Permit ' ' :, CITY OF TIGARD ELECTRICAL PERMIT
a `(:OMMUNITY DE VELOPMENT PERMIT #: ELC200700823
.i DATE ISSUED: 12/5/2007
T RO
t( : 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S101DA -00101
SITE ADDRESS: 13190 SW 68TH PKWY 200 ZONING: C -
SUBDIVISION: TRIANGLE CORPORATE PARK LOT : 003 JURISDICTION: TIG
PROJECT: BUSINESS OBJECTS
Project Description: (1) branch circuit for exhaust fan.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
SCHNITZER INVESTMENT CORP BOB'S ACTION ELECTRIC INC
PO BOX 10047 2700 NE BURTON ROAD #A
PORTLAND, OR 97296 VANCOUVER, WA 98662
Phone: Contact #: PRI 360 - 254 -7200
FAX 360 - 254 -8219
FEES
Description Date Amount Reg #: ELE 37 -431C
(ELPRMT] ELC Permit 12/5/2007 $46.85 LIC 53136
(TAX] 8% State Surcharge 12/5/2007 $3.75 SUP 4322S
Total $50.60 REQUIRED ITEMS AND REPORTS
•
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
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 than 180 days. ATTENTION: Oregon law requires you to follow rules adop Oregon Utility Notification Center.
Those rules are set forth • L O &4JJLk_ r 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain opres- of_these rules or direct questions to OUNC at
503.2 6.6699 0 1.800.3. ,
)Permittee Signature: — r � /' 4.. �' W '0 °�' --
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'N: - %, ' " 49 c- 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.
Ir
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received S . " L
Date/By: �� 7 Perm t No.: 7-6,0 8013
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 : Other Permit.
Inspection Line: 503.639.4175 `•I f B Date Ready /By: ® 0 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: G�j- Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition 1=1 Other: EService over 225 amps, comm'l ❑ Hazardous location
OService over 320 amps — rating ❑ Buildng over 10,000 sq. ft,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ 1- and 2 family dwelling ® Commercial/industrial ❑ Accessory building ESystem over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder ❑ Other: 0 Building over three stories ❑ Feeders, 400 amps or more
❑Occupant load over 99 persons ❑llvlanufactured structures or
JOB SITE INFORMATION AND LOCATION ❑ Egress /lighting plan RV park
❑Healt2 -care facility
Job no.:07 -1251 Job site address: 13190 SW 68th Parkway ❑Ot
Y Submit 2 sets of plans with any of the above.
e.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Ace, Project name'r , f N £ en6TE 3. FEE* SCHEDULE
Description Qty. Fee. I Total
Cross street/directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Exhaust fan connection.
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
El PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Business Objects 601 amps to 1 ,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
PO Box 7788 Reconnect only 66.85 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
Address: each branch circuit 1 46.85 46.85 2
Each add'I branch circuit 6.65 I 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: t t �t Each additional inspection over allowable in any of the above
2700 NE Burton Rd. "A" Per inspection 62.50
City /State /ZIP: Vancouver, WA 98662 Investigation per hour (I hr nun) 62.50
Industrial plant per hour 73.75
Phone: ( 360) 254 -7200 Fax: ( 360 ) 254 -8219 ELECTRICAL .PERMIT FEES*
CCB Lic.: 53136 Electrical Lic.: 3 -4 c Suprv. Lic.: 4322S Subtotal 46.85
Suprv. Electrician signature, require Plan review (25% of permit fee)
Print name: Kevin Broselle Date:
12/3/07 State surcharge (8% of permit fee) 3.75
TOTAL PERMIT FEE 50.60
Authorized signature: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
is \Building\Perrrats\ELC.PermitApp doc 12,'03 440 - 46I 5T(10 /02 /COM/WEB