Permit t
CITY OF TIGARD ELECTRICAL PERMIT
II 13 • COMMUNITY DEVELOPMENT Permit #: ELC2009 -00122
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/13/2009
T 1 G A R D Parcel: 2S 101 DC04000
Jurisdiction: Tigard
Site address: 7500 SW TECH CENTER DR 110
Subdivision: Lot: 0
Project: Tyco
Project Description: Install (3) branch circuits.
Owner: FEES
WALTON CWOR SOUTHRIDGE 12 LLC Quantity Description Date Amount
BY TTA/EPROPERTYTAX DEPT 325, PO BOX
4900 3 crt Branch Circuits 03/13/2009 $60.15
wolPurchase Service or
PHONE: Feeder
1 ea 12% State Surcharge - 03/13/2009 $7.22
Electrical
Contractor:
BEAR ELECTRIC
PO BOX 389
DONALD, OR 97020
PHONE: 503 - 678 -1355
FAX: 503- 678 -1108
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Total $67.37
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 952- 001 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
�I Q ��� II i
Issued By: A Q Ii Permittee Signature: Q 0 _ 4\ b\ C /h.`.1 l
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 an Inspection that business day.
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.
r.
03/12/2009 THU 11:07 FAX 5036781108 Bear Electric,Inc. 0001/002
• • • Electrical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard MAR 12 2009 �wB 3 ‘)- .09 t6 Palish No.: _ pal •0012 a
i 13125 SW Hall Blvd., Tiprd, OR 97223 PI= Review l
3. Mae: 503.639.4171 Fax: 503.598.1 5- OF TIGARD DateBy: Other Permit:
TIGARD Inspection line: 503.639 BUILDING DIVISI0 1 e ReadyiBy H See Page 2 for
Internet: www.tigard•orgov ottf iedMethod: �1 j Supplemental Information
TYPE OF WORK , PLAN REVIEW
CI New construction E® Addition/alteration/ cplacement Please am* as that apply (submit?i sets of plans w /items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
Demolition ❑Other
where the available fault current 0 Marinas and boatyards.
CA_ TEGORY OF Ca1VSTRUCI IOPI aaceds 10.000 slaps at 150 volts or ❑ Floating buildings.
❑ • l -an 2-family dwelling less to granted. or =ads 14.000 0 Commercial -use agricultural
y g ef Commercial/ industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: O Fire pump. 0 installation of 75 KVA or
. " J OB Sfl E 1INFORMATION AND LOCATION 0 Emergency system larger separately derived system.
_ ._ 0 Addition oR new motor Radof 0 "A ","E". "1.2 "•"1.3 "•
Job rte : Job site addecss 10010' or more. oocuponey
v . l J v V TP h a e O ' o $11101 dose taidemat OARS. 0 Reat:Wosul %chick pones.
City / State/ZIP: � ; ("5, '�- , (5, r � �� 3 O Haldwte facilities. O Supply voltage for more than
Y / o Hazardous localiorn. 600 volts nominal.
Suite/bldgJapt. no.: k \ 0 Project names 0 Savix or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site•. Destopo O 1 Orr. I Fee. 1 Total I •
New residential single- or multi- ramify dwelling unit.
Includes attached garage. _
Subdivision: - I Lot no.: 1,000 sq. R. or less 145.15 4
• Tax nlap/part e1 no.: Ea. addi 500 sq. R or ponion 33.40 I
Limited energy, residential 75.00 2
.. .._:4sc. _ . _ P SPIMP77QN. QF. WORK .: ..... . • .. • (with above so. a•)
kxke S � �`n2C� rC7pF 3 c n c limi si de t a l(hhab o es o . ( 75.00 2
residential (with above sq. fl) .
Services or feeders Installatio alteration, and/or relocation
`l - 7' \ \ r 200 amps or less 80.30 2
-t PROPER'L'Y• OWNER .:T 'r."
. 0 TENANT . .. 201 amps to 400 amps 106.85 2
Name 401 amps to 600 amps 160.60 2
601 amps to 1000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature Dale Branch circuits — new, alteration, or extension, per panel
A. Fee for branch enemas with
• 7 APPidCANx •.' . _ O CONTACT PERSON
above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without srnricc or feeder re x,
Contact nem= first branch circuit 46.85 �, 2
Address: Each Wet branchcircuit a 6.65 (, 2
Miscellaneous (service or feeder not Included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
::• . !CONTRACTOR Signor outline lighting 53.40 2 •
Business name Bear Electric, Inc. Signal circuit(s) or limited-
energy panel, alteration, or
Address: PO Box 389 extension. Describe. Page 2 2
City/Statc/ZIP: Donald, OR 97020 Each additional inspection over allowable In an of the above
Phone: (503) 678 -1355 1 O Per inspection 62.50 I Fax: (503) 678 -1108
\t Investigation per hour (t hr mitt) 62.50
CCB LW.: 20919 a • Electrical Lie.: 24 -1070 •% Suprv. Lie.: 81 1, S tndttstrialplant per hour 73.75
Z
ELECTRICAL PERMIT FEES
Suptv. Electrician signature, required: �.� ��iwa k 6 •
l•1') Subtotal: °- r -- . ,.•. 6
Print narttc ����9 � nil ha• Plan review (25% of permit fee):
T "ifi I . . / ati State surcharge (Ins of permit fee): . Z
Authorized signature: TOTAL PERMIT FEE: _• \ / 2
Print name: I Data TMs permit application expires If a permit is not obtained within in 4 37
days after It has been accepted as complete.
• Number of inspections allowed per permit.
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