specifically listed (' /z hr min) 90.00 / hr ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: /OU . - 70 Print name: -R136 (Z , C Co S��. I / , Date: a' i • / / 3 Plan review (25% of permit fee): State surcharge (l2 /a of permit fee): I Z U0 Authorized signature: TOTAL PERMIT FEE: 112_ 7A Print name: Date: This permit application expires if a permit is not obtained within 180 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(I1 /05 /COMM'EB Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 13221 SW 68TH PKWY 410, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal 2014-01-24 00:00:00 ELC2013-00742 PASS - No C of O Violation Summary: Inspector Contractor