Permit CITY OF TIGARD ELECTRICAL PERMIT
, ° : COMMUNITY DEVELOPMENT Permit #: ELC2010 -00244
Date Issued: 05/20/2010
T I GARL) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112AC01500
Jurisdiction: Tigard
Site address: 7319 SW KABLE LN 500
Subdivision: Lot: 0
Project: McLane Food Service
Project Description: (4) branch circuits for server room.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 4 crt Branch Circuits 05/20/2010 $78.44
wo /Purchase Service or
PHONE: 503- 624 -6300 Feeder
1 ea 12% State Surcharge - 05/20/2010 $9.41
Electrical
Contractor:
MR ELECTRIC OF CLARK COUNTY
14300 NE 20TH AVE. D102 -313
VANCOUVER, WA 98686
PHONE: 360- 574 -7200
FAX: 360- 546 -2158
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $87.85
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. ATT ON: Oreg law requires you to follow the rules adopted by the Oregon Utility Notification enter. Those rules are set forth in OAR
952 -001 -0 0 through OAR 952- % •0. Y•u may obtain a copy of the rules or direct questions to OUNC • • • .246.6699 or 1.800.332.2344. ,.
• I / � ,/�
Issued 1i� �� i Permittee Signa • • • -'� /
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:
CONTRACTORYNSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
May. 18. 2010 11:27PU ! No 3715 P. 1
Electrical Permit Applica ' I ' " ' .a, . , ' i ' ��« T �t }r`�tt; " r � , t� F � F '
i t
MAY Q r ti 1(I O FrlcE USL col l '.
i` 57 MQI 1 O 2010 Received
;t _ sd 0 ,,, ktNS k,"Atw,4•It. G ' ",,n t�li, .. it 'r 1t1
r City o Tigard an Received
2' ttl trri • " `y g Date/13 : S ! . O ' permit No.: i/.,G�j /Or a 4
�� hw 4 1-fall Blvd., Tigard, 012 9
13125 SW S Review i, Phone: 503.639,4171 Fax, 503 ,5 our TIGA�D Plan RevieDate/13 : Other Permit:
''r' , ' ,!.0 Inspection Line: 503.639.4175 BUILDING DIVISION Date Read /H r °
I!It AllLl Ready /By: y * g( SeePape2Por
escaru¢i,arr. Internet: www.tigard•or.gov Notified/Method: /�(� Supplemental Information
TYPE OF WORK • PLAN REVIEW
❑ New construction \ . 4ddition/alteration/replaccment Please check all ghat apply (submit 2 sets of plans w /ilems checked below):
❑ Service or feeder 900 amps or more (a Building over three stories.
❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards,
CATEGORY OF CONSTRUCTION exceeds 10,000 amp at 150 volts or ❑ Floating buildings.
less to ground. or exceeds 14,000 ❑ Commercial use agricultural
❑ 1- and 2- family dwelling mmercial/industrial ❑ Accessory building amps for all other installation, buildings.
❑ Multi - family [] Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived s
❑ Addition of new motor load of ❑ "A ", "E" "1.2" "1 -3•
Job no,: Job site address: 13 Lci o 2' e. to 10011P or more, occupanoy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: /f 1ciG�Yd c ryz. 7 -2.•.,u ❑ HealIh.care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: ` Project name: (-AL bu ❑ Service or feeder 600 amps or more.
F'EE , SCHEDULE
Cross street/directions to job site: 7 LP`H^ Ao�.. be,crtprton 1 Qty. I Fee. 1 Total ..f
NOV residential single- or multi -family dwelling unit.
• Includea attached garage.
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
DESCRIPTION OF WORK (with above sq. ft.) 67.84 2
�((� Limited energy, multi - family 67.89 2
! f (t v' c.0 1 5.e_C J ex ()2.5nt,v, residential (with above sq. R.)
Services or feeders Installation, alteration, and /or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT • 201 amps to 400 amps 133.56 2
w 401 amps to 600 amps 200.34 2
Name: (� P� -,) Q..- (br) NI o -
t ' ` 601 amps to 1,000 amp 301.04 2
Address: •73 Lei S t,,0 • 1,e_c.L1' L Over 1,000 amps or volts
552.26 2
�
y� � � z �� Temporary services or feeders installation, alteration, and /o
City /State /ZIP :1' Kicky- I` relocation
Phone: ( ) ( - 3'7 1 -2 Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is bcing made on property that I own which is not 201 amps to 900 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
]llraneh circuits - new, alteration, or extension, per
Owner signature: Date: A. Fee for branch circuits with
--V.—APPLICANT 1 CONTACT PERSON above service or feeder fee,
each branch circuit 7.42 2
B. Fee for branch circuits without
Business name:
{`(1 c 1 rtt t) :_ Cif =.,r e._ (ot) n.,11.#_ N— service or feeder fee, first i 56.18 ' 6 2
Contact name; (�(1 l( . branch circuit
l ,? Each add'l branch circuit 3 7.42 12.70 2
Address: t 1 l - 4 OOD Oe o Poo -D` p2 * N Miscellaneous (service or feeder not Included)
l v1 Each manufactured or nodular
City/State /ZIP: Van/ (n) ti c"- bon. 9 M dwelling, service and/or feeder 67.84 2
Phone: '(
_._.c 714 -7 ZCTO Fax' :(3(o0) S.-ly °2I 58 Reconnect only 67.84 2
E -mail: ill c �t Q.C. IQ ( Pump or irrigation circle 67.84 2
(VW Q�1 D_c ,\'y L C L • ( Sign or outline lighting . 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: '�( I _ (j CI�� C n panel, alteration,
dds io n. i extension. Page 2 2
r ' 'l � k
/ . Each additi nspeelion over allowable In any of the abov
Address: 1 �t36-0 id e. zyki,.„ f�q._ --At„,7_ )).z, Additional inspection (1 hr min) 66.25/ hr
City /State /ZIP: V � q c 1� (/e (i� Investigation (1 hr min) 66.25 / hr
C7 �'rJ Industrial plant (1 hr min) 78.18/ hr
6 \ t
Phone: ( )s7 .. Pax:( (�) s 6.t? Inspections for Which no fee is
Q 1 rf specifically listed (4 hr min)
90,00/ hr
CCB Lie.: I (I10 , /'"I El ectr i cal ll . � � f,l1 L _ I , Suprv. Lic.: y$$ 5 ELECTRICAL PERMIT FEES
Subtotal -- HN
Suprv. Electrician signature, required: — Plan review (25% of permit fee):
Print names .( . a f Date: 3.11 /( 0 Slate surcharge (12% of permit fee):
r ( TOTAL PERMIT PPE: 7 . g',-
Authorized signature; . .. This permit appnca tlon expires if a permit 1s not obtained within 110
..11.•-• ..11.•-• days after it has been accepted as complete.
Print Hartle: (llv v? C Date:) ((9 • Number of inspections allowed per permit.
I: IBuitding\Permus \eLC- PUmitA5p. 10/01/09 990- 4610T(11PoS /COMIWEB