Permit CITY OF TIGARD ELECTRICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit# ELC2011 -00594
Date Issued 10/25/2011
T IG AR.D 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 2S112AD00900
Jurisdiction Tigard
Site address 14800 SW SEQUOIA PKWY
Project Home Depot Subdivision PACIFIC CORPORATE CENTER Lot 9
Project Description (8) branch circuits for exhaust fans and swamp coolers
Contractor TIMBERLINE ELECTRICAL CONTRACTORS Owner HD DEVELOPMENT OF MARYLAND, INC
PO BOX 918 BY HOME DEPOT USA, INC
LAKE OSWEGO, OR 97034 PROPERTY TAX DEPT #4002
PO BOX 105842
ATLANTA, GA 30348
PHONE 503 - 459 -4089 PHONE
FAX 503- 254 -4227
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo /Purchase 10/25/2011 $108 12
Specifics Service or Feeder
1 ea 12% State Surcharge - 10/25/2011 512 97
Type of Use COM Electrical
Class of Work ALT
Type of Const
Occupancy Grp
Total $121 09
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 0 2 -001 -0090 You may obt- . - • • • • - ules • • - questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By 1.■■111 - Permittee Signature 0 _02 c 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 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
Electrical Permit Application FOR OFFICE USE
• c
City of Tigard Flaffifilillial =NM 11 an,
--- 13125 SW Sidi Wad.. Tigard, OR 97223 C V Plan Review
, NI
-
Phone 503.718 2439 Pax 503.598. vi Datelk OtherPcmut
11 cr ,,, v. i , Inspection Line 503 639 417 tr
Cate R
' 15 < \ atty/13y
Notified/Method RI
IV See Page 2 for
= Supplemental Information
Internet mew tigard-or gov q C a
, __ ., - risa;akviv.ir
(.._i New construction giAddillonialterationhePifrialt\S\‘)" Please check all that apply (submit 2 sets of plans whams checked below)
9 Service or feeder 400 amps or room El Building over three stones
0 Demolition Out., C\ where the available fault curium 9 Mamas and boatyards,
exceeds 10,000 impost 150s:ulna 9 Hainan buildings.
0 1- and 2-family dwelling Conimercial/industrial 0 Accessory building
TCY
' . less io ground, or exceeds 14.000 9 Commemtal-use agnadtural
amps for all otha mstallations buildings
0 Mult-funuly 0 Master builder 0 Other- 0 rim pump 9 Installation of 75 KVA or
I, '''':: r r -.: •,), T ' "'' - JOES NUE :11 VID TelirlATION ' n '"..J'', '',", -' E Adthuen7latTioter load of 9 " la ir -B R ef a l -2 ” 'Plea
Job no . Job site address I /meow 6 EQuariA- WIT 0 100HP or more
Sec ar more residential units oocuPancY
0 Reactional vehicle parks
City/Stale/GM - 0R. 9 7 go,/ 01%4n.-cam facilities
DHazarOous locations 600 Supply voltage for more than
600 vats mammal
SUlteibidgiapL no Project name. HnY19-- ap $1 0 Service or feeder 600 amps or more
,; , 9 - „ , PEE' SCIlintiti i,; -,,,,,: ', .:,`'-- - -='; •
Cross street/directions to job site cense. I Qa I Fea. I mai I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision Lot no 1,000 sq. ft. or less 168 54 4
Ea Adel 500 sq ft. or portion 33 92 1
TM InapIpanzti no
Limited enagy, residential
75 00 2
, tS & ado ,id Linut , multi-f
CiilitiON iVeRICS' : l„ C . "- - - ' - ' (with above aq ft.)
ed energyannly
RgOuriect Atnp @oaks
nd Oticizer madame! (with above sq 11) 75 00 2
fr ' Services or feeders hartaBation, alteration, and/or relocation
11/46 - ext5c17.16 etkati,E-5 200 amps or less 100 70 2
".,‘,4•2',2;;, -- „t - n . B.OPIERW 9 '0WIliFit ,-, ,9 , - „ , I - - CiliElAili (... , /'.,' , I„, '' . , - ' 201 saills to %V Imills 133.56 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/SbilerLIP. Temporary services or feeders Installation, alteration, imdfor
relocation
Phone. ( ) I Fax. ( ) 200 amps or less 59 36 1
Owner installation: This installation is bang made on property that I own which is not 201 amps to 400 amps 22508 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, P er panel
Owner signature Date. A. Fee for branch circuits with
i:: • :, ',I:J...i4+14c ':.: ,, - t" ' 'CI ,cloarAtt grasox ,..' -ti. shuns ennee ca feeder fee, 742 2
each branch circuit
Business name: B Fee for branch circuits without ,
sent= or feeder fee, fun i 56 18 6 i e 2
Contact name blanch circuit
A Each add'I branch circuit 7 7 42 61 .51 2
ddress
Miscellaneous (service or feeder not included)
C Each manufactured or modular
ity/State/ZIP
dwelling service and/or feeder 6784 2
Acme: ( ) i Fax ( ) Reconnect only 67 84 2
Pump or irrigation circle 67.84 2
E-mail
Sign or outline lighting 67 84 2
COflRACltR -Z -. Signal cun-uilis) or !muted-energy
Business mune. h it\ p Q , a ct i 624.u2 k c panel, alteration, or extension. , Page 2 2
Each additional inspection over allowable in any of the above
Address. 9,114 tt) enzeuk ewo, R-, Additional inspection (1 hr man) 66 25/ hr
City/SWOOP' bathra, it ot ,,t9 Invevtgratroe0 hr mm) lit
Inducing plant (1 hr mm)
t 7„
78 181 he
Phone: ( 543 ) 2 0 - 40 69 i Fax ( 50 469.-- 14 227 Inspections for which no fee is
specifically hated OS hr —I 90 00/ In-
CCB Lie.' /6 60,37 t Electrical pc : *- II II C. SATIN Liz. St , . • al1crateaVriarittr
supry Electrician signature, required _......ov N
...' ^---' /7 IO() Subtrksk: foe; fl.
a • 1, Plan review (25% of pema fee).
Print name 4 i 4 wi e r s Date: I t e // State surcharge (12% of pennit fee). -e425 , 4 17
TOTAL PERMIT FEE 0 .
I Al q
Authonzed signature:
a . A a _ 111IP This permit application expires Ifs permit Is not d wItIdn 1S0
. days after It has been accepted as complete.
name: i ciii i 6 a,
Punt , /4, fil Date: „i ii 4 Nomar of rispechons allowed pm peumt.
alimilmalPenrotstELCRamailap doe 07/01/I0 140-46157(11/05/COIWWEB
E00/Z002 Ili S T : Z Z TIOZ/VZ/OT