Permit I Perm :. CITY OF TIGARD ELECTRICAL PERMIT
__ = COMMUNITY DEVELOPMENT
it it: ELC2012 -00429
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/23/2012
TIGARD g Parcel: 2S101 DA00101
Jurisdiction: TIGARD
Site address: 13190 SW 68TH PKWY 110
Project: Stearns Lending Subdivision: VARNS ACRES Lot: 9
Project Description: (8) branch circuits for TI
Contractor: THREE PHASE ELECTRIC Owner: PACIFIC NW PROPERTIES LIMITED PA
493 NE 3RD AVE SUITE B200 STERN FAMILY LIMITED PARTNERSHIP
CANBY, OR 97013 STERN, HELEN R REVOCABLE TRUST
6600 SW 105TH AVE #175
BEAVERTON, OR 97008
•
PHONE: 503 - 889 -6615 PHONE:
FAX: 503 - 651 -3540
FEES
Quantity Description Date Amount
Saecifics: 8 c rt Branch Circuits wo /Purchase 07/23/2012 $108.12
Service or Feeder
1 ea 12% State Surcharge - 07/23/2012 $12.97
Type of Use: COM Electrical
Class of Work: ALT '
Type of Const:
Occupancy Grp:
Total $121.09
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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: r� f �i
Permittee Signature: D/i/ °G /C���dw
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 603.639.4175 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.
2012 -07 -18 16:16 503 - 6511 -3540 three phase electric P 1/2
Electrical Permit Applicatioc E E LVE 1 I I ll; OI 1 1(.1':1St. t A l,
City of Tigard
Rece Permit No. ` t Q042 -eV yoz 9-
U ryare/13 y : 7 0? 3 /a' .
1 8 2012 ,�tt �/
13125 S50 Hull Blvd., Tigard, OR 97223 � - - plan Aevlew Other permiigtie0Wo7 '(/O/ V
Phame, 503.7182439 Pax: 503.598.I9GU Dsrc/By:
> CITY OF TIGARD Datc ReadylkY: - hair: i Sc e page 2 for
Inspection Line: 503.639.4175 l 16P Supplemental lntormatioo
!'. ('' . 0 N Ms P
intemett: www.ligazd- or.gov ,� i ► L 1'r
'� . Tent!,.. nn ,;w;mui n,u r• i , i J I
.•re M:ra: e re , tnxr,un /; 'P(Pi' 4i.ii ' iii 1't'P1' {' � 11Ni r , t, Iip iti (t J(f I 1 ll'lj, ilitAlifi • ?T �, , ,f! llfh , I(`( }t� 1# ( # - r jl I if !
� {jtI'fr; firt?, I 1i "ill' 9' ; ii iili Jl'lllP {{ ti'l1 a i..D P. '. „ p. ire +11'1'1f�I ' !, : Villa Ei;11 J 1 �iliVi'.11l , iligit '. ii, A�IL1 411:iiilIi.I�mi4mi. , nm l,:c'..w....dic .in, E ,I. ):,i { -
JIIJ �f!tVj�flii� t lli�, "f�r'f:L��l���f < t} a41: 1.# J: 71�111����11�1h41, 1u5, �c;uai; Nknc, l: lh. d.+ amutal�ulO; �Wl;t���J���,a,�,f✓1,1..1�V.�h. 111, l�,l
12 New construction ® AddilioNalteraliunlreplacclnc (tl
Ck:asc check all that apply (,whinit z acts of plant wlitems checked below):
0 Service or feeder 400 amp or more Q Building over [Nee stories.
❑ Demolition ❑ Other: where the available fault Current D Marinas and boatyards. •
i;F1 r i f' -1;!'7 { Gltl)�'JJ ft'i1 YPl't li (n. tin; mlt, r -;A;nryAvifnnli';�Ip�tlp,�nw 1p.Mn 1451 ri 14 :1 511 1, ' +Ili FIF, { p { 11�'�I�I Gg exceeds 10,000 amps at ISO volts or [I Floating buildings.
1,i4:112T.fd it i.rikiiit wllllmL *6iiiI1Mr o liBoerne,,fei ii� !(Gnint'r'inknn r,hdl,01; 4.,11, 1611.1 /P911 :Ir�C41i1i,h eetD.tiLJ
less to ground, or e►ceedfl 14.1100 ❑ Cammereial -tine agriculltual
❑ 1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building tuts for all other mstallatio s. D b
Installation ❑Multi-family 0 Master builder ❑ o of 75 KVA or
� ['Fire pump.
❑ rr y ayatem, larger aeons to
a rig; � t x l'E' >'�rRe separately derived sy^te
0, ;t (1;4 :!` P. Il nringncJ 4n,imnur:itl
ly:,iliiT.'Vfiiicpa { •iirE:'H ;1 1 ; 11 1' . l!1 '!': fl{l,�y 1I „E' -1-2-, .•1 -q+•.
l (n f { J :C i { 1 { i 1; I 1 l ; , I 1 , 'It I . ,' t„n diet 01): )1:,haeq. ..i., -- f1, , het ,Il, .." .1.111 %, g111, 0 Addition of new motor load of Q „
j�� {.{�,)Pl.;ntlllj,t f:,llrl,bt ?7111(us tic,IJ,mrvhi,x n ,ib.i_:fiht• 100HPormute. occupancy.
Job no.: 8232400 Job site address; 13190 SW 68 Parkway Ste 110 ❑ Six or more residential units. D Iteemational vehicle parks.
Q iieaWrcerc facilities. 0 Supply voltage for more than
City/State/ZIP: Tigard, 0 197062
❑ Hazardous locations. 600 volts, nominal.
❑ Service or feeder 600 .tmpn or more.
Suitc/bldg. /apt. no.; WM Project name: Sterns Lending l l' l; 'i I"(nl}h,r'; feeder
11 11 , I . ,,.,. , mare ,,,,,,, „ i �rl,plr r ia'rrgr; lf(;fl f,fr ra; i;n
E i 1 i tm It(h, . 61.I14r.;I +', (, ;l 1l
i�'1L,:1.1 L. r illrill,axl,�. iii !i.��ahlrl,jn.�r;�;�. �I, •.. (r {:II�rrVll.li., .111r11iRi s.;J
Cross street/directions to job site: navndMn Orr- Mae. Tote1
New residential single- or multi -family dwelling unit.
Includes attached garage.
Lot no.: 1.000 sq, ft. nr less 168.54 4
Subdivision: Ea add'1500 sq. It or potion 33.92 1
Tax map/pine! no.: Limited energy, residential 75.00 2
n - . CIl' ! >f " , c ; + u I ; ttlwpga ixx!ut�6un r =a F,n r 1 pr Pt• j ,; I f ' { T 1 K ' J�' !f (with above sq. ft
;�I t:r ,J�: ,ll,,., l{ rl.r,li l .r iariIl ,l, ; ,l ,r , �i. ?� {1 1� i � ` +r l l' is ,( FI' iI l li ( q• -) , r
lCl1 lli {till �:1;ifllil;lll {:III (l l! {� f 1 1 1 ,111fi� 'tlll.l:i , r.dnluvivt.tf: to.1fIT,l4a:4 J 1,0) i 0MM i .,,l•t.rs,. ;l ! i t no - ltl:} {d,aF44.IcEl':l:l,l, Limited energy, multi - f zutl
75.00 2
General lighting and receptacles for new tenant improvement _ (with abovc -ft
_ sq
— )
S ervices or feeders installation ration, and/or relocation
200 amps or leas 100.70 2
y t ome qi "C?''P n :r nI rnur , r ill { r tltrl. , ',:I; p, { 9 !I? TF ;7i If unu l , s c I f ; ),pr,) 1! P 4(A) 133.56 2
r, •;r I 11 t , 1 ' , � .. r1 NP{. 7 Il T I;{+ t• f Pl t..� > t l ( 1 { , l l I j f 11� IlI'hlj t 1 , 201 antes to amps
Patin}({ Itl�rliji4 .; 1. di. isl: If uvcrilll[ 11111J11+ 1; GiIltl IIIIuG,1, r.)rlti i'nii,ii m i l lkll:,1L]1(althi.iriikU 401 d rugs to 6 amps 200.34 2
Name: 601 amps to 1,000 maps 301.04 2
Address: Over 1,000 amts or volts 552.26 2
• Temporary services or feeders Installation, alteration, and/or
City /State/ZIP: relocation
2 00 amps or less 59.36 1
Phone: ( ) Fax: ( )
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 • Branch drcudts _ new, alteration, or extensio, per panel
Owner si tt attire: Date; A. Fee for branch circuits with
",; a p c s;r,:. { +'u . x,ru :yr rraa! ,, I ? I r wrri , above servitx or feeder fee,
U::t: , . ,, ,:,,' r:c r fi',i1 ' J P,'Nil ;j'f' 1 )i ' %'t'r`p ; i ,l' I t ., i ;,I ; , t , l ' 1 ( f l6.t 7.42 2
'14:1r:1:: : { l+ l � l i` 1 1 1 1i 1 1.,1 111E.: 1A,: uuNipbll .li..111c''lfli6141f1 :1 :e1•i1i411:4::, lace .`1!1..2Y11t1er:1414.i.radiAi Is lUU .:.., :l�3- each branch cuctnt
R. Fee fur branch circuits without
Business name: — service or feeder fcc, first I 56.18 56.18 2
— hranlL circuit
Contact name: Each add' I branch circuit ' 7 7.42 51,94 2
Address: Miacdlaneous �w:rvice or feeder not Included)
F.ach manufactured or modular 67.84 2
City/State/ZIP: dwelt , service and/or feeder
Reconnect only 67.84 2
Phone: ( ) Fax: ' ( ) Pump or imgatiun circle 67.84 2
E.-mail: '
9 Sign m outline lighting 67.84 2
Et FTi :'q iggif r •gr g1V, 1 ' ° "� r " °' {`" iii °.!;li"19;J, tiVi, illy g P ;!jOili,9rl:;1 Signal slorlimited -
!!IJ ;('I) {i.h�. ;. i"r �Gb ;i III II'rl i ,, �` �,,:, t ,., k „,,.�.�,:iallEhlilfl ; #J(al,. {, Lei:;. t. ljh l{ 1ih�J�I 1: �J. , . , .r ` � , � „ tl:�l�17 1 a.r.fJ�a.'!. � ( limited
�.1 lei �1a.: i• .":+..Clltlui.l.,... i :'i:66J911.r i11i il:�LiliL1;S,!;,L ;: `:il;i 2 itm- Page
Business name: Three Phase Electric E nav alteration or ex 2
Each additional inspection over allowable in auuof the above
' Address: 493 NE 3" Ave. Suite B200 Additirmal Inspection (1 hr min) , 66.25/ hr L
investigation (1 hr min) 66.25/ hr
City /State/ZiP: Canby, OR 97013 industrial plant (I hr mm) 78.18/ hr
u one: (503) 263 - 2558 I Fax: (503) 651 - 3540 - Inspcaimu for which no tee Is 90.o0f hr
S. call listed h hrmid)
I II ('CB Lie„ 1623 ” E lectrical l-ic.: 3 - 332C Supry - Lit.: 3398S 1 'af'igllh ,i,.,.li,., i •,.',,. ,1 ilt4'(i ! Ii }ii,,t
v , ,rir Subtotal• 108.12
Suprv. Electrician signature. required: Plan review (25% of permit fee):
Print name; Dennis Welch Date: 7/18/12 State surcharge (12% of permit fee): 12.97
TOTAL PERMIT FEE: 121.09 r--
Authorised signature; This permit appfiudion expires if a permit is not obtained within 180
days aster it has been accepted as complete.
Print name: • Dale: • Number of inapectiun. , allowed per permlt.
1:\ 9ottdutSWermics157 .C'd'm 07A/1110 440- 4615I11IA15/COM/WI It