Permit CITY OF TIGARD ELECTRICAL PERMIT
8 . COMMUNITY DEVELOPMENT Permit #: ELC2011 -00134
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/1512011
Parcel: 2S112DC00701
Jurisdiction: Tigard
Site address: 15951 SW 72ND AVE
Project: Miller Paint Subdivision: OREGON BUSINESS PARK III Lot: 38
Project Description: (2) branch circuits for display lighting
Contractor: BECK ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES
15600 SE FOR MOR CT #B 15350 SW SEQUOIA PKWY #300
CLACKAMAS, OR 97015 PORTLAND, OR 97224
PHONE: 503-656-7396 PHONE: 503 - 624 -6300
FAX: 503 - 656 -4397
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 03/15/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 03/15/2011 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 • • R 952- 001 -0090. You may obtain a copy of the t questions to OUNC by calling 503.232.1987 or 1.800.332.2344. t .
io r / A
Issued By Permittee Signature: • — �/
i
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.
Mar 14 11 10:33a Beck Electric (503) 656 4397 p.2
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Datoe : PermitNo.: E j.-.e.,_?-oll - �) `1
13125 SW Hall Blvd., Tigard, OR 97223 R 15 2011 Plan Review
I ' Phone: 503.639.4171 Fax: 503.598.19MA DatelBy: Other Permit:
T [ t - n R 1I Inspection Line: 503.639.4175 Date Ready .13y: s El See Page 2 fur
Internet: www,tigard.or.gov CITY OF 1 T 4`7,1,44',:@ Notif Supplemental Information
L oi'_:" CITY tliN Q " F..:. 2 „t:` ?:r 3. iN ' , r .
❑ New construction Addition /alteration/replacement Please check all Char apply (subunit 2 sds of plans w/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition Other: where the available fault current ❑ Marinas and boatyards.
" 1 . T .. c ; exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
IC 1 - and 2 - CAx �F less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
family dwelling 11,��`�, Commercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑ MU lti- family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of 75 KVA or
rrs r ❑ Emergency system larger separately derived system.
JOB OT-g 1� F 3R11IA tiON'., QC`A 9!.:,..-;: _ ' : - ❑ Addition of new motor load of ❑ "A °Ei 7 -2" "l_3 ",
Job no.: .t 59 (4.3 I Job site address: t rj' 51 5 vJ 1 Z'^"1 Au E 100HPrr more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
- '7 ❑ Health-care facilities" ❑ Supply voltage for more titan
City/State/ZIP: ` a ✓t� � Zz.`i
❑ Hazardous locations. 60D volts nominal.
Suiteibldg. /apt. no.: Project name: r ,, l ' �,.k,� - ' O Service or feeder 600aau {{ e �
cr tame. VO M
Cross street/directions to job site: oeuription I Qtr.. I Pea I TO NI I
New residential single- or multi family dwelling unit.
Includes attached garage. _
Subd ivision: Lot no.: 1,000 sq. ft or less 166.54 4
Ea, add'l 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
75.00 2
f
.:' ••" roc iIB dN. i Nvott t ; , i 4 . "°'.f (with above sq. ft)
(� , . y � Limited a d energy, mu o sy 75.00 C S -i-rl✓ 1.� 6 p6.1A 511. residential (with above ve sq. it.)
l' Z - ll __ J Services or feeders installation, alteration, and /or relocation 2
200 amps or less 100.70 2
+ 201 amps to 400 amps 133.56 2
1_.] PROPERrir OWNER..... 1. ,. .:1:::';'",' ' . . C7 ' > Z.. -
401 amps to 600 amps 200.34 2
Name: --
601 amps to 1,600 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City /State /ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 . 1
Owner installation: This installation is being made on property that I 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 am to 599 amps 168.54 _
Branch circuits - new, alteration, or extension, r panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
. CI Arnie rh! - . Q es ra it ,rlr> 7A2 2
. . , eac b ranc h c
Business name: B. Fee for branch circuits without
service or feeder fee, first 1 56.18 2
Contact name: branch circuit
Each add'l branch circuit + 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service andlor feeder
Phone: ( ) Fax: : ( ) Reconnect only 67 -84 2
, Pump or irrigation circle 67.84 2
E S ign or outline lighting 67.84 2
..- : CQ CTQ i. ;. r .v. _ :. i , ; '...;;=;i',.. o , , t.- Signal circuits) or limited- energy
Business name: e V_ C t (i ` ' •. L , panel, alteration, or extension. Page 2 2
DO B Each additional inspection over allowable In any of the above
Address: ‘ S hW S E Foy �
Moe C-T' B Additional inspection (I hr min) 66.25/ hr
aGt/ 4vcS 0 COO
_ Investigation t hr min) 66.25/ hr
City/State/ZIP: f.. O S Industrial plant (I hr min) 78.118/ hr
Phone: (� ' r '? GK„, Fax: (7j3) 1056 3C 7 Inspections for which no fee is 90 00/ hr
specifically listed ('h hr min)
r" _.
CCB Lie.: 2_62_9 Electrical Lie.: 3-5 C, oz '4 Suprv. Lic.: 5 - : :. 1':I,IF.CTRIC.Y,I, rrRnirr FEES
Subtotal: � g to
Suprv. Electrician signature, required: plan review (25% of permit fee)
Print name: Date: 3 1 t q i I ! State surcharge (12% of permit fee): 1 . (03
G.� � �s $ r TOTAL PERMIT FEE "1 1- 2.3 Authorized signature: This permit application expires if a permit is rot obtained within 180
�� Dale 3f days after a been accepted as complete.
Print name:
_S 0 VhNt s 1 i f • Nu mber of inspections allowed per permit
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