Permit CITY OF TIGARD ELECTRICAL PERMIT
0 COMMUNITY DEVELOPMENT Permit #: ELC2012 -00462
Date Issued: 08/06/2012
T J GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1 S136DC04600
Jurisdiction: Tigard
Site address: 7255 SW DARTMOUTH ST
Project: Office Max Subdivision: 1995 -013 PARTITION PLAT Lot: 3
Project Description: RTU reconnect
Contractor: BOB'S ELECTRIC Owner: COMMERCIAL NET LEASE REALTY, INC
2700 NE BURTON ROAD STE A 450 S ORANGE AVE, STE 900
VANCOUVER, WA 98662 ORLANDO, FL 32801
PHONE: 360 - 254 -7200 PHONE:
FAX: 360 - 254 -8219
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 08/06/2012 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/06/2012 $6.74
Type of Use: COM • Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 kR 952 -00 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: Permittee Signature: Oki / L 4 ' r 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 Ina 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.
FROM (FRI)AUG 3 2012 1:08/ST. 1: 06 /MO. 9302925962 P 2
RECEIVED
Electrical Permit Application F (11 71( 1_ I. I1 t,\l.,
AUG u 2012 } —ot
City of Tigard N
Da. Pennit No.
: � 13125 S50 Hap Blvd, Tigard, OR 9722 ^ OF TIGARD e> r Pere F L ' � ®0 4,
Phone 503.639.4171 Fax: 503.598.
r , �,; ,, Inspection Line: 503.639.4175 g(III,DINI~iDIVISIO m asts Read 0 see Page 2 for
Internet: www.tigard-or.gov Notifed/Metbod: Supplemental Information
�_3 S 1P ,`. .� - tic c i Yip + .i-
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❑ New constru ® d";ii-tio‘ni.'lic.aci ' Ple cheek all that apply (admit' sea of plans w /items checked below):
❑ Demolition ❑ ❑ Service or feeder 400 amps or more ❑ Building over three stories.
{ where the available fault current ❑ Marinas and boatyards.
, ( j . x , c :j r w Y exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
,., eF ,.:. f. . _ less to ground, or exceeds 14.000 ❑ Commercial -use agr•icuiural
❑ I - and 2 family dwelling ® Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Fire pump. ❑ Installation of 75 KVA or
❑ Multi family ❑ Master builder ❑ Other
�d,, Q r a 7Y , s . a , ❑Emergency system larger separately derived system.
ti ,..,,.'.. a . , _ � .... � _, ,_....., .. r -.p _ _.«�,, , _ } ❑ Addition of new motor l of ❑ ••A' "E" "I _2 „ , "I -3 „ ,
Jobno.: 12 -855 Job site address: 7255 SW Dartmouth St. ,00HPornnre. occ upanc y.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard, OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more
Cross street/directions to job site: Marled= Ole. Fee. Total •
New residential single- or multi- family dwelling unit.
Includes attached garage
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 — 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.92 1
v +: ) a y + c r Limited energy, residential 67.84 2
�.. r m �? �, i. i i E iF (with above sq. R.)
a- . __. ,., _r._.. .. ,_ E 4 -,.:. 1 -... , . ,,r. . .L., .:. . ,,..• Limited energy, multi- family
Roofto• unit reconnect
resndlntial (with above sq. ft.) 67.84 2
Services or feeders instauatlon and/or relocation
200 amps or less 100.70_ 2
y� , '4 � r t r i r ,,, , f i . ! 1 .- . x ' , i`v ,i --,-,.--,..= y I : t ; 201 amps to 400 amps 133.56 2
200.34 2
Name: Of f i ceMax 401 amps to 600 amps
601 amps to 1,000 amps 301.04 2
Address: 7255 SW Dartmouth St. Over 1,000ampsorvolts 552.26 2
Temporary services or feeders Installation, alteration, and/or
1 ; relocation
Phone: ( ) F es; ( ) 200 amps or less 59.36 I I
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, panel
Owner signature: Date: A. Fee for branch circuits with
rl '* I j -, 1 s ,� hil P F 1 li r '‘:',,;r..'-, ..� 7''r 1 ","/"',,,',;,,, l above service or feeder fee, • W" " -) �,..., . .-..,..: ...■.; . . i....: ,. . J .:..'''.k, .-.� >:, . 7 s� .. 1, �:- .
' .} each branch circuit 7.42 2
Business name: B. Fee for branch circuits without
service or fader fee, first 1 56.18 6.18 2
Contact name: branch circuit
Each add'' branch circuit 7.42 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
Pump or irrigation circle 67.84 2
E-mail: Sigo or outline lighting 67.84 2
X�7361 a is 1 i. .
tea ;ir_ 1 v a ._ . T - ,fir.,. ? __._ r Signal circuit(s) or limited-energy
Page 2 2
Business name: t panel, alteration or extension.
Bob s Electric Each additional inspection over allowable In any of the abov
Address: 2700 NE Burton Rd. Ste. A Additional inspection (1 hr min) 66.25/hr L
Investigation (1 hr min) 66.25/ hr
I • • . Industrial plant (I hr min) 78.18/ hr
Phone: ( 360 ) 254-7200 Fa x: ( 36 t )254-8219 Inspections for which no fee is 90.00/ hr
s. - fecal listed 'A hr min
Electrical Lie.: y 4 Suprv. Lic.: - = -= • fr ° r _ •
• �� - subtotal: 56.18
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Kevin Broselle Date: 8/2/12 State surcharge (12% of permit fee): 6.74
Authorized signature: TOTAL PERMIT FEE: 62.92
This permit application expires If a permit Is not obtained within 180
days after It has been accepted as complete.
Print name: D ate: • Number of inspections allowed per permit.
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