Permit if CITY OF TIGARD ELECTRICAL PERMIT
' = COMMUNITY DEVELOPMENT Permit #: ELC2011 -00465
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/17!2011
Parcel: 2S 102AA00600
Jurisdiction: Tigard
Site address: 12045 SW HALL BLVD
Project: 7- Eleven Subdivision: TIGARD HIGHWAY TRACTS Lot: PTS 10-
Project Description: (2) branch circuits for LED ceiling lighting install.
Contractor: IDEAL SERVICES INC Owner: ALPROP LLC
5113 PACIFIC HIGHWAY EAST #13 6149 SW SHATTUCK RD
FIFE, WA 98424 PORTLAND, OR 97221
PHONE: 253 - 475 -8884 PHONE:
FAX: 253 - 475 -8886
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 08/17/2011 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/17/2011 $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 thro 952 -01 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 .1987 or 1.800.332.2344.
Issued By: � /���!�l . Permittee Signature: . A 41
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.
08/17/2011 09:53 2534758886 IDEAL SERVICES INC PAGE 05/07
Electrical Permit Application, FOR OL'FICE USE ONLY
�.'I 0 Tigard ∎� yReceived p Permit No-: fiCe�O,,'� 14 . 131 5 Hall Blvd., Tigard, OR 9722 ¢ D ateB : 0 � ! ".
Plan Review
2 : ' Phone: 501718.2439 Fax: 503.598.19 4- ,3' IQ ' DateB : Other Permit:
� {� 3uris: 0 See rage 2 for
'1' i e",A.RD Supplemental Information
Inspxtion Line: 503.639,4175 ® " .fin , DAte Ready/By:
Internet: www.tigard -or.gov � Notl£t�d/Met}lod:
> °P "' e i ll ' rI :r . ' ,, ,, t t - /, 4� � _ � ^ � „' i :;c 7 ' � ',.T :'" ^"
e ,{ ''" � J .n � �:.
a d t ._.:., B... fir. : - :s s ,N?
AdditiozlJalteratiozllr laeetrient� _ �? Please check all that apply (submit 2 sets of plans w/iteros checked below):
▪ New construction `ro, ing over au cc 3kgri a.
❑ Demolition ❑ Other
\ \i ❑ Service or feeder 400 amps or more ❑B uild'
r, \�� _ where the available fault current CI Marinas and boaryarda.
: i n i ` P - i� exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
�,v,t ;,, ��' .., - „,� ., /G'�<:,, , ,,, . ^..,..,. .__�...,:. • . . .� . .0 • - less to ground, or exceeds 14.000 ❑Commercial -use agriculture]
❑ 1- and 2-family dwellin, II Commercial/industrial . 0 Accessory building amps for all other installations. buildings.
O Multi-family ❑ Master builder 0 Other CI Pre P1�P. ❑ Installation of 75 KVA or
� � ;Pi. te ' ";:' say y1
- [] Emerge pry syacem. larger Separately derived systc
, :. * s 3 S t riJ tr °- sa ' ” 1 4 .. �'r : ` yl: ..
i. .r. , , - ^ , :ly 4 . Li of new Motor toed of ❑ "A ", "E ", "1-2", "I - °:
Q Jo b site address: q / k , � i i / 111 11001-1P or more. Racy.
Job no.: 1 • `" ❑Six or more residential unite. ❑ Itaerealinnal vehicle par1m.
City /State/ZIP; Tigard, d, OIL ❑ Health-care facilities, ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal,
Suite/bldg. /apt no.: Project name: 7- E leven 0 Service or feeder 600 amps or more.
Cross street/directions to job sift: nn
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'. 500 sq. ft. or portion 33.92 1
Tax map /parcel no Limited energy, residential 75.00 2
.x' , e"1 a "eYp :y:', �,— Li rgy
(with above sq. ft.)
Lt. _..:.iik „. _ .F. . . :,•ta atria::: _ „ . A.. i f' .. ` - _ . k , s fir:'"" :, Limited energy. multi family
LED Ce ilin g Lighting install (fixture replacement) residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
ay. - �^ � ������},�Iyr• !!} -.+ , ' ? r'^r ,: - r 7 ii r. .7 4 7 201 amps t 400 a 133 -56 2
1 40: 4t ^ .- i�lG� � "„ , „., 'A^.° -' ,„ , 't AFk is- : ..,:o- , -- iv.C,i+ . -,, i, ' .1 '.Z; ..�,,'''" .uta "- . - a
401 amps to 600 mops 200.34 2
Nafne: 7 - Eleven 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City /State/ZIP: Tigard, OR Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 snips 125.08 2
Owner installation: This installation is being made on property that I own which is not
k01 amps to 599 amp s 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 4-47, 449, 670, and 701. Branch circuits – new, alteration, or extension, per panel
—
Owner signature: Date: A. Fee for branch circuits with
s ,, , e N ...,, .=„ �° 4 t : ry 1 r,f 41 ,.. c " ; ;,a , ' .; 7 1• ∎ G t.. each br ands service or fee, 7.42 2
°;u. t .s. L°s�t icbF ►rte* ,,..
'Business name: Ideal Services Inc B. Fee for branch circuits without Q
service or feeder fee, first
56.18 (► 2
Contact name: James Duncan branch circuit
Each add'l branch circuit ( 7,42 "1 , . 2
Address: 5113 Pacific Hwy E##13 Miscellaneous (service or feeder not included) .
City /State/ZIP: Fife, WA 98424 Each dwelling, service or modular 67.84 2
ing, service and/or feeder
Phone; (253) 475 -8884 Fax:: (253) 47545$86 _Reconnect only 67,84 2
Pump or irrigation circle 67.84 2
E permits@idealservscesIncCent Sign or outline lighting 67.84 2
. ... . :,,,, � + . . - ,. . - ^ .# * : i + :,,- ...:1 r. °:: i S c or l energy
Business name: Ideal Services Inc i panel, alteration, or extension+, , Pape 2 2
Each additional inspection over allowable In any of the above
Address: 5113 Pacific Hwy lE #13 Additional inspection (1 hr min) 66:25/ hr
Investigation (1 hr min) 66.25/ hr
City /State/ZIP: Fife, WA 98424 Industrial plant (1 hr min) 78.18/ hr
Phone: (253) 475 -8884 Fax: (253) 475-8886 Inspections for which no fee is so.00/ hr
it S eiticall Listed '✓s bx ran
CCB Lie.: 154353 Electrical Lic -: 37 -988c Suprv. Lie.' 512's z
Sit otai: , ,
Suprv. Electrician signature, required: i pl review (25% of permit fee): ...
Print name: Ray Sauer f e/r State surcharge (12% of permit fee): 1 (,,,
TOTAL PERMIT FEE: 7 (, 'Z
Authorized signature: • This permit application expires if a perritit is not obtained withiat
� days aver it has been accepted as complete.
Faint name; James Ihurcarl ,. Date: 8/a7/><I. = Number of inventions allowed per permit_
I:\ Buildiri g\RRrmita\ELC- PearnitAPp.doa o7ro110 440 - 4015101 /0/C0M/WE.B
08/17/2011 09:53 2534758886 IDEAL SERVICES INC PAGE 06/07
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
: �..r
Fee for a 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: _ J
y , i1, L x
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
❑ VAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling C16.1#
them
Total number of commercial systems; —
"No licenses are required. Licenses are required
for all other installations
Z;18uilding\P sIP1.C•PetmitApp. 07/01/10