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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2013 00470 T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2013 Parcel: 2S115AB01900 Jurisdiction: Tigard Site address: 16200 SW PACIFIC HWY D Project: Rite Aid Subdivision: 1994-028 PARTITION PLAT Lot: 2 Project Description: Electrical for TI. Contractor: ADVANCED ELECTRIC INC Owner: SN PROPERTIES PARTNERSHIP 21811 NE 58TH ST 1121 SW SALMON ST VANCOUVER,WA 98682 PORTLAND,OR 97205 PHONE: 360-254-6864 PHONE: FAX: 360-254-2854 FEES Quantity Description Date Amount 14 crt Branch Circuits wo/Purchase 08/07/2013 $152.64 Specifics: Service or Feeder 1 ea 12%State Surcharge- 08/07/2013 $18.32 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $170.96 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 m- •• a copy=es or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /�i_�� Permittee Signature: r "`T 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. RUG-07-201301EO) 10: 43 Advanced Electric (FAX)360 2542854 P. 001/002•Electrical Permit Application ��® FOR OFFICE USE ONLY.' •,- lteecrvrd �//1 1 City off T arftl �''� D / j Permit Nn: �.,.• ]3]2,5 SW Hall Rlvd„Tigard,U �� o Date/lay. ,air", Y ix.941 1 1_cry t 7Q '' ' ' Phone: 503.718.2439 Fax: 54411!"', _ PlnJ yL `\cc"_ �ryy c)Iherpermit: 7l GARD Inspection Line: 503.639.4175 Vv 4\Q c\Q Date kcaay/uy: : ® See Paec 2 for Interact: www.tigard-or.gov V `�� Notified/Method: x""""�y • ` „_,_ (y Supplemental information . rn,”'. tr.,.v-�,-4. h,`r-4"�f."Gl'P ji{ ORK ,s o r...' r: .. ? ��;. .7(: - r ,. ❑New construction t`•'t Addition/alteration/ • , eat Please cheek all that apply(submit a sets of plans w/itetns cheered below): 0 Demolition 0 Other ❑Service or feeder 400 amps or more ❑Building over three stories. st.' l,Y.° r'' iii _ where Ore available!nail current ©Marian and boatyards. 1; 4fi ,11�; W";t.. C it T eke QI N ';:' occeeds 10,000 amps at 150 volts or ❑Floating buildings. ' �'-'�1if_ , _-.,-,. � �Se+�'??hti`er�,�t�S,�n,;r.,:c.� less m and,or maceds 14,000 agricultural ❑1-and 2-family dwelling ''Comnlercial/industrial ❑Accessory building amps foor lotherinsrallations. mat„ isl.,re n ❑Multi-family 0 Master builder ❑Other. ❑Fire pump. 0Installation of 75 KVA or larger yc dl(?H�wk�f4.�# �O �r ;I a (� TW tl i d Lr ! system larger Separately derived system. __. nL r . ❑Addition of new motor load of "A" "E" "1.2',"1-3". Job no.: Job site address: d it All •, imi1, 100HP or stare. occupancy. Q Six or mare residential units. ❑Recreational vehicle parks. City/State/7,IP: \_X■• l `�l*■ O ❑1•lealtb-care facilities. 0 Supply voltage for morn than Hazardous locations. 600 volts nominal. Suite/bldg./lopt.no.: 1 PrOjectname: � `r. ❑Scniccor fonder 600ampsormore. =' 1 f 4,1:1tiR ,3 a rki srt r v. l'l rf Cross slrecUdirectians to job site: nawwba QIr. ire. Taint • New residential single-or mulll-family dwelling unit Includes attached garage. Subdivision: �__. l Lot no.: 1,000 sq.R or less 168.54 ' 4 Tax map/parccl no Ea add'!500 sq.R or portion 33.92 1 �i -- s. _ mated enerjay,re �'1+`*,_-e; — t:a1•?:;�T I rli 1 r ." ' iid..n .+l s j!?. Al ee t 4 x` „,,„:r, _ t(with above sq,Ile)residential 75.00 2 - Limiied -..-T.• energy,multi-family 75.00 2 L..+ Lt I. dy• A . PA `C _ f / C... W\ ( residential(with above sq.R) � 4 A '� Services or feeders lnatAllAlionialtentlnn,and/or relocation ' .tii• " '` . L p (r 200 amps or less 1 00.70 2 ,11 t 1 0`, �';"a _>` + Y! Zi,Fi: i, Cl/Gt-pa1� ll F"r' a+p, 201.np sto400am s 13356 2 ...g.: ,.h ,eral Name: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301,04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/LIP: Temporary services or feeders installation,altera don,and/or relocation Phone:( ) Fax:( ) 200 amps or less 5936 1 Owner installation:'1'his installation is being made on property that I own which is not 201 maps to400 amps 125,08 2 intended for sale,lease,rent,or exchange,according to ORS 447.449,670,and 701. 401 amps to 599 amps _ 16834 2 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A-Fee for branch circuits with 1. i'r Ll i'r1t i L f1e ]7`r - ;�,l i I•'.'1 �,a 41.3 13 P71ge;l l=+i"zs' above service or feeder fee, 7.a +�_.7 ..�:. ..,.ax-.u.,r._�..►-r�+,.,a .1; : each br�ch circuit 2 2 Business name: 13.Fee far branch Circuits without I N service or feeder fee,first r Contact name: branch circuit 56.18 ' 2 °- Each add'l branch circuit `3 1 7.42 ' 2 Address: T4lseellaneona(ee-tice or feeder nut included) City/Statc/ZlP: Each manufactured or modular 67.aa 2 dwelliae,service and/or feeder Phone:( ) Fax::( ) " Reconnect only 67.84 2 — — E-mail - Pump or irrigation circle 67.84 2 lYTl Sig or outlino lighting 17.84 it ) t c/ ":iki tk; . �l0R .:r�'.^ _i t Y * signal Clrelllt$)or IIn1ICd-CRC[iy ? Business mime: ' ,^rc kj a � , nel, or extension, Pale 2. 2 `�"4 "-"te ' ' t c$Clk•- , F Ch additional inspection over allowable to any of the above Address: l�[ Additional inspection(1 hr min) 66,25/hr City/State/ZIP: V U.K)Co� Y A)(......1 `1(s�b�) `Industrialpm(lhrmnia) 66.25/hr Y 1 �-�' Industrial plant(1 hr min) 78.18/hr Phone:( 2a1-t- 1 Fax ( ) •spections for which no fee is CCa i iC.: (� fir. s.eelfun l listed '/s hr min 90.00/hr ,1CCtrlcal I,tC.. ; � -uprv.1.1 C.: *S 1 r _i •tg,t„a pm- 'Ell v n r •'-1.--,v r,...5 1' Suprv.Electrician signature,required. , :- 7. .�, Subtotal: � 2,(d4 Plan review(25%of permit fee): Print name Date: State surcharge(12%of permit fee): J S , 32 TOTAL PERMIT riot Authorized signature: ° Ibis permit application cspfrcS if a permit is not o atned wilnda Alt Print name: Date: days after it has been accepted as complete. a • Number of inspections allowed per permit. I:11 i ill ldl,,e\Pninits\LLC•TermitApp.dnc 07/111110 445.4015TO1/05/COM/WLL