Permit CITY OF TIGARD
ELECTRICAL PERMIT
= •; � COMMUNITY DEVELOPMENT Permit #: ELC2009 -00113
�...
��.. Date Issued: 03/06/2009
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S112DC00100
Jurisdiction: Tigard
Site address: 15705 SW 72ND AVE
Subdivision: OREGON BUSINESS PARK III Lot: 2
Project: Nike Golf
Project Description: Add (1) 100 amp feeder and (2) branch circuits. Job No. 290309
Owner: FEES
PACIFIC REALTY ASSOCIATES Quantity Description Date Amount
ATTN: N PIVEN, 15350 SW SEQUOIA PKWY
#300 1 ea Services or Feeders - 200 03/06/2009 $80.30
amps or less
PHONE: 2 crt Branch Circuits w /Purchase 03/06/2009 $13.30
Service or Feeder
1 ea 12% State Surcharge - 03/06/2009 $11.23
Contractor: Electrical
CAPITOL ELECTRIC CO INC
11401 NE MARX STREET
PORTLAND, OR 97220
PHONE: 503 - 255 -9488
FAX: 503- 257 -7121
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $104.83
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 -001 rough OA' 952 -101 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling . 6.6699 or 1.800.332.2344.
I '
Issued B • L • Permittee 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' • , ! d••• 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.
I FOR 014 ICI. U SE °
Electrical Permit Application RECENED
Received /
City of Tigard Date/B a" y: 3 09 Permit no.: e.LLo�00?- ce l
I ll 111 13125 SW Hail Blvd., Tigard, OR 97223 MAR 0.3 2009 Plan Review
to Phone: 503.639.4171 Fax: 503.598.1960 Date Other Permit:
T l G A R D Inspection Line: 503.639 ��/ 0G '('( eRn Date Ready/By: Juris: • See Page 2 for
Internet: www.tigard- or.gov �1 1 it Notified/Method:
DIVISION
Supplementallntonnation
BUILDING DIVISI ON
b New construction U Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
: •.: Marinas and boatyards
available fault current
where the a actable u t
b
❑ 1 and 2 family dwelling Er Commercial/industrial Ll Accessory building exceeds 10,000 amps at 150 volts or Floating buildings
❑ Multi - family ❑ Master Builder ❑ Other less to ground, or exceeds 14,000 Commercial -use agricultural
II other installations.
amps for a t ❑ buildings
Job no.: 290309 Job site address: 15705 SW 72nd Ave 0 Fire Pump ❑ Installation of 75 KVA or
❑ Emergency system larger separately derived system.
City /State /ZIP: Tigard, Or. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "1 - 3",
100HP or more. ❑ occupancy
Project name: Nike Golf ITR Equipment ❑ Six or more residential units ❑ Recreational vehicle parks.
❑ Health -care facilities ❑ Supply voltage for more than
Cross Strcct/Directio:.s to job site: ❑ Hazardous locations ❑ 600 volts nominal.
❑ Service or feeder 600 amps or more
..................... ...............................
Subdivision: Lot no.: ;•:: ::;;• :: :: :_ :._ .; ::._•::: •:: • >:•::•:::•:
Description 1 Qty. J Fee. l Total
Tax map /parcel no.: New residential - single or multi- family dwelling unit.
::.> :.:;:;;:;;::;
.::.::.:::: r:•: r
: ::: ::: ::: :: ::: :::•:::; :;•::•: • :�5-.��•�. ��.��
:• :: ' �# �'' �ii::: :::::::::<::::<:::? E::: :: is :::i::::i :::::::::: Includes attached garage.
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Added 100A Feeder & Two Branch Circuits 1000 sq. ft. or less $ 145.15 4
Ea. Add'1500 sq. ft or portion $ 33.40 1
........ ::a:` . -::• :: • •'•>:: >E : >: ::;:: >:: :;: :;::::::::::::::::::: ;;:: : »: ;;: ; :: -• :':::: :::>:::;::;:: : ::: :::::::: ::<`:? : : ::1:::::::::::: :: Limited energy residential
Name: (with above sq. ft.) $ 75.00 2
Limited energy, multi - family
Address: residential (with above sq. ft.) $ 75.00 _ 2
Service or feeders installation, alteration, and /or relocation
200 amps or less 1 $ 80.30 80.30 2
City /State /ZIP:
201 amps to 400 amps $ 106.85 2
Phone: Fax: 401 amps to 600 amps $ 160.60 2
601 amps to 1000 amps $ 240.60 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts $ 454.65 _ 2
intended for sale, lease, rent or exchange, according to ORS 447, 449, 670, and 701 Temporary services or feeders installation, alteration, and /or
Owner signature: Date: relocation
200 amps or less $ 66.85 1
::•> :.... :• :• :::::•::•: :: : ::- :- • >: •: •::•::• :•<:: >;;::: :: :;:;;• J ::::; :. ' • : '•- • :::i: ::: : >: ::: ::::::::. 2
............ ......... <:::::::: �.:: :.::��t.1;:P.S4.:.:::.::• 201 amps to 400 amps $ 100.30
401 amps to 600 amps f $ 133.75 1 2
Business Name: Capitol Electric
Branch circuits - new, alteration, or extension, per panel
Contact name: Jim Eddington
A. Fee for branch circuits with
service or feeder fee, each
branch circuit 2 $ 6.65 13.30 2
Address: 11401 NE Marx
B. Fee for branch circuits
City /State /ZIP: Portlane, Or. 97220 without service or feeder fee,
first branch circuit $ 46.85 2
Phone: 971 - 5063388 Fax: 503 - 257 -7121 Each additional branch circuit: $ 6.65 2
Miscellaneous (service or feeder not included)
E - mail: . ir?tC , at� dn^ Each manufactured or modular
dwelling, service and or feeder
90.90 2
::::: �'' 0.` �1..$ �i�. fG: ��I�:%: isE? E; E: �: �: :: :: :: :: :E'• SE; E: E: EE:: E: � ::::� :::��t:::;:::::: ?:::::c t'„
Business Name: CAPITOL ELECTRIC CO., INC. Reconnect only $ 66.85 2
Pump or irrigation circle $ 53.40 2
Contact name: Jim Eddington Sign or outline lighting $ 53.40 2
Signal circuit(s) or limited -
Address: 11401 NE MARX ST. energy panel, alterations, or
extension. Describe: Page 2 2
City /State /ZIP: PORTLAND, OR 97220 -1041 -
Each additional inspection over allowable in any of the above
Phone: 503 - 255 -9488 Fax: 503 - 257 -7121 Per inspection $ 62.50
Investigation per hour (1 hr min) $ 62.50
CCB Lic.: 48748 Electrical Lic.: 26-496C Suprv. Lic.: 3132 -S industrial planfrr hour $ 73.75
Mi: t;;#' st: �? �.'•#':#ttaR:::: s:::::::>::»::»::>::>::>:<: s::>: z<:>::>::::>:: r;:>::»::>::>::>::»:;:>:;:::: :::: >::<::::::: >:::::::: >::::::
Suprv. Electrician signature, required:
Subtotal $ 93.60
Print Name: DAR LL MCNEEL Date: 03/02/09 Plan review (25% of permit fee)
Authorized signatu State surcharge ( 12% of permit fee) $ 11.23
�� � AK TOTAL PERMIT FEE $ 104.83
Print Name: — DA g MCN EL This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
r Number of inspections per pemlit allowed.