Permit •
rip CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00197
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2012
Parcel: 2S 101 DCO3800
Jurisdiction: Tigard
Site address: 7180 SW SANDBURG ST 100
Project: Biojet Inc Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: (2) branch circuits for TI
Contractor: CURRENT ELECTRICAL CONST CO Owner: MCCORMACK PROPERTIES LP
PO BOX 19652 7190 SW SANDBURG ST
PORTLAND, OR 97280 TIGARD, OR 97223
PHONE: 503 - 245 - 5997 PHONE: 503 624 -2090
FAX: 503 - 245 -2919
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 04/06/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/06/2012 $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 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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: ' Permittee Signature: 1A" �/' _I 9' —7eA _
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 603.639.4176 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.
APR/04/2012/ 09:46 AM FAX No. P.002/002
Electrical Permit Application ) 1 c) FOR OFFICE lISF. ON IV
City of Tigard A4c)‘'A
Datefft ; 4 l imy Permit No- . (..eog -"/ / '""
11.___• 13125 SW Hall Blvd.. Tigard. 0 I 1.% Plan Rovie
: I ' Phone: 503.718.2439 Fax: 503398.1960 - ....,c‘ D . Other Permiqgu/W/ _40 ,
I• 1 G A R D Inspection Line: 503.639.4175 .ct4sXw Date Ready/By; El See Page 2 for
T:43C ' M
Internet wWW.tigard-or.gov eS,‘`-' ASN.•- Notified/Method; us Supplemental Information
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TYPE. OF Avois PLAB
f ' - - - • • • • • • '' • • ' REVIEW . . .. .... .., . . :... ...
• '
.;...:•:. ' '''... : • :•:: r ' .... ' ' ':.:: : : • ',:-.: , .. L \k.s . : .. .:.. ,..:....," .• : ..:.. .... :: •.• .....:.::...:......I :. •':•. -:. 'C. ••, ',..-1:. .:
. .. . . .. ... . . . . . .. . ... .
. . . .. .
0 New construction • • •
EA ttuclittOnialteratdanCeragrit Please check all that apply (submit 2 sets of plans wine= checked below):
D Servize or feeder 400 amps or more CI Building over three stories.
El Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
..: .' '.. ••••••••• ' • : '.g •• OF CONSTRUCTION i.• • •• ' • ' • . .: • • • •::: •• • ' • • exceeds 10.000 amps at 150 vela or ID Floating buildings. • lam to grouad, az exceeds 14,000 C1Cominacial-use agricultural
D 1- and 2-family dwelling 0 Commercialimdustrial 0 Accessory building amps fx all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
. . . 0 Eraergeaey system. larger sepamteb derived system.
;','.. ,: . :.,:. :: 401E 81TE: tIFORP44TIONAND W. 10N : ........:',..: : :• :::•...::. '-. ...."
CI Ad4itioa of new motor load of
Job no.: Al2121 Job site address: 7180 SW SANDBURG, STE. 100 10013P or more. occupancy.
El six or more resideatial traits. 0 Recreational vehicle parks.
City/State/2TP: TIGARD, OR 01•Icaltbame facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal
liklitite/bIdgiapt. no.: 100 I Project name: BIOJECT 0 Service or feeder 600 amps or more.
- • .........1•• 7 ::':::::,:• .::•'.• FEE SCHEDULE ..'":.:.".:,.':'. '-: r :1!:'•.'.' : :. .
Cross street/directions to job site: Due r1Pdan I OM I Pet I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft, or less 168.54 4
Ea. addl 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
75.00 2
. ,.: ... ::.. •,••••• '.., • ..: . .... ,': • 1' - 'DT.SCOPTION CIF.. wortit. . • : - :. •• - r:• .• " •••••••• '. (with above sq. ft.)
-" • • limited energy, multi-family
ADD CIRCUITS residential (vrith above aq. ft) 75.00 2
Services or feeders installation, alinration, and/or relocation
200 amps or ims 100.70 2
:.' ........ ...:0 ::PROPERT.Y..owNEak, : .• : .1 ': ... .:... ,:.: ' j... . TENANT . : '...:,........ . • : i .... , : 201 amps to 400 amps 133.56 2
.
Name: • 401 amps to 600 amps 20034 2
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/Z1P: relocation
Phone: ( ) Fax: ( ) 200 amps or less 5936 I 1
Owner installation: This installation is being made on property that I own which is not 2011111)s 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: APPLICANT ' . 7 .
:' .H.;:..:.I.. ... . E.1 CONTACT PERSON ' . :: above service or feeder fee, 7.42 2
each bnmch circuit
Business name: H. Fee for branch circuits Without
- service or feeder fee, first 1 56.18
56.1 8 2
Contact name: bunch circuit
Each adr.P1 branch circuit I 7.42 7.42 2
Address: Miscellaneous (service or feeder not Included)
Poch manufactured or modular
City/State/ZIP:
dwelling, service and/or feeder 67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
. . Sign or outline lighting 67.84 2
• .. • . • •. • •.,•:.: • ''......S.:••• ' cony:Atm • ' : •• .. • : . .
Signal circuit(s) or limited-energy
Business name: CURRENT ELECTRICAL panel. altendion, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: PO BOX 1%52 Additional inspection (I hr min) 6625/ hr
Investigation (1 hr min) 6625/ hr
City/State/ZIP: PORTLAND, OR 97280
Industrial _ plant (1 hr min) 78.18/hr
one: (503) 245-5997
CCB Lie.: 46994 it' Electrical Lic.: Fax wc - l ( C 51)3) 245- Su 9 p 1 :. Lic.: 52323
0-6 _ Inspections for which no fee is
' specifically listed eh hr min)
./ 90.00/ hr
• '.. . •• - .. •• • • •ELECTRICAL 'PERMIT FEES • .. • ... . • •
, 4vdhs- Subtotal: 63.60
Suprv. Electrician signature, required:
-- • Plan review (25% of permit fee):
Print name: JASON JACOBUCCI Date: 04104/12 State surcharge (12% of permit fee); 7.63 _.
1.-••'"
TOTAL PERMIT FEE; 71.23
Authorized signature:
This permit applicadon aspires If a permit is eat Obiliiiit8 Within 180
•
days after It has been accepted
Print name. DAVID THOMPSON Date. 04/04/12 • Numba of inspecdons allowed per permit as complete.
LABuilermetrogiMELC•PermitApp.dna 07101110 440-46151111/05ICOMME13