Permit C� • r
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` CITY OF TIGARD ELECTRICAL PERMIT
1. . n COMMUNITY DEVELOPMENT Permit #: ELC2009 -00142
Date Issued: 04/02/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S102DA00401
Jurisdiction: Tigard
Site address: 13125 SW HALL BLVD PERMITS
Subdivision: Lot: 0
Project: City of Tigard
Project Description: Permit Center - Interior wall for new office for Commercial Crimes Unit.
Owner: FEES
TIGARD, CITY OF Quantity Description Date Amount
13125 SW HALL BLVD 4 crt Branch Circuits 04/02/2009 $66.80
TIGARD, OR 97223
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 04/02/2009 $8.02
Contractor: Electrical
OREGON ELECTRIC CONSTRUCTION INC
1010 SE 11TH AVE
PORTLAND, OR 97124
PHONE: 503 - 234 -9900
FAX: 503 - 535 -2763
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $74.82
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 wit
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. ATT r • : Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0• • through OAR ° 2 -00 ■10• You may obtain a copy of the rules or direct questions to OUNC by calling . .6699 or 1.800.332.2344.
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ssue• B �� /L � _
y: Permittee 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'N �� Date:
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.
APR-01=09 13:53 FROM- OREGON ELECTR [ i t 5032349900 t C21t OFFICE T-455 St P.001 002 F -650
.Electrical Permit Application
APR - 1 2009 Received
City of Tigard DatCIB . or �� • •�
74
n 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
9 ITV O F TIGARD Date/B .
Other Permit;
>a Phone: 503.639,4171 Fax: 503,59t1
Sec Page 2 rot
,, -; „ n Inspection Line: 503.639.4175 BUILDING DIVISION Aare Ready/By `i S lcmcn for ormatlon
Internet: www.tigssrd- or.gov Notified/Method; pP
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w/itemi checked below):
(71 Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition El Other: where the available fault current ❑ Marina: and boatyards.
Cpl I;COTtY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 1:1 Floating buildings.
_ less to ground, or exceeds 14.000 El Commercial -use agricultural
❑ 1- and 2- family dwelling El Commercial/industrial ❑ Accessory building amps tar all other installations. buildings.
o Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA Or
❑ Panergency system. larger separately derived system. •
JOB SITE INFORMATION AND LOCATION 13 Addition of now momr load of ❑ "A ", "E",' I - ", "1 -
100HP or mote. occupancy.
Job no.: 80016-103 Job site address: 13125 SW HALL BLVD _ ❑ Six or more residential units- ❑ Recreational vehicle parks.
City /SIate✓ZIP: TIGARD OR ❑ Henith•care facilities. ❑ Supply voltage for more lbsn
1] Hazardous locations. 600 volta nominal.
Suitc/bldg-/apt. no.: Project name: CITY OF TIGARD PERMIT CTR ❑ Service or feeder 600 amps or more.
— FEE SCHEDULE
Cross street/directions to job site: inscription mar., i Per_ I Tot " I
New residential single- or multi - fancily dwelling unit
Includes attached garage. _
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. IL or portion 33.40 1
Tax map/parcel n0,: Limited energy, residential
75,00 2
DESCRIPTION OF WORK . (with above sq.
Limited energy, multi - family 75.00 2
INSTALL FOUR NEW OUTLETS IN PERMIT CENTER residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER - I 1:1 TENANT 201 amps to 400 amps 106.85 2
1 1 1- / b 401 amps to 600 amps 160.60 2
Name: �' L <• I 601 amps to 1,000 amps 240.60 2
' Address: Over 1,000 amps or volts • 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 1 66.85 l
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 cztension, pe panel
Owner signature: Date: A. Fec for branch circuits with
• ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits p
-� .8
without service or feeder fee, 1 46 -85 465 2
Contact name: first branch circuit
Address: Each add' l branch circuit 3 6.65 19.95 2
Miseellaneousiservice or feeder not included)
City /State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax: ; ( ) Reconnect only 66.85 2
1 E-mail: Pump or irrigation circle 53.40 2
. ' CONTRACTOR • . Sign or outline lighting 53.40 2
Signal cart uit(s)
Business name: OREGON ELECTRIC limited -
energy panel, alteration, ation, or
Address: 1010 SE 11 AVE extension Describe: Page 2 2
City /State/ZIP: PORTLAND OR 97214 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 234-9900 Fax: (503) 535 - 2763
Investi per hour (1 hr ruin) 62.50
CCB Lic.: 203 Electrical Lie.: 26 - 95C Suprv. Lie.: 4549S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, reci .4 - Nc ` S;lj,� Subtotal: 66.80
Print name: RICHARD MCELLIOTT Date: 4-1 - 0 9 Plan review (25% of permit tee)-
State surcharge (12% of permit fee): 8.01
Authorized signature: TOTAL PERMIT FEE: 74.81
Print name: RICHARD MCELLIOTT Date; 44-09 This penult application capirra it's permit Is not obtained within 150
days after it has been accepted as complete.
• Number of allowed per permit.
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