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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2014-00041 Date Issued: 01/29/2014 T i G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 101 AA03800 Jurisdiction: Tigard Site address: 12259 SW 69TH AVE Project: Capital One Bldg B Subdivision: WEST PORTLAND HEIGHTS Lot: B Project Description: Electrical for Building B cubicle configuration. Contractor: MCKINSTRY ELECTRICAL LLC Owner: TIGARD CORPORATE CENTER LP 16790 NE MASON STREET SUITE 100 15325 SW BEAVERTON CREEK CT PORTLAND, OR 97230 BEAVERTON,OR 97006 PHONE: 503-278-3954 PHONE: FAX: 503-331-6907 FEES Quantity Description Date Amount 46 crt Branch Circuits wo/Purchase 01/29/2014 $390.08 Specifics: Service or Feeder 1 ea Signal circuit or Limited 01/29/2014 $75.00 Type of Use: COM Energy Panel Class of Work: ALT 1 ea 12%State Surcharge- 01/29/2014 $55.81 Electrical Type of Const: Occupancy Grp: Total $520.89 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 .• - • 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. • TENTION: Oregon -w r-• res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 001-0010 throu.h OAR 952-0, -0090. ig may obtain a copy of the rules or direct questions to OUNC by calling 503.232 1987 or 1.800.332.2344. Issued By: Permittee Signature: s 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 FOR OFFICE USE ONLY City of Tigard �� Received permit No.: • 13125 SW Hall Blvd.,Tigard,O', ' ..,c, lv y Date/B : I �1 j� —GC o�d� Q �( 111111 g ,J Plan Review Phone: 503.718.2439 Fax: 503.! �'t• Date,'B : Other Permit. `L f 40 13.. aZs T 1 C A R I3 Inspection Line: 503.639.4175 Date Ready/By: Juris: 13 See Page 2 for Internet: www.tigard-or.gov Al' 9' \4 Notified/Method: 7�G Supplemental Information y4 Tl'PE OF VVOR P PLAN REVIEW y ❑New construction ®Addition/alteraQr Ctl `T)'t Please check all that apply(submit 2 sets of plans w items checked below): 11 ) � �.7 ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: rj where the available fault current ❑Marinas and boatyards. . ``. 'A, 17.11 $ F. .t�, 4 3 ,? `$ 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 ®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 El Emergency system. larger separately derived system. ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.:532048 I Job site address: 12259 SW 69th AVE 1001IP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: PORTLAND,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: I Project name:CAPITAL ONE-BLDG B ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description Qty. I Fee. I Total New residential single-or multi-family dwelling unit. Includes attached garage. i Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK ',.-4 (with above sq.ft.) fi- Limited energy,multi-family 75.00 2 Cubical reconfigure 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: CAPITAL ONE 401 amps to 600 amps 200.34 2 Address: 12259 SW 69TH AVE 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: PORTLAND,OR 97223 Temporary services or feeders installation,alteration,and/or Phone:(503)686-2000 I 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 ' Sy ' y A.Fee for branch circuits with above service or feeder fee, Business name:MCKINSTRY CO each branch circuit 7.42 2 B.Fee for branch circuits without Contact name:MICHAEL ANTONIETTI service or feeder fee,first I 56.18 s6. 2 branch circuit / Address: 16790 NE MASON ST.,SUITE 100 Each add'I branch circuit 'i f` 7.42 ?533,1j 2 City/State/ZIP: PORTLAND,OR 97230 Miscellaneous(service or feeder not included) Each manufactured or modular Phone:(503)331-0234 Fax: :(503)331-6906 dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 E-mail: Pump or irrigation circle 67.84 2 R -. .e #•a-�-; >n 175 A Sign or outline lighting 67.84 2 Business name:MCKINSTRY CO Signal circuit(s)or limited-energy See 7 panel,alteration,or extension. 1 Page 2 2 Address: 16790 NE MASON ST.,SUITE 100 Each additional inspection over allowable in any of the above City/State/ZIP: PORTLAND,OR 97230 Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 66.25/hr Phone:(503)331-0234 Fax:(503)331-6906 i Industrial plant(1 hr min) 78.18/hr a V 5 Inspections for which no fee is 90.00/hr CCB Lic.: 148685 Electrical Lie.: 37-930C Suprv.Lic.-542.859-- s�-cifcall listed '%hr min) Suprv.Electrician signature,required�!�,, , Subtotal: 4(g a Print name: ANDREW L.CRALL ''''°°�� Date: 1/29/14 Plan review(25%of permit fee): State surcharge(12%of permit fee):4 g r Authorized signature: G� f TOTAL PERMIT FEE: �0, Tel Print name: MICHAEL ANTONIETTI Date: 1/29/14 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. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(I1/05/COM/WEB 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 12259 SW 69TH AVE, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal 2014-04-04 00:00:00 ELC2014-00041 PASS - No C of O Violation Summary: Inspector Contractor