Permit CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: ELC2012 -00305
T [ G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/22/2012
Parcel: 1 S134BC00100
Jurisdiction: Tigard
Site address: 12100 SW SCHOLLS FERRY RD
Project: 7 -11 Store Subdivision: WINDSOR PLACE Lot: 32
Project Description: (2) branch circuits for machine & roof top condensing unit
Contractor: BECK ELECTRIC INC Owner: GREENWAY CENTER LLC
15600 SE FOR MOR CT #B ANA KALAKAUA CENTER
CLACKAMAS, OR 97015 2155 KALAKAUA AVE #602
HONOLULU, HI 96815
PHONE: 503 - 656 -7396 PHONE:
FAX: 503 - 656 -4397
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 05/22/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/22/2012 $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 0 952- 001 -0090. You m �y obbtain copy of the rules or direct questions to OUNC by calling 503.232.1987 or 4T fr 1.800.332.2344. ,/�� A I
Issued By: 1 ' `tl�l Permittee Signature: ✓ P LI CAD 0 •d/
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.
May 221210:43a Beck Electric (503) 656 4397 p.1 5 ei
Electrical Permit Applicatio . 1 1 FOR OFFICE USE ONLY
. i° '' Received
IN City of Tigard DateBy: ,�1 (1�-te Permit e'1�j�/1 6031105'
13125 SW Hall Blvd. Tigard, OR 97223 &J AY 2 2 2U' 1
Plan Review
I ' Phone: 503.718.2439 Fax: 503.598.19 " Date/By: Other Permit:
TIGARD Internet: ww w . : 503 tigar .63g ov 503.639.4175 175 /OII i OF t� ^: Noti etY�tehol , Supplemental B See Page .2 for
lnfotmaeon
Iternet: w•a -or. CITY 1 LZ �
F , :.
Yi, ,1�. .:I• .ua "�' .....;.,. � _._.. .., iI' ..... .,..._... _. - : : :n .t' .':. F*A4- 1r1.�',: . :. " - ;_
❑ New construction XAddition/alteration /replacement P lease check a ll that apply *trait 2 sets or plans wAtems checked below):
0 0 p
0 Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Narinas and boatyards.
__ 61 - t ,If - yiI :, I i T t - . ` - •., - exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
- . ......1:1;'
- - less to ground, or exceeds 14,000 ❑ CcmmerciaFuse agricultural
❑ 1- and 2- family dwelling $ Commercial /industrial ❑ Accessory building amps for all other installations. buildings_
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
_ F _ �«' ❑ Emergency system. larger separately derived system.
it ., i t y s; ; kii. k a ; ,tom, ,�i : :' ('r..,, -r ,.<' ❑ Addition of new molar load of ❑ " A ^, "E "I - 2" "I.3 ",
_ 100HP w more. xcupatcy.
Job no.: Job sit address: ,
[ lO�Cl t� ( !d j'L) �t.I-i - it,,{1 ens Cv 1 !' e. ❑ Si x or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: „ i f► ❑ Health -care fadlities. ❑ Supply voltage for more than
f 1 C r �s f .. (z��f� ❑ Hazardous locations. 500 volts nominal.
Suite/bldg. /apt. no.: ( Project name: ./' —, , 511-1rt"• 0 Service or feeder 600 amps or more.
- Y+FJE G E .,
Cross street /directions to job site: ntsvipti.n ) Qt.. I Fee. 1 Total I -
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
*• _ -- _ = 75 1 2
-- : _ ` :- :,,; ., . IF�[,'�dire -' ” `..._ .'' �e ^� :.�k;.�.,.: c'rr (with above sq. ft.)
u ,) �" Limited energy, multi - family 75.(10 2
f r residential (with above sq. ft.)
C 4r - Services or feeders installation, alteration, and/or relocation
._ CCYt- � CAin ,d e4i p Up- c-4_;1 200 amps or less 100.70 2
:.._ ..'S" . _ - -® } - j amps to amps - � = ' " ; ,cam '= 'f''`J =:a;, p 201 400 1 "'.56 2
401 amps to 600 amps 200.34 2 I
Name: 601 amps 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: ( ) Fax: ( ) 200 gimps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 241 amps to 400 amps 125.08 2 j
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 441 amps to 599 amps 168.54 2
Branch circuits - new, alteration. or extension, per panel
Owner Signature: Date: A. Fee for branch circuits with
l�;�,
s :.. .: r'i " t '; _ j_ti`, '.d?_'S U10' S1Q_s. ','_ above service or feeder fee, each branch circuit 7.e.2 2
Business name: B. Fee for branch circuits without
service or feeder fee, firit i 56.18 ,ax,,,:/••S• 2
Contact name: branch circuit
- Each add'l branch circuit _ ` 7.42 11-4L" 2
Address: Miscellaneous (service or feeder not included)
CI /StatelZlP: Each manufactured or modular 67 84 2
City/State/ZIP: dwelling, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 67,84 2
Pump or irrigation circle 67.84 2
E -mail:
Sign or outline lighting 67.84 2
. 1 ._ _ >_., . ' ,, :,; is ;- :-.. l:. +b :G . 1;. "' t.i. t,` _ �.,.. _ >'m.«tW;4 :. :- ; :.::..;., Signal cirluit's or limited-ener
.mss.= . -. t ,. fir.- -. ._.. h O ay
-� panel, alteration, or extensior.. Page 2 2
Business name. / Ci %L ` J . n C. Each additional inspection over allowable in any of the above
A dditional ins ection(l hr 66.25/ hr
Address: �('�4)e...4) 6-'." CSC. ,1- �!?�rpL- :�T 6 p- )
C ' /Statc/ZIP: s w C ,n 7, _
City/State/ZIP: Investigation (1 hr min) 66.251 Fr
Y � I.. 4 F4z I, 5 �� /.,� 1 � I. Industrial plant (I hr mm) 18.18 / hr
Phone: %�`) 1- e�Qi, ` ' �, r ` Fax: ( 3 " 3 ` -r' J am - 7 Inspections for which no fee is 90.00 / hr
� " .�/' (,� ,t specifically listed eh hr min [ '
/CB Lic.: �I(:..1C ` 1��O� ;tricalill ` C_ prv. Lic.: t :• ,;-i - , :',r,';',:',.::: . _ - terR1Ci .. T. MO 63:6 ' V
Sri i , r Subtotal:
Supry, Electrician signature, required: • c _ 9 -, ( )'i - Plan review (25% of permit feel
Print name: t . .. 5.�1.In .. '� Date: : IL Zt. State surcharge (I 2% of permit fee Tf L, -,
�rrt /
.) TOTAL PERMIT FEE 7 ^ /
Authorized signature: 1� �}• JJ i1'
�/-1 This permit application expires if a permit is not ohtnin tihio 86
t days after it has been accepted ns complete.
Print name: CY,c.l.-L to AA, i5. `� I Date:1 -y / • Number of inspections allowed per permit.
IiBuilcnenmlts£LC- PermitAppdoc 37,01110 4404615T(11105!COM/WEB