Permit •
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EVJSED
CITY OF TIGA R D I i• ELECTRICAL PERMIT
° . COMMUNITY DEVELOPMENT Permit #: ELC2012 -00637
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 • Date Issued: 11/06/2012
Parcel: 1 S135DC00200
Jurisdiction: Tigard
Site address: 11825 SW GREENBURG RD 110
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: (4) branch circuits for TI 11/15/12 REPRINT Adding (1) low voltage for phone, computers
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Contractor: VAST ELECTRIC Owner: TWO G'S REAL ESTATE LLC
1525 SEATTLE SLEW DR. SE 18395 WOOD THRUSH ST
SALEM, OR 97301 LAKE OSWEGO, OR 97035
PHONE: 503 - 566 -7274 PHONE: 503 - 684 -0550
FAX: 503 - 585 -8828
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 11/06/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/06/2012 $9.41
Type of Use: COM Electrical
Class of Work: ALT 1 ea Limited Energy 11/15/2012 $75.00
Type of Const: 0 ea 12% State Surcharge - 11/15/2012 $9.00
Electrical •
Occupancy Grp:
Total $171.85
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 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503. or 1.800.332.2344. ,,�,.. II
Issued By: �� Permittee Signature: Ok 11 AP 0 C-�71(
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.
q CITY OF TIGARD ELECTRICAL PERMIT
1114 - - COMMUNITY DEVELOPMENT Permit #: ELC2012 -00637
TI GAItD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/06/2012
Parcel: 1 S135DC00200
Jurisdiction: Tigard
Site address: 11825 SW GREENBURG RD 110
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: (4) branch circuits for TI
Contractor: VAST ELECTRIC Owner: TWO G'S REAL ESTATE LLC
1525 SEATTLE SLEW DR. SE 18395 WOOD THRUSH ST
SALEM, OR 97301 LAKE OSWEGO, OR 97035
PHONE: 503-566-7274 PHONE: 503 - 684 -0550
FAX: 503 - 585 -8828
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo /Purchase 11/06/2012 $78.44
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/06/2012 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 952 -00 -0090. Yo 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 r 8l jr r1PL-/t 6 r 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 the next available inspection date.
Thls 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.
Nov 14 12 03:24p Vast Electric RECEIVED 503 -585 -8828 p.2
Electrical Permit Application. Felt UFE,c:E { (mi.)
NOV 1 4 2012 Received
of Tigard Datem Permit No.: ELC2012 -00637
13125 S W Hall Blvd., Tigard, OR , u.. : (f T Plan Review
Oth
12 Phone: 503.718.2439 Fax: 503. ' - . • .11• 1 Date./13 : ° Permit
1 C. It r> Inspection Line: 503.639.4175 BULL I G DIVISION Dare Ready /By: kris: la See Page 2 for
Internet: www.tigard-or.gov Notsed/Mulbod Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply (submit j sits of plans wfnems checked below):
❑ New construction ® Addition /alteration /replacement
❑ Service or feeder 400 maps or more ❑ Building over three stories.
❑ Demolition ❑ Other where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
le ss to go und, or exceeds 14,000 ❑ Commercial-use acricuhural
❑ 1- and 2- family dwelling g .CommerclaVindustrial ❑ Acc building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other, I ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
13 Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ A "E t -2 ", "1 -3
Job no.: Job site address: 11825 SW Creenburg Rd Lmore. �"�7
❑ Six x o orr m moore residential units. ❑ Recreational vehicle parks.
City /StateiZiP: Tigard, OR ❑Hcah�
bc facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: 110 Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: I Decrlptlan I Qt.. I Fes. I Total I •
New residential single- ur multi- family dwelling unit.
includes attached garage.
Subdivision: i 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
DESCRIPTION OF WORK (with above sq. R) 75.00 2
Limited etwgy, multi- family 7500 2
Adding low voltage to permit #ELC2012 -00637 residential (with above sq. ft.) _
Services or feeders installation, alteration. and/or relocation _
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
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
Phone: ( ) I Fax: ( ) 200 amps or less 5936
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, 0, and 701.
401 amps to 599 amps I 168.54 2
Branch circuits new, alteration, or ex tension. per panel
Owner signature: Date: A. Fee for branch circuits with i
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee. 7 42
each branch circuit I
Business name: Vast Electric, Inc. B. Fee for branch circuits without i
service or feeder fee, first
Contact name: branch circuit 56.18 2
Fads add'l 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
('hone: ( ) i Fax:: ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited-energy
Business name: Vast Electric, Inc panel, alteration, or extension. 1 Page 2 75'00 2 !
Each additional inspection over allowable in any of the above •
`. Address: 1525 Seattle Slew Dr Se Additional inspection (1 hr min) 66.25/ hr
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Cityi State /ZIP: Salem, OR 97317 Investigation (l hr min) 6625/ hr
Industrial plant (1 hr mist) 78.18/ hr
Phone: (503) 799 -5627 I Fax: (503) 585 - 8828 Inspections for which no fee is i
90 .001 hr
speciiiolly listed (14 hr min) 1
CCB Lic.: 175531 Electrical Lie.: C -28800 \ �� rv. Lie.: 5186S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require 11 j � o Subtotal: 75.00
Y tJ�A - . � I _ _ Plan review (25% of permit fee):
Print name: Tim Vander Stoep Date: I ' 4/2012 State surcharge (12% of permit fee): 9.00
Authorized signature: 1 TOTAL PERMIT FEE: 84.00
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date:
Number of inspections allowed per permit.
1:1BuitdingiPermitAF-I C- PermilApp doe 07g11/10 440 -461 Sri1 VO5/COM/WEJ3
Electrical Permit Ap�licatioRECEwED FOR OFFICE t SE ONLl
Received
City of Tigard NOV 6 2012 aamB : ( l , s Permit No.: EL , V(a. m(,3 t
13125 SW Hail Blvd, Tigard, OR 97223 Plan Review
Phone: 503.7182439 Fax: 503.598.1 Received
/� � �r� p ; Other Permit: ? -MOO
T I G A } P Inspection Line: 503.639.4175 Vf 1 1 o TI GARD
l- 1 ► Oats Ready /By: hde See rage 2 for
Internet: www.tigard- or.gov BUILDING DIV Notified /Method: O H Supplemental information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three statics.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
less to ground or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 - and 2- family dwelling g Commercial / . ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. tuner separately derived system.
❑ Addition of new mater load of ❑' A ", 'F', "I -_ , 1 3 ,
Job no.: I Job site address: 11825 SW Greenburg Rd I xor m o e yes more. occupancy.
CI Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR ❑ Health -care facilities. ❑ Supply voltage for more than
❑llaardous locations. 600 volts nominal.
Suite/bldg./apt no.: 110 Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Drxripdon I on. I ter. l royal I •
Ncw 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
75.00 2
DESCRIPTION OF WORK (with above sq. IL) ,
Limited energy, multi - family 75.00 2
Tenant improvement rasidentiat (with above so. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less I 100.70 2 .
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Cit '; Statc/ZlP: Temporary services or feeders installation, alteration, and /or
> relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 ; 1
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 salt, !case, rent. or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: ; A. Fee for branch circuits with
® APPLICANT 1 ❑ CONTACT PERSON i above service or feeder fee, 7 42 2
each branch circuit
Business name: Vast Electric, Inc. B. Fee for branch circuits without
service or feeder fcc, first I 56.18 56.18 2
Contact name: Trung Nguyen branch circuit
Each add'I branch circuit 3 7.42 22.26 2
Address: 1525 Seattle Slew Dr SE Miscellaneous (service or feeder not included)
(1 /Statel!,l P: Salem, OR 97317 Each manufactured or modular
67.84 I 2
tY dwelling. service anther feeder
Phone: (503) 793-0871 I Fax: : (503) 585-8828 Reconnect only 67.84 2
Pump or irrigation circle 67.84
E -mail: vastelectric()comcastnet "
Sign or outline lighting 67.84 2
CONTRACTOR Signal cireuit(s) or limited- energy
Business name: Vast Electric, Inc
panel. alteration. or extension. Page 2 2
Each additional insj ction over allowable in any of the above
Address: 1525 Seattle Slew Dr SE Additional inspection (1 hr lain) 66.25/ hr
City /State/ZIP: Salem, OR 97317
investigation (1 hr min) (16.25! hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 799 -5627 I Fax: (503) 585 -8828 Inspections for which no fee is 9000 / hr
specifically listed ( hr min)
CCB Lie.: 175531 I Electrical Lie.: C - 280 I,ic.: 5186S ELECTRICAL PERMIT FEES aturo Subtotal: 78.44
Suprv. Electrician signature. required. i
✓(' - ....e "n• ` f�j` Plan review (25% of permit ice):
Print name: Tim Vander Steep Date: 1/9/2012 Slate surcharge (12% of permit fee): 9.41
TOTAL PERMIT FEE: 87.85
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
1 1Builc6ndPermil4 .ELC- IhxinitApp doe 07101.'10 44046 iT111/OS,'COM/WEB
Z 8Z88 'cal o!. lSen 8 96 :01. Zl. 90 AON
Nov 14 12 03:25p Vast Electric Inc. 503- 585 -8828 ,
Electrical Permit Application -City of Tigard -
Page 2 Supplemental Information
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LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
.Fee for all residential systems combined... $75.00
Check Type of Work Involved:
❑,' Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Coaditioning System*
❑ Vacuum Systems*
❑ ,Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00.
system .
y (SEE OAR 918
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
p Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
• ❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
E l Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
® Other Phone, computer
Total number of commercial systems: 1.
*No licenses are required. Licenses are required
for all other installations •
Ii.Building PamitOEL - PemilApp.du. 07/01/10
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