Permit II CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit #: ELC2012 -00214
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/13/2012
Parcel: 2S103DA02201
Jurisdiction: Tigard
Site address: 10975 SW PARK ST
Project: Bank of New York Mellon Subdivision: DERRY -DELL NO.2 Lot: 23
Project Description: (5) branch circuits for electrical repairs identified under electrical reconnect permit, ELC2012- 00205.
Contractor: ALL PRO ELECTRIC INC Owner: BANK OF NEW YORK MELLON, THE TR
PO BOX 280 BY RECONTRUST COMPANY
6327 -C SW CAPITOL HWY 400 NATIONAL WAY
PORTLAND, OR 97239 SIMI VALLEY, CA 93065
PHONE: 503 - 246 -0361 PHONE:
FAX: 503 - 246 -0406
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo /Purchase 04 /13/2012 $85.86
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/13/2012 $10.30
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 ugh OA7i� -r r 1 - 0. You obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. J \ ' % � Permittee Signature: !fir '
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' /0 (61--4 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.
Apr 11 12 02:31 p All Pro Electric 503.246.0406 p.1
Electrical Permit Application anent Ft.ilt O[ I I('[ i 'I ()NI., .1
Iii . Ci ty of Tigard �� d/ Permit No.: Ehe /a..dp
a
13125 SW Hall Blvd., Tigard, OR 97 r �
Phone: 503.718.2439 Fax: 503. rLQ Ppa�e Rev
tw Other Permit:
T 1 c A n Inspection Line: 503.639.4175,` \\. pate Resdy/sy: citric B sec gage 2 for
Internet www.tigard-or.gov TYPE OF WORK O
� Notified/Method: Supplemental Information
[ � � z �� 0(':cp.' 7 PLAN REVIEW .
❑ New construction AdditioIl/alteratio lag lent Please check all that apply (submit b sets of plans Winans checked below):
❑ Demolition �•+' Vv � ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ �: .((��\* t where the available Paull rtent ❑ Marinas and boatyards.
CATEGORY OF CON I exceeds 10,000 amen at 150 votes or ❑ Floating buildings.
$ 1 - and 2 - family dwelling ❑ CommereiaUindustrial I less to mend, or exceeds 14,000 ❑ Commercial-use agricultlaal
❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger sgharately derived system
l ❑ Addition of new motor load of ❑ Job no.: no.: I t2. V1b I Job site address: I Don 5 s w ?am/. & . 100HP or moue. ReOe aary•
❑ Six or more residel snits. ❑ Recreational vehicle parka.
: Cityi Stal'CIZIP: T ['Health-care facilities. ❑ Supply voltage for more than
tivDl. ott-
❑ Hazardous locations. 600 volts mminai.
SuitelbldgJapt. no.: '&ject name , ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Drxriptrm I Qty. I r«. I Total I -
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 14
Ea. add' 1 500 sq. R or portion 33.92 l
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Wit,. met ' 't�7tC�P 1 ► Q. residential (with S Limited energy, multi-family
sq. 75.00 2
above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
601 amps to LOCO amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
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 extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT • ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each branch circuit
Business name: a Fee for branch circuits wirhow
service or feeder fee, furs[ 1 56.18 510.1$ z
Contact name: branch circuit
Each add'I branch circuit 4 7.42 Vt. 1 l 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
^
Business name: Ii. p � e �(Q i � � panel, or extension. Page 2 2
� Each additional inspection over allowable in any of the above
Address: �� SW l "o L , } . S-C., L -vo GS D Additional inspection (I hr min) 66.25/ hr
City/State/ZIP: ApOeC ') • b Q cr ., I n du stigatiorrh (t hr min) 66.251 hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( S ) aliS b ato ` Fax: ( ) 24.1 t FICA0 Inspections for which no Pte is 90.001 hr
CCB Lie.: 1% \t %� ] Electrical Lic.: i�t14 a Suprv. Lie.: 4160 6� h ELECTRICAL PERMIT FEES
/I Subtotal: QSj•810
Suprv. Electrician signature, required: 7 Plan review (25% of permit fee):
Print name: [/7 l■S `PbOL I Date: 4f« I 12 Slate surcharge (12% ofpermit fee): lb . go Authorized signature: TOTAL PERMIT FEE: C hit • fy1. f
This permit application e tion expir if a permit Is not obtained within 180
Print name: I Date: • days after it has been accepted as complete.
Number of inspeclitms allowed per permit IV
r \ auildingiremitsELC- PamitApp.doc two to 410- 4615t(1 1/O5/COM/WEB