Permit P rt CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00094
Date Issued: 02/09/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S102AB02800
Jurisdiction: Tigard
Site address: 12485 SW MAIN ST
Project: Tyler's Automotive Subdivision:E LECTRIC ADDITION TO TIGARDVILLE Lot: PTS 1 -9
Project Description: (3) branch circuits for lighting and electrical.
Contractor: MCCOY ELECTRIC CO INC Owner: THOMPSON, DENNIS C
2014 SE 9TH AVE 9295 SW ELECTRIC ST
PORTLAND, OR 97214 TIGARD, OR 97223
PHONE: 503 - 234 -7521 PHONE:
FAX: 503 - 234 -9473
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 02/09/2012 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/09/2012 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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. AT TION: • , .on law requires you to follow the rules adopted by the Oregon Utility Notification Center: Those rules are set forth in OAR
952 -001- 10 through OAR :5 :41 - You may obtain a copy of the rules or direct questions to OUNC by calline i . 2.1987 or 1.800.3 , .2344.
/
Issued y: ����i_�. Permittee Signature: \ 4 : 4111'
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
Leiti 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.
Feb. 8. 2012 2: 05PM VcCoy Electric Co. No. 8030 P. 1
Electrical Permit Applica OR OFF ICE t isb 0�'1.1'
Y t ' k-. , G , • Rectiv ed 1-61",04,01,-61V579
GiCy of Tigard taiell g /, J Permit No,:
t — v 13125 SW Hall Blvd.. Tigard, OR 971213 R — 8 2012 plan Review Other Permit:
Phone: 503.718,2439 Fax: 503.50.1960 Date/By:
Inspection Line: 503.639.4175 Dare ReadyBy: mri,: iii Ste Pope 2for
TIGARD C ITY OF TIGA ID Notified/Method: Supplemental Information
Internet: vvww- tigard•ar.gov , ,
w'< 'A ,fir h +;k: s }Wvi . . . p ; y �. � .
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,.719 �"�'. � ..,�.,,_��. "} < - '',1�: - n hh ,�..`y��',�` -r . �:, . c ��.:. ;� ;t . VJ. P'� �r!T� %i; �•�i �-,ip,..,.�. .��� i...., . w c. ��'5
:. 3i '.�• , :: i , .,::•.i �:. + .K ;: 5 , '.i.ti .. ....... .. .. ti` ''[(� a;•v5 „ ✓..,�"vpgm':.i . ��, - �..� ..; b; ”.
LI New construction 0 Addition/alteration/replacement Please check all that apply submit 2 sets of plans w /iremc checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: _ where the available fault current ❑ Marinas and boatyards.
i i
s a � � ' ' "r " �QO G ih s, '
i
;;'; ;,p
, �c. ��i .: E, ` " exceeds 10.000 amps at 150 volts or ❑ Floating buildings-
;:_;':-'1'i:1;% - "p :• `i" (y ' " a � f`
t i FQ „ ° -... 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: VA or
3 'r r•r:. Fire
nay sysle se derived system.
Fi Install
❑Em m larger
:r .. x `' „ SOB L Ito TiG A'D;• .PAT �Tia�, `sv ,. : ' iono fnewmc of
. . i:, .....,��>�,:. �M�,,.... ...,- �..�,. T Qtr,, ' ❑Add lorloado ❑ ,
Job no.: D6657 lob site address: 12485 SW MAIN ST I9OHP or more. occupancy.
Cl Six or more residential units, 0 Recreational vehicle parks.
City /State /ZIP: TIGARD, OR 97223 - 6109 ❑ Health - care facilities. ❑ Supply voltage for more than
0hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: TYLER'S AUTOMOTIVE ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: r »cecdprtnn l Qir• Per- Total l .
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1000 sq. ft. or less 168.54 4
Ea, add'I 500 sq. ft. or portion 33,92
Tax map/parcel no.; Limited energy, residential
;,1y :` )r ON: OF WOY1 ,. .. , i , (with above sq. ft.) 75.00 2 •
Limited energy, multi- family 75.00 2
Electrical and Lighting 'Work - 3 branch ckts _ residential (with above sq. ft.) _
Services or feeders installatlon,•alteration, and/or relocation
200 amps or less 100.70 2
.M
-
0 • OpEAT O /N r i ;
:' n ; TEN A NT :::;: • 201 amps to 400 amps 133.56 2
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 I 552.26 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and /or
Y relocation
I Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
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 ex_ tension, per panel
Owner signature: _ Date: A. Fee for branch circuits with
' ' . ' : ' , 0 APPLICANT : ❑ .. CONV'TAC)C PERSON ...maul circuit feeder
above fbe , 7A2 2
e ach _
Business name: B. Pee for branch circuits 'without j `
service or feeder fee, first 56 -18 ` / 2
1
Contact name: branch circuit 1
— Each add'i branch Circuit 91 7.42 I 2
Address: ,Miscellaneous (service or feeder not included)
Each manufactured or modular
City /State /ZIP: 67.84 2
_ dwelling, service and/or feeder
Phone: ( ) Fax: ; ( ) Reconnect only 67.8 2
Pump or irrigation Circle 67,84 2
_
E -moll: Sign or outline lighting 67.84 2
„
RACTOR,.. , .. . :� . .
. r:::::' ..,... . _: ".... Cbly'I' .. - -'. , ,, ,r Signal circuit(s) or limited-energy
Business name: MCCOY ELECTRIC panel, alteration, or extension, Page 2 2
Each additional inspection over allowable in al ,y of the above
Address: 2014 SE 9 AVENUE Additional inspection (1 hr min) 66.25/ hr
— City /State /ZIP: PORTLAND, OR 97214 lnvcstigauon (I In m 66,25/ hr
min) 66,251
Industrial plant (1 hr min) 78,18/ hr
Phone: 503 234 -7521 Fax: Inspections for which no fee is
Phone: ( 503) ( 503 ) 234 -9473 90.00/ hr
specifical[y listed (�hrmin) _
CCB Lie.: 8277 IElectrical Lie.: 26 -82C Suprv. Lie.: 5208S °`l"• • ELECTRICALPERM1T ..'';,'''<. ., .
Suprv. Electrician signature, required: Snbtot is rT 1 , 02.
Plan review (25 %ofpcmlit fee):
•
— — State surchar a 12/0 of permit fee). _ _
Print name: ZACK ARMS 'KONG Date: 2-8-12 B ( _ P )= `CJ r `Jp�.
TOTAL PERMIT FEE: r9 "3U
Authorized signatur This permit application expires if a permit is not obtained within 18L' gD
Print name: Date: days atler it has been accepted AS complete. U{L�
Nu mber of inspections allowed per permit.
13fluildi Ag \ Pt MIN \ SLC- PermirApp.doc o5ioui10 440,46157(11105/COh00n