Permit •
CITY OF TIGARD
T
ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 -00667
TLCiAAD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/26/2012
Parcel: 2S 101 DA00104
Jurisdiction: TIGARD
Site address: 13333 SW 68TH PKWY
Project: Clear Channel Subdivision: VARNS ACRES Lot: 9
Project Description: (2) branch circuits for wiring 2 signs on south and east stairwell
Contractor: PARKIN ELECTRIC INC Owner: TRIANGLE POINTE LLC
14001 FIR STREET 901 NE GLISAN ST, #100
OREGON CITY, OR 97045 PORTLAND, OR 97232
PHONE: 503 - 657 -4958 PHONE:
FAX: 503 - 557 -1059
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 11/26/2012 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 11/26/2012 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 9 2- 001 -0090. You may obtain copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: W t 1 Z in. Permittee Signature: £ J Pf PPL.i l - 7)OKI
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.
1
From: 11/21/2012 14:11 #765 P.002/002
Electrical Permit Applications t ECEl
City f Ti 2 2012 Received
N O V �''�
1.1h • '' y Tigard Date/By: r (I a to (1,-- s Permit No.:Ett e9-10 o0 , 7
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2439 Fax: 503.598.1 �b4 J f Plan Review mw Other Permit: _
I' I G R U Inspection Line: 503.639.4175 �I)1 1 T K7A IG A ^ i J Date Ready/By: Saris: 63 See Page 2 for s)
Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Ti 4' Supplemental Information
DIVISION
N ew construction ddition/alteration/replacement that p ~ su b mit s
: TYPE OF'WORS � - . ', ` .: ; " •_ -.�= � ,_.;:.' W ID ` Ple ase check all tha apply (su 2 sets of plans w /items checked below): U
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: �/
where the available fault current 0 Marinas and boatyards.
ti (ATEGORY.`OF • - <- exceeds 10,000 amps at 150 volts or ❑ Floating buildings. �' i •
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling `Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
. . B IT
SE;INF'O�TION':AND: 1n, ❑ Emergon of new Larger separately derived system.
_ -. JO- �¢.. • � � . _ ❑ Addition of oew motor load of ❑
1 3 ?33 S4) / C{ �L-� 100HP or more. occupancy.
Job no.: Job site address: ✓ J tOIJ /� ❑ Six or more residential units. ❑ oc Re crea tion al vehicle parks.
City/State/ZIP: f i 0r c G ' l ❑ Health -cam facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominaL
Suite/bldgJapt. no.: Project name: ['Service or feeder 600 amps or more.
F.• SSUI>E:
Cross street/directions to job site: Descriptio I Qty. I Fee. 1 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
Limited energy, residential
DESCRIP'TION OF WORK . - (with above sq. ft) 75.00 2
( Limited energy, multi - family 75.00 2
fd / if ✓ I ors S d l S0tug. 7, residential (with above sq. ft.)
r U /� Services or feeders installation and/or relocation
t'O --Y4' S v-eLit Ce. tee 200 amps or less 100.70 2
PROPERTY- OWNER I 0 tl A,, ..: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
�`l o_ far - 601 amps to 1,000 amps 301.04 2
Address: C3333 t—c,) 6 . ev/&,), Over 1,000 amps or volts 552.26 2
City /State/71P: oi D Q Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) f Fax: ( ) 200 amps or less 59.36 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 clrcuils — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
. . , Q' APPLICANT :: _ Q' LONTACi' P RRSON; 7.a2 2
each branch circuit
Business name: B. Fee for branch circuits without • E
2
service or feeder fee, first 56.18 SG /
Contact name: branch circuit
Each add'I branch circuit I 7.42 7. Y vZ 2
Address: Miscellaneous (service or feeder not Included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67.84 2
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
E - mail:
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
.. . •.,__ CQNTTtACTOR '.., .. , - - ' ... . -. , _ .: Signal circuit(s) or limited- energy
Business name: Parkin Electric panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 14001 Fir Street Additional inspection (1 hr min) 66.25/ hr
City/State/ZIP: Oregon City, OR 97045 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.I8/hr
Phone: (503) 657 Fax: (503) 557 - 1059 Inspections for which no fee is 90.00/ hr
specifically listed (h hr min)
CCB Lic.: 3515 Electrical Lic.: 34-4C Suprv. Lic.: 4241-S ,; :.; _ .:'; ` - ;' .'- gE C-nl PEP tYE - .;: _ '.< . ;' :,';,;
Subtotal:
Suprv. Electrician signature, required: Plea review (25% of permit fez): D
Print name: David B Parkin Date: State surcharge (12% of permit fee): 7. 4 3
TOTAL PERMIT FEE: 7 / , ., 3
Authorized signature: This permit app0®tlon 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: 1Building \Permas1ELC- PermiiApp.doc 07/01/10 440.4615T(I INS/COM/WEB