Permit q CITY OF TIGARD - ELECTRICAL PERMIT
``'.. :• CO MMUNITY DEVELOPMENT Permit #: ELC2011 -00638
TEGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/10/2011
Parcel: 1 S134AA01800
Jurisdiction: Tigard
Site address: 10240 SW NIMBUS AVE L1
Project: Scholls Business Center Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: Lighting retrofit.
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 hr Hourly Electrical Rate 11/10/2011 $90.00
Specifics: 1 ea Hourly Electrical 12% 11/10/2011 $10.80
Surcharge
Type of Use: COM
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain - • - z • e rules or •'rect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ✓ice _. ��� Permittee Signature: .
/
, 2:(r.1----‘
' OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
01 15:21:33 11-10-2011 1 /2
Electrical Permit ApplicationRECEI Y ED �~ ��� FOR OFFICE-USE - --- __
City of Tigard
Received
IN S , 1 0 20 11 Da te/Sy: i i� i) 6TT� Permit No.: a/'2 it •- O ,
13125 SW Hall Blvd., Tigard, OR 97223 �,." . / V — ° 0 J
Pla Rev iew
Phone: 503.639.4171 Fax: 503.59$.1960 D Other Permit:
T t GA R n Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: .tuns: E1 See Page 2 for
Internet: www.tigard or.gov RI iiLDING DIVISION Notified/Method: ( lie Supplemental Information
''; ':TYPE OF
. $IC: : - `'PIAIV:.REVIE'1'V:
0 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 1:1 Other;
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CON exceeds I0,000 amps at 150 volts or 0 Floating buildin
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.
El Multi - family ❑ Master builder ❑Other: ❑fi pump. ❑ Installation of75 KVA or
ystem. larger separately derived system.
:., A O „• : ...: •' '
mergency s
JOB. SITE INFORMATION'AND.LO'CATION�. , ";:', ,, ❑ Addition of new motor toad of
Job no.: 1S3 (4.2 Job site address: \z'ZLk 9_0 N + ��D�c--, 100HPor more occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City / State/ZiP: 0 2— ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bfd ./a t. no.: Project name: S ❑ S erv i ce or f eeder 600 amps or more.
g p Project �� t \5 �'�S� J`'e5 •t i t p
f i;;� -.FEE SCHEDULES
k 4 �, 0- i-� -- `1.� \ -
Cross s to job site: Description I Qty. i Fee i Total I *
J New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax snap /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
Limited energy, residential 75.00 2
. ' ' .: ; D.ESCRIPTION'.OF:WORK , ': ` ' ' r (with above sq. ft.)
r Limited energy, multi - family 75.00 2
th vs residential (with above sq. il.)
Services or feeders installation, alteration, and/or relocation
\■Q ) ° C. .. 5L'..1■.-50 J".= \Fri.... &co_ _, cc. n 200 amps or less 100.70 2
ROPERTY OWNER• ;'' . El ` 'TENA'NT ` :';' . 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
S `^ 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
Phone: ( ) F ax: ( ) 200 amps or less 59.36 l
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 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, per panel
Owner signature: Date: A. Fee for branch circuits with
0 APPS ICANT - above service or feeder fee,
.. ; ` y CO19' c l -PO OL, :• • each branch circuit 7.42 2
Business name: Wi
" n e, �s CDr' - •L�. B. Fee for branch circuits without
6J U� service or feeder fee, first 56.18 2
Contact name: > � , `; v -e branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City / State/ZIP: Each manufactured or modular 67.84
dwelling, service and/or feeder
Phone: I CO D ' zes- Fax: : Reconnect only 67.84 2
E -mail:
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
r' ,�
signal circuit(s) or limited- energy
SS name: can, panel, alteration, or extension. Page 2 2
Business
C1.M Each additional ins, ection over .flow le in a ,A f the above
Address: 15 50 W V.. (' - S ( " # 0 Additional inspection (I hr min) wilm rr am ���;,
City / State/ZIP: iOa, CA 0K Q 72 Z 3 Investigation (I hnnin} 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: 3o3) 2_34_ 656 c/ Fax: ( � 3 ) 2 2_09.3' Inspections for which no fee is ,'�
1 90.00/ hr q Q
specifically listed ( hr min)
CCB Lic.: 1 ' 4 a z Electrical Lie.: r7 5L/ c Suprv. Lic.: '3 .;t•.'.:: ?i ; .:•'ELECTRI;GAL'iQER11SIT'FEE5;
Suprv, Electrician signature, required: Subtotal: • ��� q�• fa
Plan review ( 25% of permit fee): (Z Print name: KP n (\ � Date: V ( h ( l k - State surcharge (12% of pennit fee): -7 " 0, v
Authorized signature: TOTALPERM(T FEE: hk' 1, 16.0 .
This permit application expires if a permit is not obtained within 180
Print name: days after it has been accepted as complete.
Date: * Number of inspections allowed per pennit.
I Muilding 'cnnirs•ELC -Penn ilApp.dec 07' 01.10 440- 46 15T(t l'OS'COM.:WEB