Permit q CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00207
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/21/2011
Parcel: 25101 CA00200
Jurisdiction: TIGARD
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Subdivision: BEVELAND CORPORATE CENTER Lot:
Project Description: Temporary service to lab trailer.
Contractor: OREGON ELECTRIC CONSTRUCTION INC. Owner: WALL STREET INDUSTRIAL LLC
1709 SE 3RD AVE A RICHARD VIAL EXECUTIVE CENTER LLC
PORTLAND, OR 97124 7000 SW VARNS ST
PORTLAND, OR 97223
PHONE: 503 - 234 -9900 PHONE:
FAX: 503 - 535 -2763
FEES
Quantity Description Date Amount
1 ea Temp Services or Feeders - 04/21/2011 $59.36
Specifics: 200 amps or less
1 ea 12% State Surcharge - 04/21/2011 $7.12
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $66.48
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 by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 952- 001 -0090. You m- 'btain a c•?� pri t questions to OUNC by calling 50� 7 or 1.800.332.23 4.
Issued By: �- /�f � . --. Permittee Signature: _...ras
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.
RECEIVED
Electrical Permit ApplicatiolP R 2 0 2011 lul<miu I isl om.)
C ty of Tigard Received
Permit No.; 15 1/C-P 0(1 dr) 7
IN . 13125 SW Hall Blvd., Tigard, 0107U OF TIGARD Date/By; 7 , ii
Plan Review
Phone: 503.7182439 Fax: Other Pmi
ert:
TIGARD Inspection Line: 503.639.417r ti.DING DIVISION Date/By:
Date Ready/By: funs: elf See Page 2 for
Internet: www.tigard-or.gov Notified/Method: - tr.& Supplemental Information
NOti...i**:.0*:.i*0*: . ? , ::!-: . 4::.5.e32:::i;E:R•',::::::::::::::0::::::::::.V.:04 .. , - 4.44:,::::#*EW
0 New construction El Addition/alteration/replacement Please check all that apply (submit,/ sets of plans w/items checked below);
0 Service or feeder 400 amps or more 0 Building over three stones.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
1 .. 607 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
loss to ground, or cxeoc46 14,000 Ell Commercial-use agricultural
0 1- and 2-family dwelling rg Commercial/industrial 0 Accessory building snips for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 1:1Fire pump. 0 Installation of 75 KVA or
i , 0 Emergency system. r sere t sly derived system.
1 9P;.STF.,: - .':*.,... , 90.11:4.0J.;q1:40.0:?::4:0,..c4.7, 7 49.Pkik.':::::::: : ::.f?.-.?::::4::::•:,:' 0 Addition of new motor load of 0 "A", "E". "7-2
Job no.: 79369 Job site address: 7904 SW HUNZIKER ST 10014P or more. occupancy.
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: PORTLAND OR 97223 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locatiom. 600 volts nominal.
Suite/bldg,/apt. no.: Project name: AGILYX 0 Service or feeder 600 amps or more.
aigi:
Cross street/directions to job site: Description f QV,. I Fee. L Total I • ,
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 1_41
Fa. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
75.00
e (with above sq" 0) Limited energy, multi-family
TEMP SERVICE TO LAB TRAILER residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
JOB # 79369
200 amps or less 100.70 2
...- ..'... :1:**0i***40.*::***; 201 amps to 400 amps 133 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
-
Temporary services or feeders installation, alteration, and/o
City/State/ZIP:
relocation
Phone: ( ) Fax: ( ) 200 amps or less 1 59.36 59.36 1
201 amps 1o400 amps , 125.08 2
Owner Installation: This installation is being made on property that I own which is not
1 54
4 599 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 01 amps to amps 68.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or fexxler fee,
13'; PERSON
•••.''' vs each branch circuit 742 2
Business name: B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: branch circuit
Each add'l 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 7
Phone: ( ) Fax: : ( ) Reconnect only 67,84 2
Pump or irrigation circle 67.84 7
E
. . .. , . . Sign or outline lighting 67.84 2
c5;g4Tita,i,erchFt.'.:-,: Signal circuit(s) or limited
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 Additiou-,d iasixxxiou (1 hr min) 66.25/ hr
Investigation (1 lirnin) 66.25/ hr
City/State/ZIP: PORTLAND OR 97214
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 234 Fax: (503) 535 Inspections for which no fee is
90.00/ hr
specifically listed ( ii hr min)
CCB Lic.: 203 Electrical Lie.: 26-95C Suprv. Lic.: 4549S i..,:::ii.::::::::,:;::::.'iig::::;:.,ig:'.'Ji:'::::•:•...::,;':ELEC:TRICAL::::::1!EJLIVIIT:.::FEES:::Ficn...?:::::,:::::;::.:::,...:::::'::...:
1 C3 ' hlr.90Z),
0,-)4r\Nk\Z-.S)1).3.1. _
Plan review (25% of permi 5936
Suprv. Electrician signature, required: .
Print name: RICK MCELLIOTT Date: 4 State surcharge (12% of permit fee): 7.
• TOTAL PERMIT FEE: 66.48
Authorized signature: f1/4 4 vf..i3S1 3,35...
. This permit application expires If a permit is not obtained within 180
i•
days atter it has been accepted as complete.
Print name: RICK MCELLIO'TT Date: 4-20-11 • Number of inspections allowed per permit.
IABilikling‘Permtts \ELC-PernutApp.doc 07/01/10 440-4615TM/05/C014/WEB
L____