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Permit CITY OF TIGARD ELECTRICAL PERMIT "'� COMMUNITY DEVELOPMENT Permit #: ELC2011 -00084 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2011 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST 400 Project: Everest Institute Subdivision: Lot: 0 Project Description: Electrical for TI. Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: PLAZA WEST LLC 1709 SE 3RD AVE BY NORRIS BEGGS & SIMPSON PORTLAND, OR 97124 121 SW MORRISON ST STE 200 PORTLAND, OR 97204 PHONE: 503 - 234 -9900 PHONE: FAX: 503 - 535 -2763 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 02/08/2011 $100.70 Specifics: amps or less 6 crt Branch Circuits w /Purchase 02/08/2011 $44.52 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 02/08/2011 $17.43 Electrical Type of Const: Occupancy Grp: Total $162.65 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are `et forth in OAR 952- 001 -0010 through OAR • 2- 001 -0090. You may • • . • - • • •f the rul - •r • uestions to OUNC by calling 50 1987 or 1.800.332.2344. Issued By: _ Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC' Date: LICENSE NO. call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application ..„ Orel( 1: i sr: O\l_1 City of Tigard �� Recei IN teJB ved 170/111M11, Permit N. .. L f t Da = 'e 13125 SW Hall Blvd., Tigard, OR 9 Q.) Plan Review Phone: 503,718.2439 Fax: 503.59 1 Q Other Permit: i 4 .1 i L — . •' Ia action Line: 503.639.4175 f� r , D ate Inv B ' A TIGARD 1 ' od/Me •. S ee Page 2 for Internet: www.tigard-or.gov ``� Alb /`— Supplemental Information ,yam C. * 15 t�s +l : 4 2 .:i�;n �, xa��. n,. 7 ?� # }{. a h ? * 1E e ,y� w tiN �. <! � 3.t /1;;- 4 S, : a$ CI New construction ® Addition/alteration/t�(V. , - , Please check all that apply (submit 2 sets dotal:" w /items checked below): ❑ Demolition ❑ Other ' „ % ❑ Service or feeder 400 amps or mom ❑ Building over three stories. v k where the available fault =rent 1:3 Marinas and boatyards. "{ R ? P # 1 � ,, , t t 7 ,� , exc 10,000 amps at 150 volts or ❑ Floating buildings. .r., '' " `� '" it : to g round, or exceeds 14,000 ❑ commmial -use agricultural ❑ 1- and 2- family dwelling ,e Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump, ❑ Installation of 75 KVA or +' Q © r , IO CI nmageney system, larger separately derived system. JO . s0 * ,, .:. <,,, ❑ Addition of new motor load of ❑ "A", "V. "1 -2" "1 -3" Job no.: 78866 Job site address: 9600 SW OAK 1°°x1' or more. occupancy. y ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State/ZIP: TIGARD OR ❑ Health -care facilities, 0 Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Lido Project name: EVEREST) GE x4 5�i>^ ❑ Service or feeder 600 amps or more FEE StC11EI$Jli E Cross street/directions to job site: n )' Qtr. 1 F. ` 1 Toter I « ;, New residential single- or multi- family dwelling unit. Includes 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 r 5 Es y }� 'nom ,; e 5:t r: 75.00 2 Limited energy, multi - family 75.00 2 PHARMACY TECH ROOM REMODEL residential (with above sq. II.) Services or feeders Installation, alteration, and/or relocation 200 amps or less I 100.70 100.70 2 El PROPERTY OWNER 173 TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: _ 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/ State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that 1 own which is not 401 amps to 599 amps 168.54 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new, alteration, or extension, per panel Owner signature: ,„,,, A. Fee for branch circuits with M, k) > ,, ; " zR ^ : ` o 1 z 4� above service or feeder fee, 6 44.52 . ; f r . _ ' > _ 2 ���,11511 • * 3 Iii * ,,s - , each branch circuit 7.42 2 Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'1 branch circuit 7.42 2 Address: - -............__ Miscellaneous (service or feeder not included) Each manufactured or modular City/ State/ZIP: dwelling, service and/or feeder 67.84 2 Reconnect only 67.84 2 Phone: ( ) Fax:: ( ) y Pump or irrigation circle 67.84 2 Email r 67.84 Sign or outline lighting 2 ,. „ Y .: =- . �S ����R * >...: i ... .. . Signal circuits) or limited-energy Business name: OREGON ELECTRIC GROUP panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: 1709 SE 3" AVE Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr nun) 66.25/ hr City/ State/ZIP: PORTLAND OR 97214 ' Industrial plant (I hr min) 78.18/ hr Phone: (503) 234 - 9900 Fax: (503) 535 - 2763 Inspections for which no fee is 90.00/ hr -- si tica x cill l Y: � hr m CCB Lie.: 203 Electrical Lic.: 26 -95C Suprv. Lic.: 4549S Suprv. Electrician signature, require a r: r! 9 ` C ; ' Snbt 145.22 J e.� Plan review (25% of permit fee): Print name: RICHARD MCELLIOTT p Date: 2-7-2011 State surcharge (12% of permit fee): 17.43 rt. 't► b 4. - i. h * , TOTAL PERM I FEE: 162.65 Authorized signature: � 1` `v'` This permit application expires if a permit it is not obtained within 180 days after It has been accepted as complete. Print name: RICHARD MCELLIOTT Date: 2 -7 -2011 * Number of inspections allowed per permit. I: \Bonding\Permita \ELC- PernutApp.doc 07/01/10 440-46t5T(11ro5/COWWEB