Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00728
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2011
Parcel: 1 S136CD00101
Jurisdiction: Tigard
Site address: 11675 SW PACIFIC HWY
Project: West Coast Bank Subdivision: 2006 -016 PARTITION PLAT Lot: 3
Project Description: TI
Contractor: IES COMMERCIAL INC Owner: WILSAL LLC
16135 SW 74TH AVE 834 SW ST CLAIR ST
TIGARD, OR 97224 PORTLAND, OR 97205
PHONE: 503 - 648 -1900 PHONE:
FAX: 503 - 670 -9572
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo /Purchase 12/29/2011 $122.96
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/29/2011 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 co of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
_
Issued By: C� �� _� _ 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' 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.
12/28/2011 13:2 5036709572 IES COMMERCIAL INC PAGE 01/02
Electrical Permit A licatio ii j ‘
.05) FOR OFF10E 11S1f, ONIN
'Received - gar Permit No.:
City of Tigard , ri.%\\ DaterBy: , ' ••2111Ir - . a a • •
I Phonc 503,7
R " 13125 SW I-Tall Blvd., Tigard, OR 97223 c 1, .., ,....‘ Plan Review Other Permit:
: 14 ; i 18,2439 FaX: 503,598-* c .,..t i , s, V Dnic/13yi
Inspection Lin: 503.639,4175 C \
i N" A 40 Dat e
e Rndy/By: AMA; iZ See Page 7 far
1 I • (1.A I. o ' I .-J1' SupplcmcidnI Information
Internet; www.tigard-or.gov OV OW Not ified/lvtethodt --.—
-.. ... .... . .. . ! ... , i ., .. .... „ ..:. , .,•,„li ....,., „ . ri,,,i„, ,,,,....tio‘,.i.ir
:..: .:: .7: ':';i:..';:':'7'2.'":**.' '"..iiiiii .'6 I • lc. q • ....:! ,..,.: . , . .. ,.. : .. . - . ,:: . ..,, ...•::::. y , • :I': .!: .• .,. .!.. •. . i.H.KPCN4, T
Pie= CilCCk eTthat apply (submtt A acts of plans w/items checked below):
ID New construction El Addition/altei ion/replacement 0 service or feeder 40D amps or more 0 Building over three storie,
0 Demolition D Other: where the available flint current r:i Marinns and bootynrds.
•
;','''' ,'..:' 1.l.; l:'::::.i.: " :'. ‘1 ;' :• ''" exceeds 10,000 amps at 150 volts or lin Floating buildino, .
'' : ':.:..,...,,,,.... .....,-- . ,':•••••,.. lass to ground, or exceeds 14,000 0 Commercial-use agricultural
El 1- and 2 dwelling IS] Commercial/industrial 0 Accessory building amps for another instantlions. buildings,
0 Multi 0 Master builder 0 Other: 0 Fire pump. installation (4'75 4'75 KVA Of
larger separately derived system,
g ,.:,.. 4 17014.. -.....: . : ..:. .:' . :, . ,.... 0 Addition of now niolor load of El "N, "13", "1-r. "1.3",
100BP or more. occupancy,
Job no.: 311420031 Job sito address: 11675 SW Pacific Hwy ID Six or more residential units. El Recreational vehicle perks.
El Hcalth-eare fncilitics. El Supply voltage for more don
City/State/ZIP: Tigard, OR 97223 — 0 lanzirdous locations. 500 volts nominal.
Suite/bldg./apt. no.: Project name: West Coast Bank 0 Service or feeder 600 amps or more,
Cross street/directions to job site: Doerlpthin I_ I . Fee. total ^
— New residential single- or multi-family dwelling unit.
Includes attached garage. .
— _
Subdivision: Lot no.: 1,000 sq. It or less 168.54 4
— -- En, adcrl 500 se, .11. or portion 33,92 1
Tax map/parcel no,: Limited energy, residential 75.00 2
i:'..:-::,Ii!iii':tii:: !i:!:,il;!i!`.:i.%,,rrit§dorti.iildj4::.:?wiikiji i..yhi,.' ; ...: , '.,., .,;::,.:,... _iwith ra>mL,,,____......_,—
' Limited energy, multi 75,00 2
Remodel residential wffli iilL ).
--"---------- Services or feeders installationoltera ion, and/or relocation
200 snips or less 100,70 2
in :i iTiOPEBTY OWl'41:111:j. il..;!:n .:,.:::. . .;(.::.., ,:.I..' El , TF,NANT:• ,, , , t ,, . ::. , ,..,!:.. . 201 amps to 400 amps 133.56 2
Nam — 401 amps to 600 amps
200.34
601 amps to 1,000 amps
301,04 2
2
Address: over 1,000 amps or volts 552.26 2
Temporary services or feeders installation. alteration, and/or
City/State/ZIP: relocation .
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 snips to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not _
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701,
Branch circuits — new, alteration, or catcnsion.zes panel
Owner signature: Date: A. Fee for branch circuits with
.:: .i..! . -,...; :::.: .:' . APELI ' AN. .:': . .. ,L ' . 'T!('"." ..:: ., : • . . , , . .!, ..,,' 7,42 2
• ,
each branch circuit
Business name: B, Fee for branch circuit without
— service nr feeder fee, first 1 56,18
56.18 2
Contact name: Jorge Algeciras branch circuit
— . -- Each add'I branch circuit 9 7,42 66.78 2
Address; 16135 SW 74 Ave. — Miscellaneous (service or feeder not included)
— Each manufactured nr modular
City/State/ZIP: Tigard, OR 97224 dwelling, service and/or feeder 67,84 2
_
—
Phone: (503) 648-1900 Fax: ; (503) 670-9572 Reconnect only
67.84 2
Pump or irrigation circle 67.84 2
IS-mail:
Sign or outline lighting 67.84 2
'.Y7 ',;?:,;:7ii.7:::,:.;C:.. i. ''.7 •; . • ..::"::. "7: : ' .• i ..! • 7• Si
l . ' 1 ini r gY
Signal circui or . -cric
panel, alteration, or extension, Page 2 2
Business name: IES Commercial, Inc. Each additional inspection over allowable in any of the above
Address: 16135 SW 74 Ave. Additional inspection (1 hr min) 66.25/ hr
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—
• Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Tigard, OR 97224
Industrial plant (1 lir min) 78,18/ hr
Phone: (503) 648 Fax: (503) 670 inspections for which no fee is 90,00/ iir
- specifically listed (4 hr min)
CCB Lic.: 1824.52 Electrical Lie.: C448 Suprv. tic .: 4911S 7. FT." i. ',:;',::: ,,;!;
......_. —
, .
Suprv. Electrician signature, required: ... _ Subtotal: 122.96
A , Plan review (25% of permit fee):
Print name: Corey Baysinger , ' Date: 12 State surcharge (12% of pcmlit fee): 14.76
.________--------------
— — TOTAL PERMIT FEE: 137.72
Authorized signature: This permit applitntion expires if n permit is not obtained within 180
days after it has been accepted us comrade.
—
Print name: Date: * Number of inspcatiom allowed per permit,
rukafi omit o 445.451 5T( 1 li06/COM/W1213