Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2004 -00539
DEVELOPMENT SERVICES DATE ISSUED: 8/25/2004
13125 SW Hall Blvd.. Tigard. OR 97223 (503) 639 - 4171
PARCEL: 25101 DA -00102
SITE ADDRESS: 13221 SW 68TH PKWY 460
SUBDIVISION: TRIANGLE CORPORATE PARK ZONING: MUE
BLOCK: LOT : 002 JURISDICTION: TIG
Project Description: 1 200amp serv, 30 branch circuits and low voltage for fire alarm.
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: SIGNAL/PANEL: 1
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 30 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
TIGARD TRIANGLE I LLC GREENWAY ELECTRIC COMPANY
4650 SW MACADAM AVE STE 220 9460 SW TIGARD STE. 104
PORTLAND, OR 97201 TIGARD, OR 97223
Phone: Phone: 503 - 620 - 6020
Reg #: LIC 153421
ELE 34 -617C
FEES SUP 5025S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 8/25/2004 $354.80
[TAX] 8% State Surcharge 8/25/2004 $28.38 Low Voltage Inspection
Elect'l Service
Total $383.18 Rough -in
Elect'l Final
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 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 copies of these rules or dire questions to OUNC at (503)
246 -0699 or 1 -800- 332 -2344.
Issued By: 44,1_, Permit Signature: •
-
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: DATE:
LICENSE NO:
Call 639 -4175 by 7:OOpm for an inspection the next business day
IP PIL . il, -
' Electrical Permit Application RECEIVED )li I c►rhlch: t;S1.:. i.l'
I' AUG 25 2!ii •
R eceiv.
CI of Tigard • Permit No. }
b Date/B : � re / ' - / . p
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
e ,
Phone: 503.639.4171 Fax: 503.598.1960 CITY OF TI c* I'''; Date/B Other Pennit:
Inspection Linc: 503.639.4175 BUILDING p `ti • L I Date Ready/By: ® See Page 2 for
Internet: www.ci.tigard.or.us - Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq.
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
❑ I- and 2 - family dwelling ® Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family 0 Master builder 0 Other:
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: 1032 -23 Job site address: 13221 SW 68th Parkway, Ste. 460 ❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: AuctionPay TI @ Triangle III FEE* SCHEDULE
Description I Qty. I Fee. I Total I ••
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 0.00 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 0.00 1
Limitcd energy, residential 75.00 0.00 2
Tax map /parcel no.: Limitcd energy, non - residential 75.00 0.00 2
DESCRIPTION OF WORK Each manufactured or modular
Tenant Improvement • `1 �� � - -4
welling, service and/or fccdcr 90.90 0.00 2
rvices or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 0.00 2
- 401 amps to 600 amps 160.60 0.00 2
Name: Cadence Design Systems 601 amps to 1,000 amps 240.60 0.00 2
Address: 13221 SW 68th Parkway, Suite 200 Over 1,000 amps or volts 454.65 0.00 2
Reconnect only 66.85 0.00 2
City/State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
Phone: 503 - 968 -5400 I Fax: relocation
200 amps or less 66.85 0.00 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 0.00 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 0.00 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fec, each
Business name: branch circuit 30 6.65 199.50 2
B. Fcc for branch circuits
Contact name: without service or feeder fec,
each branch circuit 46.85 0.00 2
Address: Each add'I branch circuit 6.65 0.00 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax:: ( ) Pump or irrigation circle 53.40 10.00 I 2
Sign or outline lighting 53.40 0.00 2
E -mail: Signal circuit(s) or limitcd-
CONTRACTOR cncrgy panel, alteration, or
extension. Describe: Page 2 2
Business name: Greenway Electric Company 1 _ 75.00
Address: 9460 SW Tigard St., Ste. 104 Each additional inspection over allowable in any of the above
Per inspection 62.50 0.00
City/State /ZIP: Tigard, Oregon 97223 Investigation per hour (I hr min) 62.50 0.00
Phone: (503) 620 -6020 I Fax: t (503) 620 -6124 Industrial plant per hour 73.75 0.00
ELECTRICAL PERMIT FEES*
CCB Lic.: 153421 I Electrical Lic.: 34 -6 C i Suprv. Lic.: 5025S Subtotal $354.80
Suprv. Electrician signature, required: - Plan review (25% of permit fcc)
Print name: James V. Ro• ' e VVV Date: 08/25/2004 State surcharge (8% of permit fec) $28.38
y i TOTAL PERMIT FEE $383.18
Authorized signature: ; �j / This permit applicat expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Mark Short / Date: 08/25/2004 • Fee methodology set by Tri -County Building Industry Service Board
. •• Number of inspections per permit allowed.
i:\ Building \Permits \ELC- PermitApp.doc 12/03 4704615T(10/02/COM/WEB