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Permit CITY OF TIGARD ELECTRICAL PERMIT R ``= COMMUNITY DEVELOPMENT Permit #: ELC2011 -00384 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/12/2011 Parcel: 1 S136DD01300 Jurisdiction: Tigard Site address: 6855 SW BAYLOR ST Project: Tillamook Foods Subdivision: Lot: Project Description: (2) branch circuits in server room Contractor: MILESTONE ELECTRIC Owner: GSP LLC 1281 NE 25TH AVE, STE. T MALCOM & SHARON ESLINGER LLC HILLSBORO, OR 97124 BY DWIGHT SCHWAB LAKE OSWEGO, OR 97035 PHONE: 503 - 645 -5323 PHONE: FAX: 503 - 690 -4843 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 07/12/2011 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 07/12/2011 $7.63 Type of Use: SF 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 OAR 95 -101-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: - Permittee Signature: ©mot/ /51/7/4 G /e' 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 603.639.4176 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. Jul. 8. 2011 12:21 PM Milestone Electric No.0117 P. 2 Electrical Permit Applicatio> CEP/ED htNR on l e ' 1 : t ' I: o\ 1.1 City of Tigard Received ' lfi11� ��, D �. Permit No�LC" p //- � ' -• • 13125 SW Hall Blvd., Tigard, OR 97223 JUL 0 8 2011 Plaae R : !n ovicw • Phone: 503.639.4171 fax: 503.598,196 Date/B : Other Permit: is i , Inspection Line, 503,639,4175 CITY OF TIGARD Date Ready /By: See Page 2 for Or,gov Notified/Method: Supplemental upplemental Infotwation Internet: www.tt a.. BUILDING DIVISION . T of w RZK ❑ New construction , ' Addition/alteration/replacement Please cheek all that apply (submit j sets of plans w /items chocked below): CI Demolition ❑ service or feeder 400 amps or more ❑ Building over three stories. ❑ Other: where the available fault current ❑ Marinas and boatyards. . '. ATEGOR'i 41N': CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural p 1- and 2- family dwelling *Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 15 KVA or JOB. ST CE INFORMATION AND L.00e1 TION CI Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: / Job site address: (,g Sw .,i3 fa / /- Six or or more. occupancy. © Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: 7' c) H a , � 074 9 7e. ❑ Health-care facilities. ❑ Supply voltage for more than ./ 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: Project name :I — 1/ 4)0w ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: nercriptien I Qry. i Pen I Tetar I • New residential single- or multi- family dwelling unit Includes attached garage. Subdivision: Lot n0.: 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 75.00 2 DESC IttiN OF WORK /with above sr,ft.) Limited energy, multi- family Ail 5)1z2,71 S` -3e) Rec e -. >'7_s / 61 , 56 r residential (with above sq. ft.) 75.00 2 Services or feeders installation, alteration, and/or relocation (".) --,::, {44. 200 amps or less 100.70 2 ❑ PROPERTY OWNER ' I ❑ 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 Temporary services or feeders installation, alteration, and /or City /State /ZIP: 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 I own which is not 401 amps to 599 amps 168S4 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: Date: A, Fcc for branch circuits with above service or feeder fee APHLICANT I CO NTACT PEON 7.42 2 .- - each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 561 S 2 Contact name: branch circuit / . 5 ,, Each add'l branch circuit / 7.42 7, 4 4 7. 2 Address: MisctllancoUs (service or larder not included) City/State/ZIP: Each manufactured or modular 67.84 2 dwelling, service and/or feeder Phone: ( ) Fax: : ( ) Reconnect only 67,84 2 Pump or irrigation circle 67,84 2 E - mail: Sign or outline lighting 67,84 2 CON7RAC'EOR. Signal circuit(s) or limited- energy 4 � ! . 7 ' panel, alteration, or extension. Page 2 2 Business name: /f /r�i` �' � / �' � r � Each additional inspection over allowable in any of the above Address: /28,./ // 5 - 4✓ /44, e . 7 Additional inspection (1 hr min) 6625/ hr 4 /, 4b . e (�Tr2' �j/ Industr 66.25/ hr City /State/ZIP: i/ °' 7 Industrial plant (I hr min) 78.18/ hr Phone: ( Fax: ( ) c' - Inspections for which no fee is �) Z ` � �- Y � `� } s cificall listed K hr min 90.00 / hr 0/CCB Lic.: /5 e f�j0 Electrical Lic,: 4/-6,1g Suprv. Lie.: S 3! s •' >rrEEC'CIt/C; ;IIERMI!''C.`t~EI S.. Suprv. Electrician signature, required: Subtotal: 4 0 Plan review (25% of permit fee): Print name: s D ate: State surcharge 7 r (o 3 o� �- �i 7 � '� l ge (12% of permit fee): TOTAL PERMIT FEE: 7/, Z Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: Date: days after It has been accepted as complete. N um b er of inspections allowed per permit. 1:1 Building7rrmits \ELC- PermitApp.doc 07/01/10 440 4615T(11 /05 /COM/WES