Permit 4 CITY OF TIGARD ELECTRICAL PERMIT
I I ° COMMUNITY DEVELOPMENT Permit #: ELC2013 -00091
T [ G A.R o 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2013
Parcel: 25101 CB00500
Jurisdiction: Tigard
Site address: 12670 SW HALL BLVD, BLDG# 3
Project: Canteen Vending Subdivision: 2007 -064 PARTITION PLAT Lot: B
Project Description: (2) 200 amps or less; (1) 201 -400 amps and (35) branch circuits to install electrical for TI
Contractor: ADVANCED ELECTRIC INC Owner: TCTPI LLC
21811 NE 58TH ST 4260 GALEWOOD ST, STE A
VANCOUVER, WA 98682 LAKE OSWEGO, OR 97035
PHONE: 360 - 254 -6864 PHONE:
FAX: 360 - 254 -2854
FEES
Quantity Description Date Amount
35 crt Branch Circuits w /Purchase 02/07/2013 $259.70
Specifics: Service'or Feeder
1 ea 12% State Surcharge - 02/07/2013 $71.36
Type of Use: COM Electrical
Class of Work: ALT 2 ea Services or Feeders - 200 02/07/2013 $201.40
amps or less
Type of Const: 1 ea Services or Feeders - 201 to 02/07/2013 $133.56
Occupancy Grp: 400 amps
Total $666.02
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 - 0010009 . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or
Issued By: Yl/ U/L..LL l j��jf Permittee Signature: O/L) PT 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 503.839.4175 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.
FEB 05 - 2013(TUE) 13:26 Advanced Elect (FAX).360 2542854 P. 001 /002
Electrical Permit A r ., ,i.c �� i. ;iii \ I' I) , . FOR OFFICE USE ONLY
City of Tigard Received
Datd13 . 1 3 Permit No.: CLC 0 2 0 / 3 •- 0001
13125 SW I•Iall Blvd., Tigard, OIt 97224 S' 2013 Pin„ Review _
11. . Phone: 503.7182439 Pax: 503.598.1060 Meant : Other Permit: / 3 -00(
TIC n lr n Inspection Line: 503.639.4175 Date Ready/By: 1 / ®y page z for
Internet: www.tibwd -or. � �p� Notified/Method: (7 Su pplemental Information
1 .t al 11.. :Ivy' . _ _
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit it acts of plans w /items checked below):
D Service or Rcdcr 400 amps or mom I] Building over dace stories.
Q Demolition GI Other:
whom the available fault email ❑ Marinas and boatyards.
.Mlnl•W'' y 'mom exceeds 10,000 sat 150 volts or g buildings.
�� 1� +��: ' t0'����, arms � f buildings. '� `� �'� — — _ T leas to ground, or exceeds 14.000 Cl Commercial -use agicuttutal •
❑ 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building amps mr all other installations. buildings.
❑ Mullii- family ❑ Master builder ❑ Other. CI Fire pump. D Installation ar75ICVA or
{O _ D Iimertgensy system. threes separately derived system.
1, ,.,:_ . - -•�_ -z b`il . _. T!►D Ce1!Fl�lt :r ^�' D Addition ofaew molar l of 0 "A ". "E". "1-2"."1-3".
Job no.: I Job site address: 12670 SW HALL BLVD. • 100HP or more. occupancy.
D Sa or more nnidcntial units. D Recreational vehicle parka.
City / State/ZIP: TIGARD, OR 97223 0 tleutih.ca,e facilities. D Supply vollago for mart than
0 Hazardous locations. 600 volts nominal.
Suit.c/bldg. /apt. no.: BLDG #3 I Project name: CANTEEN LEASEHOLD IMPROV 0 Ravi= or feeder coo amps or more.
Cross street/directions to job site: nne.trna. I ow. l r«. I Tact I •
New residential single- or mb111- family dwelling gall.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq. 11, or less 168.54 4
Ea. odd'I 500 sq. R or portion 33.92 I
Tax trop /parcel no.: Limited energy, residential 75.00 2
iirli yy iii =ff M'N. Vt (with above sq. lid
Limited energy, multi - family 75 00 2
INSTALL ELECTRICAL FOR TI ' residential (with above sq. It)
Services or feeders inslalation and/or relocation _
200 amps or less 2 100.70 201.40 2
WAMIStribl*WablitaHltligligiiipf-Affgfialitririrgfatil 201 amps to 400 snips I 133.56 133.56 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 55226 2
•
City/ State/ZIP: �� pore services or feeders installation, alteration. and/or
Phone: ( ) I F ( ) 200 amps or less 59.36 1
R Owner installations 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, per panel
Owner signature: _ .Dale A. Fee for branch circuits with
1 above service or feeler fee, 35
72 259.70 2
-. - = . each branch circuit
Business flume: B. Foe for branch circuits withuui
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each ndd'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not Included)
City /Stu.e/7,1P; dwelling, service and/or feeder
67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E -mail: _ _ Sign or outline lighting 67.84 2
- 3 '= _-Z' .': = >x:
Signal circuit(S) or limited-energy
Business name: ADVANCED ELECTRIC, INC. panel, alteration. or extension. Parte 2 , 2 .
Each additional inspection aver allowable in any of the above
Address: 21811 NE 58 STREET Additional inspection (I hr min) 66.25/ hr
City /State/ZIP: VANCOUVER, WA 98682 Invesligrttiem (1 hr min) 6625/ hr
, Industrial plant (I hr min) 78,18/ hr
Phone: (360) 254.6864 Fax: (360) 2542854 Inspections for which no fee is
specifically listed (1/2 br min) 90.00 / hr
CCB Lie.: 117052 I Electrical Lie.: 37 - 873C Suprv. Lie.: 3734S EMNREIVWSEIIEEEZOWELM,
Subtotal: 594.66
Suprv. Electrician signature, required: Plan review (25% of hermit fee):
Print name: KENNETH H GER f Date: 2/5/13 State surcharge (12% of permit fee): 7136
Authorized signature: �,/ TOTAL PERMIT ICE: 666.02
' „,., r,// - �'� i This per,nit application expires if a penult is not obtained t el 180
Print none; Da • days after it has besn emoted as complete.
Number of inspections athtwed per permit.
1:11kaldiugtrmmitsU3 .C.PermiMpp.doc 07/01/10 .140. 46157(11/05 /COMIWm