Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
Permit 0: ELC2009 -00474
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/10/2009
Parcel: 2S110AA01200
Jurisdiction: Tigard
Site address: 14300 SW PACIFIC HWY
Subdivision: Lot: 0
Project: Bywater Denture Center
Project Description: (4) branch circuits for replacement of (3) RTUs and additional circuit.
Owner: FEES
CAIN, JAMES L Quantity Description Date Amount
27775 NW WILLIAMS CANYON RD
GASTON, OR 97119 4 crt Branch Circuits 09/10/2009 $66.80
wo /Purchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 09/10/2009 $8.02
Electrical
Contractor:
ACCURATE ELECTRIC
P.O. BOX 873425
VANCOUVER, WA 98687
PHONE: 360 -944 -7001
FAX: 360 -944 -7013
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
Total $74.82
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 R 952 - 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
issued By: Permittee Signature: OA /5 ee77U.' V
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 an Inspection that business day.
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.
.SEP -09 -2009 09:36 Accur IA c. 3609947013 P.001/002
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City of Tigard Received
D , i , e n 3 y : ? /6 / J f Permit No.: 6 y 7y
II 411 13125 SW Hall Blvd., Tigard, OR 97223 S E P 09 2009 Plan Revi
12 Phone: 503.639A171 Fax 503.598.1960 Date/By: • Other Permit:
TIGARD
Inspection Line: 503.639.4175 Date Ready/By: 10 See Page 2 for
Internet: www.tigard CITY OF TIGARD Notified/Method: . r/6 Supplemental Information
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'':',..!:,4k0..:.1:;K'Zi':;"-- t ,, ...?,, ,.. : ,.1,..,•'... , ....q,; , , ,: 14 - , % , 5 , ; , , •?0. : , ,.. it ,; wf . rptw .,r.i5.;;, ,.,,.,....
El New construction Er Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/ftems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition El Other: where the available fault current 0 Marinas and boatyards.
l'5. ...:0-:''A'.•.:A''':':',,,','.'.::::,•:;...•,:..1'.:.,':•,:•,::...;4:.:,..,,=...;,. !
.,; exceeds 10.000 amps at 150 volts or 13 Floating buildings.
i'::'W.'',' : - .::: %::".'; .. ;i1t,!.11,..!•,#Y49!,, , , - H : :., . :-..!....
less to ground, or exceeds 14,000 0 Conunercial agricultural
El i - and 2-family dwelling la Commercial/industrial 0 Accessory building stops for all other installations. buildings.
El Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived system.
40:::****0.0:0* 0 Addition of new motor load of 0
100HP or more. occupancy.
Job no.: i (190 1 Job site address: 11.4300 31,0 Pa( i f, i4 tAiy
0 SiX or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: T icrci i 0 v 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: P141 4. Denjuvr. W Service or feeder 600 Min or more.
. L , ,.•Vr.::;•±.9";.:44E":SiDEPt1.00:'.....g.,'::.::.;:::'..:'
Cross street/directions to job site: ..464 - /9/4.2_, en)/ C At Desettdon I Qty. L Fee, I Tow 1 •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft or portion 33.40 1
Tax map/parcel no.:
Limited energy, residential
....: iiitaujill,:i,b.i..:*ijiiie./?,:::;:,N11,:. . ..:;:,.:. i?.f.w. ( a sq. (1.) 75.00 2
,....: , .. ,. , .,. ; ftt r . ... . , ..::..,;;, i .,.....;:.. ;... :;-: : r ' , r 1 ":V . .:
Limited energy, multi-family
Tr.MOVC. 21 12.,-_
Pt CLC I. ( . re
RT U 1 5 sidential (with above sq. R.) 75.00 2
Services or feeders Installation, alteration, and/or relocation
Ct. rci j 1 200 amps or less I I 80.30 I I 2
':.•;:'; 1:;: 201 amps to 400 am Ps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 I 1
Owner Installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 [ 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps , 133.75 2
Branch circuits - new, alteration, or extension, per panel _
Owner signature: Date: A. Fee for branch circuits with
a:Otii;i10:41sti)::: - above service or feeder fee,
6.65 2
each branch circuit
Business name: ,i CAI Ai B. Fee for branch circuits
without service or feeder fee,
46.85 1-14 2
Contact name: A 7 75 A./Al C/5 Ai / first branch circuit
Address: G-e9S7 6'7 77&? Each add'I branch circuit - 5 6.65 iq.q$ 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
z ' .............. :.. -',:::,,:,, : ....":;- .5 .,;::: : ;A:, cortR*CTogi:.?:, . , ,......,:..z.,...' ,-.;:,... Sign or outline lighting 5340 2
Signal circuit(s) or limited-
Business name: Accurate Electric, Inc. energy panel, alteration, or
Address: P.O. Box 873425 extension. Describe: Page 2 2
City/State/ZIP: Vancouver, Wa. 98687 Each additional inspection over allowable In any of the above
Per inspection 62.50
Phone: (360) 944-7001 Fax: (360) 944-7013
Investigation vestigation per hour (I hr min) 62.50
4/CB Lic.: 158875 Electrical Lic.: 37-1029C Suprv. Lie.: 5094S Industrial plant per hour 73.75
Suprv. Electrician signature, required: P16 EL
)
7(44 . :. :. : ,.:,, ::',,...:::-ECTRICAI, PERMIT FER5.:',:.
Subtotal: (sty .8(
Plan review (25% of permit fee): ---.
Print name: Ken Sweo Date:
I State surcharge (12% of permit fee): e3-c?.?-
Authorized signature: alai TOTAL PERMIT FEE: '14 , es 2, 4••••'"
This permit application expires if a permit is not obtained within 180
Print name: Debi Watts Date: days after it has been accepted as complete.
" Number of inspections allowed per permit.
1:•Building•Permits.ELC-PerreitApp.doc 05 440-4615T( I 1.05,COKWEB