Permit CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT Permit#: ELC2011 -00564
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/12/2011
Parcel: 1S134AD06200
Jurisdiction: Tigard
Site address: 10565 SW NIMBUS AVE 100
Project: TSE Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: A
Project Description: (3) branch circuits for new equipment. UL listing application on file.
2/24/2012: printed to add (1) 200 amp feeder and (2) additional branch circuits.
Contractor: COCHRAN INC Owner: HANSON, RONALD D
7550 SW TECH CENTER DR. #220 ROBINSON, CONSTANCE A
TIGARD, OR 97223 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 234 -6564 PHONE:
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 02/24/2012 $100.70
Specifics: amps or less
5 crt Branch Circuits w /Purchase 02/24/2012 $37.10
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 02/24/2012 $16.54
Electrical
Type of Const:
Occupancy Grp:
Total $154.34
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 -00 -00 0. 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: QN /1 /- 1./ L
� C - 77 V
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.
CITY OF TIGARD ELECTRICAL PERMIT
'• COMMUNITY DEVELOPMENT Permit #: ELC2011 -00564
Date Issued: 10/12/2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 1 S134AD06200
Jurisdiction: Tigard
Site address: 10565 SW NIMBUS AVE 100
Project: TSE Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: A
Project Description: (3) branch circuits for new equipment.
Contractor: COCHRAN INC Owner: HANSON, RONALD D
7550 SW TECH CENTER DR. #220 ROBINSON, CONSTANCE A
TIGARD, OR 97223 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 234 -6564 PHONE
FAX: 503 - 238 -2098
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 10/12/2011 $71 02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 10/12/2011 $8 52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By: � �� � - -- •ermittee Signature:
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 09:27:46 10 -12 -2011 1/2
Electrical Permit ApplicaticRECEIVED FOR OFFICE USE mile'
City of Tigard Received { A p
OCT 12 2011 Date/By: ® Penult No: i +
" 131 SW Hall Blvd., Tigard, OR 97223 y " — '�� L �
• Plan Review
Phone: 503.639.4171 Fax: 503.598 Date /By: Other Permit
TL(' ARL) Inspection Line: 503 639.4175 GI 1 Y OF T1GARD Date Ready /By: turfs: E1 See Page 2 for
Internet: www.tigard -orgov BUILDING DIVISION Notified /Method: e may Supplemental Information
''':'TYPE 'O ;,•WOR.K - ; , . /. - . )%1:-REV,IEW .
❑ New construction ,Addition /alteration /replacement Please check all that apply (submit 2 sets of plans whims checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition El Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION '~' ;, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to und, or exceeds 14,000
El 1- and 2- family dwelling 'Commercial /industrial ❑ Accessory - buildin gr0 ❑ Commercial-use agricultural
Y g amps for all other installations. buildings
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SIT t
• - Emer system. larger separately derived system.
. F ; D .LOCATION; • •
E INFORMATION, A N Addition of new motor load of
0"A", "E" ,.1_2,...1.3„
Job no.: I50( 1 ( Job site address: 'I int_ �C- std � 1 ' ` tC IOOHP ormore occupancy.
El Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: et q ❑ Health-care facilities. ❑ Supply voltage for more than
1 ` ZZ 3
El Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: l I Project name: •-r' G
l El Service or feeder 600 amps or more.
1 -FEE SCHEDULE.. •
Cross street/directions to job site: Deseriplton j Qty. 1 Fee. I ' .....
otal 1 *
' New residential single- or multi- family dwelling unit,
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. 4. or less 168.54 J 4
Ea. add'l 500 sq. fi. or potion 33.92 1
Tax map /parcel no.: Limited energy, residential
.. , ' - • 'DESCRIPTION OF WOK • ' , • (with above sq. ft.) 75.00 2
p _ t / Limited energy, multi - family
75.00 2
--L e' CD C. w 3 t 7 •� \D �f A Ct, Ls ' s residential (with above sq. ft.)
(, Services or feeders installation, alteration, and /or relocation
''C f \-L e c . \( 31 4r •ew ' 200 amps or less 100.70 2
' ❑ PIROPERTY.OWNEIr .'`
,, ,`j2'E■A■T ' 201 amps to 400 amps 13156 2
Name: "'` 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City / State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
r.
Phone: (5 ) C. (c2 � ._ 2 so Fax: ( ) 200 amps or less 59.36 1
(J 201 amps to 400 amps 125.08 2
Owner Installation: This installation is being made on property that I own which is not
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
0, APPLICANT above service or feeder tee,
:I ,', D',CONTACT,-PFRSON each branch circuit 7.42 2
Business name: am' 4O, �S CZ '( c •-j_ v � – B. Fee for branch circuits without
service or feeC23
Contact name: J ` branch circuitder fee, first t 56.18 61.
2
Address: — Each add'I branch circuit 2.- 7 ( Lts - 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular I 67.84 2
dwelling, service and/or feeder i
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E -mail:
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
.. ' • CONTRACTOR . . • • - ' ' Signal circuit(s) or limited - energy
Business name: Lc - (
n ,_ , panel, alteration, or extension. Page 2 2
`.I / " �� Each additional inspection over allowable in any of the above
Address: - 1 CC 550 c J I PG C1Ln ( - r #�,�(� Additional inspection (I hr min) 66.25/hr
City/State/ZIP: -71 ro t 0 9 72. Z C� Investigation (1 hr min) 66 25/ hr
� / Industrial plant (I hr min) 78.18 / hr
Phone: 503) 2_34_ 1,25.6 q I Fax: (j3 ) 2_38'- 2_09-g' Inspections for which no fee is 90.00 / hr
specifically listed (' /, hr min)
CCB Lie.: - - 7 2 _ , 3 , 4 2 . I Electrical Lie.: 3 CI Suprv. Lie.: 341.475 V" ... •''';: ; ; `;ELECTR[CAL'.EERMIT'FEES .' ., , -
Suprv. Electrician signature, required: \(..,..~i,,- Subtotal: - 7 I, ( 0'Z
\t, Plan review (25% of permit fee):
Print name: KP.r k State surcharge (12% of pennit fee): X . r�e, 1 Date: i(� (tz1 t l 6-2_
Authorized signature:
TOTAL PERMIT FEE. �~i e
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
1:` huilding ' Perm its•ELC- PermsAppdoc 07101.10 440- 46t5T(I1,05,COM,WEn