Permit r a CITY OF TIGARD ELECTRICAL PERMIT
11111 ' COMMUNITY DEVELOPMENT Permit#: ELC2014-00577
TI{+A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/06/2014
Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10220 SW NIMBUS AVE K1
Project: Scholls Business Park Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 2
Project Description: Modifying(2)circuits.
Contractor: CROWN VOLTAGE Owner: HANSON, RONALD D
609 SW EATON BLVD ROBINSON, CONSTANCE A
BATTLE GROUND,WA 98604 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK,WA 99331
PHONE: 360-666-0995 PHONE:
FAX: 360-666-4673
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 10/06/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/06/2014 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.c
Issued By: Permittee Signature: :may
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 ApplicatiMECEIVEP FOR OFFICE USE ONLY
City of Tigard Received
: ♦ Permit No
7 13125 SW Hall Blvd.,Tigard,OR 972 s 2014 Plan Review �f,' 1.77-.44., r 7 II Phone: 503.718.2439 Fax: 503.598. Date/B : Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: 0 See Page 2 for
Internet: www.tigard-or.gov CITY OF"1 IGARD Notified/Method: Supplemental Information
TYPE cilli[OEiNG DIVISION PLAN REVIEW
❑New construction J Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑ Demolition ID Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
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 I50 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","I-3",
Job no.: Job site address: 10220 sW NIMBUS AVE IOOHP or more. occupancy.
❑Sir 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.: 14 ( Project name:R15890 56hillj T 0 Service or feeder 600 amps or more.
f FEE SCHEDULE
Cross street/directions to job site: 01' 19 DescriPtypn _Rt7.j Fee. 1 Total 1
I' , New residential single-or multi-family dwelling unit.
S( W I S' , 0 I� Includes attached garage.
Subdivision: r Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add•l 500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
75.00
mod 2 circuits residential(with above sq 0 1
---1 Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER 0 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 551.16 2 •
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone: relocation ___
( ) Fax:( ) _____T______,
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 I25.08 3
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:Daniel Tucker service or feeder fee,first 1 56.18 2
branch circuit
Address: Each add'I branch circuit 1 7.42 I 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Each manufactured or modular
Phone:(360)9360764 Fax: :( ) dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Crown Voltage, Inc. Signal circuits)or limited-energy See
i --- panel,alteration,or extension. Page 2 2
Address: 1403 SE Columbia Ridge Drive Each additional inspection over allowable in any of the above
T
Additional inspection(I hr mm) b6.25/hr
City/State/ll}':Vancouver WA 98664 _ _ _ � Investigation(I hr min) + 66.25/hr
Phone:(360)6660995 Fax:(360)6664673 Industrial plant(I hr min) `—� 78.18e hr
Inspections for which no fee is
CCB Lic.: 153934 Electrical Lie.: 37-984C Suprv.Lic. 5777S (p /-^'J I jo I pecitically listed(% 90.00/hr
hr min) _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal: �-- (p0
Print name: Daniel Tucker Date: Plan review(25%of permit fee):
— State surcharge(12%of permit fee): J,(�" —
Authorized signature: TOTAL.PERMIT FEE: ' I ,Z
•
This permit application expires if a permit is not obtained within 0
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit
I,BuildingiPermits\Elk Permit App ItI.R ERE:doe Rev 05/21/2013 440-4615T(I lr0s'('OM:W I/B
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