Permit r
sr •
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2009 -00108
' ' Hall Tigard Date Issued: 03/03/2009
;'I4ill'R 13125 SW Hll Bld Ti d OR 97223 503.639 4171 Parcel: 1S126DB02800
Jurisdiction: TIG
Site address: 9370 SW GREENBURG RD O
Subdivision: Lot:
Project: Spec Space
Project Description: TI
Owner: FEES
FRANKLIN COMMONS ASSOCIATES Quantity Description Date Amount
BY NORRIS + STEVENS, 520 SW 6TH STE 400
PORTLAND, OR 97204 1 crt Branch Circuits 03/03/2009 $46.85
wo /Purchase Service or
PHONE. Feeder
1 ea 12% State Surcharge - 03/03/2009 $5.62
Electrical
Contractor:
RELIANT ELECTRIC LLC
20200 SE OLDENBURG LN
SANDY. OR 97055
PHONE: 503- 860 -4240
FAX: 503 - 668 -4190
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: B
Total $52.47
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 i ccordance h 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 A ENTION: Oregon .w re. es 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 -00 .100. iYo. ay obtain a copy of the rules or direct questions to OUNC by calling 503 246 6699 or 1.800.332.2344.
U • / /
Issue By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made.dn property I own which is not intended for sale. lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' � /� _____._..____...._ -.... _. _ - . Date: S/
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
f Ele`rutrical Permit Applicati i FOR,OFFICE USE ONL .
City of Tigard D DateB ' u/! D�
EC E D
Permit No.: � ..
I II
° 13125 SW Hall Blvd., Tigard, OR 97223 3 2009 Plan Review
__ Phone: 503.639.4171 Fax: 503.598.19 (MAR
0 Date /By: Other Permit:
T I GA R D Inspection Line: 503.639.4175 Date Ready /By: Juris ® See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information
•. - `.TYPE `OF' IS ING DIVISION . , . . " ' PLAN REVIEW •
❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
` CATEGORY OF' CONSTRUCTION. , • : ' e exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ' Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
" J . OB' SITE IFORMATION "AND LOCATION' - ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 95 7O Sk ��'le Six or or more. occupancy.
❑
❑ Six or more e residential units. Recreational vehicle parks.
City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal. w
Suite /bldg. /apt. no.: O Project name: n� ❑ Service or feeder 600 amps or more.
FEE SCHEDULE -' .
Cross street/directions to job site: Description I Qty. I Fee. I Total I *
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
,,'Na _DE OF' WORK , ' _ (with above sq. ft.)
" Limited energy, multi - family 75.00 2
r ..S.1,1/4. ,` i c •.,k 6 / residential (with above sq ft.)
` `` /� ) CJ Services or feeders installation, alteration, and/or relocation
L ` � h "i' $ x �l �� - 200 amps or less 80.30 2
❑' PROPERTY pOWNER,' " . . , 0.. TENANT' 201 amps to 400 amps 106.85 2
Name: / Si 401 amps to 600 amps 160.60 2
l -� r e:: n 3 J t 1 S a, .. , -1-C.. v 601 amps to 1,000 amps 240.60 2
Address: 3 -' 0 -5 1T- c.e.,. t I r IZ tX Over 1,000 amps or volts 454.65 2
City /State /ZIP: .)—...3 Temporary services or feeders installation, alteration, and/or
�\ ` < , „ . c_, 2 GI —
- 7 .)—...3 relocation
Phone: ( ) � I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with ® •APPLICANT ,1=1 CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee, k 0.5
Contact name: first branch circuit 46.85 Li G - 2.
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
' - • - - '' ', CO O R` ',, ' - . Sign or outline lighting 53.40 2
Business name:
Signal circuit(s) or limited -
Re-1 t, .,., .\--• I e I, t 4 L L c_ energy panel, alteration, or
Address: a-0 - a-L , '0 SE C� `c \@ ^ i ` L4, C extension. Describe: Page 2 2
City /State /ZIP: n U � � 11 U S Each additional inspection over allowable in any of the above
S L ` s Per inspection 62.50
Phone: ( ) f 1 t 1 1 Fax: ( ) investigat per hour (1 hr min) 62.50
CCB Lie.: 16 Z 6 Electrical Lie.: G S c1 Suprv. Lie.: 5 i y 7_5 industrial plant per hour 73.75
' ELECTRICAL' PERMTT'FEES "'. "`
Suprv. Electrician signature, required: £ •—__ -_ 1 /6 Subtotal: � .
• t � Plan review (25% of permit fee): .-
Print name: ...,,' L E r-1 t _t,� J n Date: State surcharge (12% of permit fee): 5, (p l-
Authorized signature: TOTAL PERMIT FEE: 5,2 . 4 17
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(I1/05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK;ONLY: '_ 77
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
❑ Other:
C D VIMERCIAL, WORK`ONLY:„ 77
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
1.\ Building \Permits\ELC- PermitApp.doe 03/23/06