Permit 1,, 11 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Per COMMUNITY ELC2012 -00013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/11/2012
Parcel: 2S101AD03200
Jurisdiction: Tigard
Site address: 12909 SW 68TH PKWY 290
Project: Champion Hardware Subdivision: WEST PORTLAND HEIGHTS Lot: 9 -25, PT
Project Description: (2) branch circuits for TI
Contractor: BACHOFNER ELECTRIC LLC Owner: PACIFIC REALTY ASSOCIATES
12031 NE MARX ST ATTN: N PIVEN
PORTLAND, OR 97220 15350 SE SEQUOIA PKWY #300
PORTLAND, OR 97224
PHONE: 503 - 327 -8872 PHONE:
FAX: 503 - 327 -8869
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 01/11/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 01/11/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
This permit is issue* b'ect 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 ac.•rdance wit - pproved 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. ATTE ION: Oregon I- - qu' - you to follow the rules adopted by the Oregon Utilit L. • • - ion enter. Those rules are set forth in OAR
952-001-001i thropgh OAR 95 i r -04 % I ou may obtain a copy of the rules or direct questions to OUI3 ca • = ,a .232.1987 or 1.800.3 '.2344.
Issued B \..._ • / 0 • Permittee Signal e: �� i� r ' £" «
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' , �, .. 1mril /` 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.
Jan 12 12 12:24p Bachofner Electric 503 3278869 p. 2
Electrical Permit Applicatio ti V CENEt) FOR OFFICE USE ON Y , .
City t� Of Tigard' Received
Date•13v: / ./y A i�
lir //' Permit No.: ea��GtiY
q 1312.5 SW Hall Blvd., Tigard, OR 97223 n 11 '1 1 2 \ �
0 Platt Review
' Phone: 503.718 2439 Fax: 503.598.1960J Date BV: Other Permit:
t Inspection Line: 503,639.4175 ^ Date Ready. By: tuns: Bl See rage 2 for
TiGAR1]' Nit OF Notified Method: Supplemental Information
Internet: www.tigard- or.gov 4s 1 t
t
all that apply (submit 2 sets of w /item
❑ New construction ® Addition /alteration /replacement Please check a s checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY f1F CONSTILUCIT0IV
• exceeds 10,000 amps at 150 volts or 0 Floating buildings"
,' " ' - -..' "„ : : -.(; :. ... . .... .. ... . .. less to ground. or exceeds 14,000 ❑ Commercial-use agricultural
❑ I - and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: 0 Fire pump. `tt ❑ Installation of75 KVA or system.
:mgr
gene }' cyst 1. larger separately derived •
JO"B SI TE% INFOORMATIOlsi',:AM) L:OCAT'ION. ". •,;:
. , ...: - ,., . ; ". ,. .... .. .. . , ... . , . ,. 0 Addition of new motor load of ❑ "A° "E" ., 1 -2" "1 _�..
100111' or more. occupancy.
Job no.: 680 Job site address: 12909 SW 68 Parkway Q Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, Oregon 97224 ❑ lteahh - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 290 Project name: Pacific Parkway Center ❑ Service or feeder 600 amps or more.
Cross strcet/directions to job site: SW Hampton and 68 Parkway Description I oar• I Fee. I Tntsi 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. add'I 500 sq. ft. or portion 33.92 l
Tax map /parcel no.: Limited energy, residential 75 UO
, .. �D.ESCRIPTION OF_ 'WOR�[c., -x ,, ,; ,_, '-', , _; : ir.;_ (with above sq. 11.) 2
- Limited energy, multi- family 75.00 2
Cut in receptacles residential (with above sq. ft.)
Services or feeders installation,_ alteration, and/or relocation
200 amps or less 100,70 2
201 amps to 400 amps 133.56 -
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 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 t
201 amps 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
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: _ _ , Date: A. Fee for branch circuits with
above service or feeder fee,
1" CONTACrf"ERSON' % _ ''' 7.42 each branch circuit 2
Business name: Bachofner Electric LLC B. Fee for branch circuits without
service or (ceder fcc, first 1 56.18 56.18
Contact name: Rob Bachofner branch circuit
Each add'l branch circuit 1 7.42 7.42 2
Address: 12031 NE Marx St. Miscellaneous (service or feeder not included)
Each manufactured or modular 67 84
City /State /ZIP: Portland, Oregon 97220 dwelling, service and /or feeder
Phone: (503) 327 -8872 Fax: : (503) 327 -8869 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: rbachofner@ bachelectric.com Sign or outline lighting 67.84 2
- ,,..
' ` ''' "', '"CONTRACTOR; ;'..;<' Signal circuit(s) or limited - energy
mess name: Bachofner Electric LLC panel. alteration, or extension- Page 2 2
Each additional inspection over allowable in any of the above
Address: 12031 NE marx St. Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City /State /ZIP: Portland, Oregon 97220
Industrial plant (1 hr tam) 75.18 / hr
Phone: (503) 327 -8872 Fax: (503) 327 - 8869 Inspections liar which no fee is 90.00 / hr
specifically listed (1•i hr min)
CCB laic.: 187062 Electrical Lie.: 0514 Suprv, Lie.: 5625S EL CTR.(CAL;...PERMIT FEES = -;t ",... ' ,'`'.
Subtotal: 63.60
Suprv. Electrician signature, required: "- s:;-< '' - ' Plan review (25% of permit fee):
Print name: Troy Connors Date: 1 - - State surcharge (12% of pennit fee): 7.63
TOTAL PERMIT FEE: 71.23
Authorized signature: /
t' Vein, tt.! % t — �.,,T if This permit applicat expires a permit is not obtained within 181
days after it has been accepted as complete.
Print name: Rob Bachofner Date: 1 -11 -12 * Number or inspections allowed per permit.
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