Permit CITY OF TIGARD ELECTRICAL PERMIT
1
... COMMUNITY DEVELOPMENT Permit #: ELC2010 -00505
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/15/2010
Parcel: 2S113AC00103
Jurisdiction: Tigard
Site address: 7236 SW DURHAM RD, STE# 500
Subdivision: PACTRUST BUSINESS CENTER Lot: 0
Project: St. Jude Medical
Project Description: (4) branch circuits.
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
15350 SW SEQUOIA PKWY #300
PORTLAND, OR 97224 4 crt Branch Circuits 09/15/2010 $78.44
wo /Purchase Service or
PHONE: 503- 624 -6300 Feeder
1 ea 12% State Surcharge - 09/15/2010 $9.41
Electrical
Contractor:
IES COMMERCIAL INC
16135 SW 74TH AVE
TIGARD, OR 97224
PHONE: 503 -648 -1900
FAX: 503 - 670 -9572
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. 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 -0100. You may obtain a cop rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By./ Permittee Signature: 'g '
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.
CaII 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.
09/15/2010 08:54 50367095 RECEIVED NEW TECH ELECTRIC PAGE 02/02
Electrical permit Application CEP . 5 ?CIO FO�i OFFIC IC. IFS E' OVA
City of Tigard
Received �� ���� Perm No _
13125 SW 14x11 Blvd., Tigard, OR 9 A'. OF TIGARD Plan Review �� , •
111 a .' Phone: 503.639.4171 F ax 503.5; ' 't VISION . Dateay. Other Perron!
:,r1 G �1 li p �
ins etiOn Line: 503.639.4175 a ' ING DI 17nte Ready/By: 1uri El See Page 2 for
Internet: www.tigard- or.gov Notified/Method! 7 Z 6 Supplemental InformRbion
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❑ New construction G Addition/alteration /replacement Please ch all that apply (submit 2 sets of plans w /items checked below):
CI Service or feeder 400 amps or more ❑ Building over three stories.
['Demolition ❑ Other: where rho available fault current ❑ Marinas and boatyards.
h igr J � ;, a , r;! - , y . { . ^. ,till J4r '+r� :i �ry " 1 , n o c E n
. .., } r 1 . .,G 1 C 7 ;, ,.l �tM ai ,� r ' . exceeds 10.000 amps at 150 volt, or ❑ floating buildings.
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, :`?:;a.d,.' .,: _'.le liS•'. .:6!'.. ..,1r,:.3!N. i, I�r n1:1 x , . u r .a� d ti les to ground, or exceeds 14,000 Q Commereiat.use agricultural
❑ 1- and 2- family dwelling ! ommerciallindustrial ❑ Accessory building amps for all other installations. bwildinp
❑ Muitt family ❑ Master builder ❑ Other: 0 Fire pump. ❑ installation of 75 KVA or
' 11 r 9 �"('1' (� +a P,/`l ' r '+, - - 1 +" ! J.?;, 'vi , r 1 � a - , . d Y' ,, .7:! , l; ,t , �,� ,F, 7. %, ❑ Emergency system: Carper separately derived system.
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. lei t i �' , 7 r } .1i roil ) ..n r r " F i, te r :1 ar &nf i, ! r, 9l r M . .�. i l � 1 ls. ^ i.Si -ii 7::Ir ,..,.t', u 1.:(04 ilk i/,e;;,,: ❑ Addition of now motor toad of 0 "A' "E"."1.2"."1-3".
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fob no.: ' 03 Job site address: - a3 I , 5 :6 . R . lovr>P or more. occupancy. Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: 'TT #. d. c;• ,e. ""742--# 5 . 4-- 0 0 ❑ Healthcare facilities. ❑ Supply voltage for more than
❑ tisrardous locations. 600 volts. nominal.
Suite/bldg. /apt no.: Project name: s7. > O service or feeder 600 amps or m ore
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Cross street/directions to job site: rick. Description ot, • Fre Total -
Ncw residential single- or multi- family dwelling unit. ,
Includes attached garage.
Su • )r j � � - yam.* L n o.: 1,000 $l . ft. O less 168 .54 _ 4
a Ea. add'I 500 sq. R or portion 33.92 _ 1
Tax map/parcel no.: a s 4 r r � i '.: l �� r t r nr Limited energy, residential 67.$4 2
V ,' i:':: , i� 7 .P1 f ry t 1 14 i�7 � ii E M r Y S ' � ♦ 1 '1 n 9 r F NS, "i ; 7 9 ' 1 I 'ply r,i , : 49?. F�i�i r I r : , i + „ � � i I. /With above 9Q. ft.) e.„ :I.A...1 l ;12; r4g..,!t ��A ia.I , n. Y :t to f7thfil :aini- Ittral"zKle'._i,�] �.S- •
Limited energy, multi- family
67.84 2
residential (with above so. R.) .
Services or feeders instillation, alteration, and /or relocation
P Ni �r - ~ a r ew tw rr r1a M u x zl t , t t 2P v1 �, K 1 xs w x nt-r ^� R rit „ 200 amps or less _ 100.70 , 2
fr°�ii irJrC'i;,l" lil�lihd th ,Vei� t/ t,' i,.T. ,�Lh 1 �1(7' r r 1 .YIlr 1 1a11t,�7-'1:' fir 4� 1 `4'7 7 Ir , ai ,rf S !i,4 (1t 20 am ps to 400 amps 133.56 2
.4enr Emb•l.: r, T[t3+r:rs.sir.,..vr, ray rr.., t ,, .,- .c„r,h•iti.•..,l:,u „ }.. e,,a,,.nAi7:il, i•, .,fish,?, ....•`.�ra.•c •r. -
Name: 401 amps to 600 amps 20034 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 1 ) 2
City/State/Z1P: Tcmpor my services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 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 turps to 599 amps 168.54 2
OWnct signature: Date:
'Br'anchcircuiti- new, alteration, or extension, per panel
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t n a. i a :475 err e • vr- ^rv r. .. , -r vr: A. Fee for branch circuits with
#Y Ns ,,, F S.� i - I 1d iw{ T t, a+• t 1. '� nj r r ����.'i�", 5 _
t t o errlr, ;fey1* 7i• ,s �t. '' 11 - ,fi r _ •i Fe service with 1.:s:: 9446...1. � n ..,n1v:. t'eie1,14, ....61..41, . r_, r :}:5,....,14: WiC /v:11 ,1'-� .err- .t...�r`c".., ... .. r yl+,Aek ! each branch circuit 7.42 o 2
Business name:
B.F.= for branch circuits
Contact name: without service or feeder fee,
first branch circuit 56.18 As 2
Address: Each add'l branch circuit 7 , JP 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 67.84 2
E -mail: Pump or irrigation circle 67.84 2
, t o4ylr{ �f�.�' {I' '' gr ¢)f s•" -rf r AA t t ,Tnr"'�, t ry T rc - 7 , : r'iF 7f , .' T� ' l , , li r ,., Ig:,y Si or outline ll tin 67.84 2
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Business name: IES COMMERCIAL Signal circuit(s) r limited-
energy panel, alteeration, or
Address: 16135 SW 74111 AVE extension. Describe: Page 2 2
City /Statc/ZIP: TIGARD, OR 97224 Each additional inspection over allowable in any of the above
Per Phone: (503) 648 -1900 (ax: (503) 670 -9572 Investigation 66.25
on per hour (1 hr min) 66.25
CCB Lie.: te 2245 7. Electrical tic.: C448 Suprv. Lic.: 53yr5 industrial plant per hour 78.18
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l,.c;;}at' a�a i�+'•0• :-• va 2.c�.r,trii:Ji'wk"..5 f'r
Su Electrician signature, required: ;-,- _,. - ,. Subtotal; o
x 4, 'I- Date: Plum review (25% of permit fee): , �.
State surcharge (12% of permit fee): 7 'f/
Authorized signature: TOTAL PERMIT FEE: . - . r 8S
Print name: Date' This pe application expires if a permit is not obtained within 180
days After it has tarn steepled eta complete.
' Number of inspections allowed per permit,
r;\ Sulldlrteennitel5T .C- PdnhitApp.doe 10/01/09 44O-4 °15T( /COM/WE+B