Permit I.
CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT
Permit #: ELC2012 -00303
T i G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/22/2012
Parcel: 25101 BC00201
Jurisdiction: TIGARD
Site address: 8255 SW HUNZIKER RD 201
Project: Prolink Solutions Subdivision: CROW PARK 217 Lot: 4
Project Description: (3) branch circuits for TI. 6/11/12, reprinted to correct project name.
Contractor: RELIANT ELECTRIC OF OREGON LLC Owner: JOHANSON TRANSPORTATION SERVICE
20200 SE OLDENBURG LN 5583 E OLIVE AVE
SANDY, OR 97055 FRESNO, CA 93727
PHONE: 503 - 701 -4562 PHONE:
FAX: 503 - 668 -4190
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 05/22/2012 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/22/2012 $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 issue 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 ac ance with appro : • 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 law req 're ou to follow the rules adopted by the Oregon Utility Notification r. Those ,rules are set forth in OAR
952- 001 -001 throw h OAR 952- 001 -00 •. You , obtain a copy of the rules or direct questions to OUNC by 87 or 1.800.332.234.
�l
Issued By: / / �' k / Permittee Sig lure:
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 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.
CITY OF TIGARD ELECTRICAL PERMIT
'- COMMUNITY DEVELOPMENT Permit #: ELC2012 -00303
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/22/2012
Parcel: 25101 BC00201
Jurisdiction: TIGARD
Site address: 8255 SW HUNZIKER RD 201
Project: Johanson Trucking Subdivision: CROW PARK 217 Lot: 4
Project Description: (3) branch circuits for TI
Contractor: RELIANT ELECTRIC OF OREGON LLC Owner: JOHANSON TRANSPORTATION SERVICE
20200 SE OLDENBURG LN 5583 E OLIVE AVE
SANDY, OR 97055 FRESNO, CA 93727
PHONE: 503 -701 -4562 PHONE:
FAX: 503 - 668 -4190
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 05/22/2012 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/22/2012 $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. 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 2 001 -00 . You may a co y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .� I Permittee Signature: �r� LJ 6411 0
/ 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 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.
•
RECEIVE
Si
(0
•
Electrical Permit Application MAY 2 1 2012 a i i \ l'
City of Tigard vO d C L K P erm i t N o. :6 . b I a a )
N_
Delta 13125 SW Hall Blvd, Tigard, OR 97223 CITY OF TIGAR f
u Phone: 503.718.2439 Fa>Z: 503.598.1 / ` Pe : aOlot' ,
• i e . n ; I , Lapoceion Linc: 503.619.4175 IJILDI�iG DI 'i / In � IO . neoer/or
Internet: www.tigard- or.guv Notifiedmtemad: ElallIEEIEEMII
TYPE OF WORK PLAN REVIEW
El New construction a Addition/altcration/replaccment Plena chair all that apply (submit 2 tan of plans w/items checked beltrw ).
Q Demolition
0 Service or feeder 400 amps or more 0 Building ova three stories.
❑ Other: where the available ain't current 0 Marhw, and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps a1 150 volts or ❑ Floating buildings.
lee to orma, or exceeds (4,000 ❑ Comateraial -ate agricultural
❑ 1- and 2- family dwelling 0.Commerciallindusnial 0 Accessory building amps for all other installations, buildings.
0 Multi - family 0 Muster builder ❑ Other. O r'ue prunes. Cl Installation of 75 KVA or
Q o new system. tea" B", sepatutely
",' 1.3", system.
JOB SITE INFORMATION AND LOCATION
't ❑Additioa motor load of Q "A ", "8", "1.2 ",`1.3 ",
Jul/ uu.. % . -2 I c)I rub ohs a hlev.so. Q2- ! 1 L �v ' 1001 or more. oer�i+a
Ju san
I��er I r` 0 ais sa mew aceala,diet units, V Remwtlonnl vehicle perW-
Ci /State/Z1P: 9 -7 0 Heal hcare facilities.
ca t i o cv. ❑ Supply voltage for more than
Ti 1 3 O Hersrdoat Incationc. 600 volts nominal.
w�t' bldg. /apt no. Project name: ,5 ka 5 Se , ❑ service or feeder 600 amps or room.
Cross street/direcd T
oru to j'ob site: FEE SCIIC I lrm I Toni 1 •
New residential tingle• or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: ix) sq. ft. or less 168.54 4
Tax map/parcel n0.: EJt. add'1 500 sq. ft. or portion 33.92 I
Limited energy, residential 75.00 2
DESCRIPTION OP WORK (with above sq. ft,)
4 l
Ere C*ii l__C J ( � fi)'.( 1
Limited energy, tit a sq. 75.00 2
residential (with above sq, ft)
t ^^ Services or feeders Inetaliatlon, alteration, and/or relocation
�' O V 'erne e 200 amps or ims 100.70 2
❑ OPERTY OWNER I ❑ TENANT 201 arena to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
7 601 maps to 1,000 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: ( ) j Fax: ( ) 200 amps or leas 59,36 1
201 amps to 400 amps 125.09 2
. Owner hes0ollatlane This installation Ia being ensile on property that I own which is not 401 amps to 599 amps 1 6N.S1 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteratdon or extension, per panel ■
Owner signature: Date: ,_ A. Fee for branch circuits with
❑ APPLICANT CI CONTACT' PERSON above service or feeder fee, 7,42 2
each hunch circuit
Business name: l D. Fee for branch circuits 'Wiwi n
Q ( Up_ Y (� � �Y�+� service or feeder fee first 56.18 r�p D 2
name: ne: _ t 1 1 I r a• � branch circuit '
Iry Each add'I branch circuit 7.42 I lam, 2
Address: v . O , o ,, LI M/U -- Miscellaneous (service or feeder not iaduded)
City/State/ZIP: / l US5 � dwellm�ser der 67.8 2
� � ✓ Reconnect only 67.84
2 �
Phone: 6 (J n 0 _ 4W � Fax: : €,)/3) ,( _4
E -mail: v Pump or irrigation crcic 67.84 2
1 d-'-'3 , . C ( ) , CC)r - ' Sign or outline lighting - 67.84 - 2
CO t R Signal circuit(s) or limited-energy
Business name: panel, alteration, or extension. - Page 2 2
Each addltloaal Inspection over allowable in any of the above
Address: Additional Inspection (1 hr min) 66.25/ hr
City/State/ZIP: Investigation (1 hr min) . 66.251 hr ,.
jl A 4 - al ma Industrial plant (1 hr min) 78.18/ hr
Phone: ( VP� r f — �!C' i' r . f v Inspections for which no fee is 90.001 hr ,
J specifically listed ('h hr min) _
�(;B Lie.: t :lecdical Lic,: t, ' ► , t 3 ELECTRICAL PERMIT FEES total: •
� � "+ / ► Sub 7 C) ? -
Suprv,1"lectrician si r • aired: ,,,I /�. � Plan review (25% of permit fee): 44
Print name: 4 0 r • 4 ' ' 144 e: J - -). I -(� State surcharge (12%ofpennit fee): g. 5 '
P TOTAL PERMIT FEE; �'}'; 5 5
Authorized signature: ( i i / , .,..t j 0 ) . Mk peemft application expires if a permit ie not obtained within 180
/ days after It has been accepted as complete. e'Llr la
Print name: 0 ge? � y . y `�- l- Date: 5— 2-4 - 2- • Number of inspections allowed per penal. • 14
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