Permit CITY OF TIGARD ELECTRICAL PERMIT
11 1 g COMMUNITY DEVELOPMENT Permit #: ELC2012 -00489
TIGARD 13125 SW Hall Blvd.. Tigard OR 97223 503.718.2439 Date Issued: 08/20/2012
Parcel: 25101 DD00800
Jurisdiction: Tigard
Site address: 14020 SW 72ND AVE
Project: United Rental Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: (12) branch circuits for new receptacles and lights
Contractor: JET INDUSTRIES INC Owner: I S PROPERTIES LP
1935 SILVERTON RD NE ATTN: UNITED RENTALS LEASE ADMIN
SALEM, OR 97303 BY FISCHER & COMPANY URI
13455 NOEL RD, STE 1900
DALLAS, TX 75240
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PHONE: 503 - 363 -2334 PHONE:
FAX: 503 - 364 -2488
FEES
Quantity Description Date Amount
12 crt Branch Circuits wo /Purchase 08/20/2012 $137.80
Specifics: Service or Feeder
1 ea 12% State Surcharge - 08/20/2012 $16.54
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $154.34
Required Items and Reports (Conditions)
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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 '01 -009' You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
j
Issued By: � Permittee Signature: 0.1 4'PrU CA ► ) 01.1
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.
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From: R CEIVED 08/16/2012 13:55 11521 P.003/003
AUG 16 2012 U
Electrical Permit Application
CITY ��R ® Re role 0 rr iCI: USE OONLY ONLY Nr
City of Tigard ��`{ f 1 OF TIGARD K Permit No.: (i(,C,aD,�• Bv`T
111.
• 13125 SW Hall Blvd., Tigard, OR 97 2UI G ��� � P Review 2 _ 0 f a
a Phone: 503.718.2439 Fax: 503.598.1960 D : Other c • u a.° f �-' OD
TIC' A R D Inspection Line: 503.639.4175 Date Ready/By: lots RI See Page 2 for
Internet: www.tigard-or.gov Notified/Method; Ti S upplemental Information
:ye`• r%� lM ra'�a � � r�:y Yr�"c"T.,yE.' m'_a% ^__t . „ A , ��.,?�r. ,J;G'� �=:i�5�: '=r.'EtiCa;;e .-r, - � . •,.,�„_
I:.?t �s ' 1 .r NY -x"'-i' TYP1Ill0F WOBK? �:y,+,; -f;y •ru ^ a c ,r fi 74i. ! iP 4`�r� • 1
=�' KM.? 3=7i�...F.•:.� `�'.' �G� �.:21���, �7 �:� +^a^ Ek � ._.. .,.�w�vt✓ -AS1�` a� z
❑ New construction e Addition /alteration/replacement Please check all that apply (submit Z sets of plans whams checked below):
❑ Service or feeder amps or more ❑ Building over three stories.
❑ Demolition
❑ Other where the available Snit current ❑ Marinas and boatyards.
. ,: , , . �'' + . � U N -- " 2 ;'F ,' - exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -sae agricultural
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps for ailed= installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or
- �v, . �, - ❑ Emergency system larger separately derived system.
� � d G' t. :7, ' :I Y Y : �jll(IIfO j I 110CATION' • '',° 7 A ra
, .fir' .- , ll �.�.�...�:.� s,:��. ❑ Addit(on dam motor load of ❑ "A ". "E', "1 - ", "1 - ",
Job no.: I Job site address: 14020 SW 72" AVE. 10011P or more. occupancy.
❑ Six or mom residential units, ❑ Recreational vehicle parks.
City/State/ZIP: TIGARD, OR 97223 ❑ filth -cam tbciities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominaL
Suite/bldgJapt no.: I Project name: UNITED RENTALS T.I. ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Description 1 t 21y . i Fee. I Total I •
. New residential single- or multi - fatally dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or leas 168.54 4
Tax map/parcel Ea add'l 500 sq. R or portion 33.92 1
no.: Limited energy, residential 75.00 2
P.g ) , a 'r 3try� i $e 'x 11 : • a • I ,■w • o •r vet ? ga s in g p„ (with above sq. R) .
Limited WIRE NEW RECEPTACLES AND LIGHTS _ residential (with above ft.) 75.00 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 100.70 2
�; 3� x� x • s fir to 400
�r�'�'�,�: � �f� i I l:r • y ��:� 1:� , ,, '�:���f.:a� , -� � ��? � r-rs,�C- .i: a_�1�%�K �� 'Y J?'s . 201 � amps 133.56 2
Nerve: 401 amps to 600 amps 200.34 2
601 amps to 1,000 coups 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: ( ) I Fax: ( ) 200 amps or less 59.36 ' 1
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 599 168 54 2
Branch circuits - new, alteration, or ex tension, per panel
Owner signature: Date: A. Fee for branch circuits with
;Sy ` ,', 123PN _ h rc? \ q t `b . l ;; t l'Itg AM N* N 3'' 4fi A. above each service c or fader fee, 742 2
� <.. , `� • branch tit
Business name: JET INDUSTRIES, INC. B. Fee for branch circuits without
service or feeder flee, first 1 56.18 56.18 2
Contact name: BEAR KORSNESS branch circuit
Each add'l branch circuit 11 7.42 81.62 2
Address: 1935 SILVERTON RD NE Miscellaneous (service or feeder not included)
City/State/ZIP: SALEM, OR 97301 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
67.84 67. 2
Phone: (503) 363 - 2334 Fax: : (503) 364 - 2488 R econnect only °
Pump or irrigation circle 67.84 2
E - mail: BERNT.KQJETINDUSTRIES.NET
::WW,,�� q Sign or outline lighting 67.84 2
;J�s" " =�:. '' � . -'a'� W.n •a.;; =r . ,, :. si eireuit(e) orlimited- energy
. Business name: JET INDUSTRIES, INC. panel, alteration, or extension. Page 2 2
Each additional Inspection over allowable In any of the above ;
Address: 1935 SILVERTON RD NE Additional inspection (1 hr min) 66.25/ hr
I ` 3 lnvesligadon (1 lir min) 66.25/ hr
City/State/ZIP: SALEM, OR 97301
X01 l industrial plant (1 hr min) 78.111/ hr
Phone: (503) 363 -2334 3 I Fax: (503) 364 - 2488 4 DAIS Inspections for which no fee is 90.00/ hr -
specifically listed C1 hr min)
CCB j�,
3944 - I E ical Lie.: C226 11 1 5.11 Lie.: CiL;' pJ T I!1zE8 ZELVABIO
Suprv. Electrician signature, required: Subtotal: 137.80
% Plan review (25% of permit fix); 0.00
Print name: CHRIS DUNLAP Date: 8/16/12 State surcharge (12% of permit fee): 16.54
TOTAL PERMIT FEE: 154.34
Authorized signature: This permit application expires If a permit Is not obtained within 180
Print name: CHRIS D LAP I Date: 8/16/12 days after It has been accepted as complete.
• Number of inspections allowed pa permit.
Il9uOdoi tPe ma,\ElcPamiiApp.doc 07ro1 /10 410.4615T(11/OS/COM/WEB
From: 08/16/2012 13:54 11521 P.001/003
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HEATING PLUMBING ELECTRICAL FIRE PROTECTION MAINTENANCE WOOD PRODUCTS
"Solutions for a streamlined project"
Date: 8/16/12 Pages including this sheet: 3
To: COMMUNITY DEVELOPMENT DEPT.
Company: CITY OF TIGARD
Fax: 503 - 598 -1960 Phone: 503 -718 -2439
Message:
Hello,
Attached is an electrical permit application and
_ payment authorization form for a project called "United Rentals
T.I."
Can you please fax me a copy of the permit when you are able to?
Fax# 503 -364 -2488
Direct Line# 503 -798 -4434
Thanks so much!!
Thank you, Alicia Comstock
Phone 503.363.2334 • Fax 503.364.2488.800.659.0620
1935 Silverton Rd NE • Salem, OR 97303 • www.jetindustries.net