Permit 71 ,� CITY OF TIG ELECTRICAL PERMIT
'- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00156
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2011
Parcel: 1 S135DD05106
Jurisdiction: Tigard
Site address: 11999 SW PACIFIC HWY
Project: BANK OF AMERICA Subdivision: Lot: 0
Project Description: (2) branch circuits and low voltage for satellite.
Contractor: COCHRAN INC Owner: CCC PROPERTY MANAGEMENT LLC
7550 SW TECH CENTER DR. #220 BY CHERI LETHIN
TIGARD, OR 97223 3443 SW DOSCHVIEW CT
PORTLAND, OR 97239
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Limited Energy 03/29/2011 $75.00
Specifics:
2 crt Branch Circuits wo /Purchase 03/29/2011 $63.60
Service or Feeder
Type of Use: COM 1 ea 12% State Surcharge - 03/29/2011 $16.63
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $155.23
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 OAR 952- 001 -0090. You may obtain a co• of the r questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By �� !%�— — a .rte Permittee Signature: ��� _. Ldc --
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.
01 06:51:46 03 -28 -2011 1/3
Electrical Permit Application FOR Ot l l( F l S1'. ()M.)
lig City of Tigard Received 3
• 1 3125 SW Hall Blvd., Tigard, OR 97223 DateB • i ' , J/ Permit No.: _ • 1
R Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
AatelB : Other Permit:
T t t � A R n Inspection Line: 503.639.4175 bate Ready/By;
Internet: www.ti and -or. ov Su See Page 2
g g N o tif i e d/ Mcthod: a/ Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans wfrtems checked below):
❑ Demolition Othef: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
❑ 1 -and 2- family dwelling ® Commercial/industrial 0 Accessory building less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ Multi-family amps for all other installations. buildings.
Y ❑ Master builder ❑ Other: ❑ Fire pump.
El Installation of 75 KVAor
JOB SITE IIVFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E", "1-2", "1-3",
Job no.: `yo 11 Job site address: 1 C t� ( - �( r � , 100HF or more. occupancy.
` ?&( CT `` "' 4 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZIP: �-' OP, G - Z � ❑ Health -care facilities. ❑ Supply voltage for more than
1 ', ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: d,../A.--• t f,:G� ❑ Service or feeder 600 amps or more.
—
Cross street/directions to job site: FEE SCHEDULE
Description 1 ob- T I Total f ^
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision:
Lot no.: 1,000 sq. ft or less _ 168.54 I 1 4
Tax map /parcel no.: Ea. add'l 500 sq. ft or portion 33.92 1
DESCRIPTION OF WORK Limited energy, residential
(with above sq. ft.)
2
1 1 t Limited energy, multi- family 75.00
k (l t " 3 G (p t? -"-- --1-. .Lt CC 4 - C J . � '(-= ,r- residential (with above sq. ft.) 2
� I ervi installation, alteration, relocation
SCc ��G �� e �� .T ct �`� �C, 2 amps ces or or less feeders 100.7 0 ` 2
❑ PROPERTY OWNER [ ❑ TENANT 201 amps to 400 amps 133.56 2
Name: a,,,,, ` A <- 401 amps to 600 amps 200.34 2
v 1fi vV...„,, Cam' 601 amps to 1,000 amps 301.04
Address: 2
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 t 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 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee, each
❑ APPLICANT ❑ CONTACT PERSON 7 42 2
branch circuit
Business name: B. Fee for branch circuits without
- service or feeder fee, first branch {
Contact name: circuit 1 56.18 5( 1 53 2
Address: Each add'1 branch circuit 1 7.42 `l (12_ 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
CONTRACTOR Sign or outline lighting 67.84 2
_ ^ Signal circuit(s) or limited - energy
Business name: Cochran Inc panel, alteration, or extension. Page 2 '1 S 2
Each additional inspection over allowable in any of the above
Address: 7550 SW Tech Center Drive #220 Additional inspection (1 hr min) 66.25/ hr
br min
City/State/ZIP: Tigard OR 97223 Investigation (1) 66.25/hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 234 - 6564 Fax: (503) 238 - 2098 Inspections for which no fee is
specifically listed (' /, hr min) 90.00 /ltr
CCB Lic.: 72942 Electrical Lie.: 37 -546C Suprv. Lie.: 3447S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: V. C Subtotal: `3 . (
\ \ \\ Pl an review (25% of permit fee):
Print name: Kenneth Kato Date: 3/27/11 State surcharge (12% of permit fee): \ , ( 3
Authorized signature: TOTAL PERMIT FEE: 1 j Z,"�
This permit application expires If a permit is not obtained within 180
Print name: ! Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
LAnuadiag \Permits\ELC- PennitApp.doc 07/01/10 440- 4615T(11 /05 /COM/wan
01 06:52:12 03 -28 -2011 213
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
C Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other Satellite
Total number of commercial systems: 1
*No licenses are required. Licenses are required
for all other installations
I: 18uildmerermits\ELGPcmtitApp.doc 07 /01 /10