Permit 1.
•
N CITY OF TIGARD ELECTRICAL PERMIT
' sx COMMUNITY DEVELOPMENT Permit #: ELC2009 -00347
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 639.4171 Date Issued: 08/06/2009
a 7 5W f 0 . a Parcel: 1S136CA01601
/
y� f�/o{ � k � Cl � Jurisdiction: Tigard
Site address: H
Subdivision: Lot: 0
Project: Keybank
Project Description: Add (1) 200 amp panel and (30) branch circuits for TI.
Owner: FEES
HALL, DONALD W & GRACE L & Quantity Description Date Amount
HALL, JOHN G ET AL, BY FIRST AMERICAN
REAL ESTATE TA, 8435 N STEMMONS 1 ea Services or Feeders - 200 08/06/2009 $80.30
amps or less
PHONE: 30 crt Branch Circuits w /Purchase 08/06/2009 $199.50
Service or Feeder
1 ea 12% State Surcharge - 08/06/2009 $33.58
Contractor: Electrical
COCHRAN INC 7 crt Branch Circuits w /Purchase 08/06/2009 $46.55
626 SE MAIN ST Service or Feeder'
.PORTLAND, OR 97214 0 ea 12% State Surcharge - 08/06/2009 $5.58
PHONE: 503 - 234 -6564 Electrical •
FAX: 503 - 238 -2098
•
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp:
•
Total $365.51
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.
Issued By: �� U U.. ` -JK % A.L. Permittee Signature: IL;
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.
FROM COCHRAN— BROADWAY (THU)AU6 8 2008 10: 62 /ST. 10: 62 /No. 7500000888 P 1
Electrical Permit Applica i �/ F I ()N 4 , 1 1 1, I , , 1 i
City of Tigard pp II II Date/By:
1 4 Permit Na : c 1 2. -co 3q7
13125 SW Hall Blvd., Tigard, OR 97 @ffi G O 2009 Nan Review
503 639.4171 Fax: 503.598.1960 r± Date/By: Other Permit:
I I c , \ ; ■ Inspection Line: 503.639.4175 CITY OF TIGARD a See Page 2 ter
Internet: www.tigard-or.gov
Dill_ 10 � NatiSedllvtethod: R*- SapplSupplemental la>o
fotaeiw
TYPE OF W DUG DIVISIn PLAN REVIEW
❑ New construction ® Addition/alteration/replacement ire chock all that apply (submit 1 sets of plans wrrums checked below):
❑ Demolition
['Service or feeder 400 amps or more 0 Building over three stories
❑ Other: where the evadable fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or O Floating buildings.
[1] 1 -and 2-family dwelling less to ground, or exceeds 14,000 0 Commercial -use agricultural g ® Commercial/industrial ❑ Accessory building amps for an other installed/ins. buildings.
❑ Multi-family ❑ Master builder ❑ Other: 0 Fire pump 0 Installation of 75 K V A or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system.
Addition n of new motor load of 0 "A" "E" ", "1-2", "1 -3•
Job no.: 141386 1 Job site address: 12744 SW North Dakota 100HP or more. occupancy.
0 six or more r dential units ❑ Recreational vehicle perks.
City/State/ZIP: Tigard OR 0 Heahhcme facilities. 0 supply voltage fee more than
0 Haamdous locations. 600 volts nominal
Suite/bldg. /apt no.: Project name: Key Rank 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Descrlpdo. I Q4. I Pee. I Tend I •
New residential single or multi family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. add'1500 sq- fl. or portion 33.40 I
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. tL)
Bank Ti, new lights/pane l Limited
residential (with a s ilf 7500 2
Services or feeders installation and/or relocation
200 amps or less I 80 30 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106 85 2
Name: Key Bank 401 amps to 600 amps
, 1 1 60 °685
60.60 2
601 amps to 1,000 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: ( ) _7 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
Branch circuits — new, alteration, or extension, per.panel
Owner signature: Date: A. Fee for branch circuits with
® APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 37 6.65 246.05 2
each a circuit name: Cochran Inc.
B. Fee for branch circuits
without service or feeder fee,
Contact name: Larry Shoff 46.85 2
first branch circuit
Address: 626 SE Main Street Each add'I branch circuit 6.65 _ 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Portland OR 97214 Each manufactured or modular 2
90.90 dwelling, service and/or feeder
Phone: (503) 2346564 Fax: : (503) 2382098 fee Reconnect only . 66.85 2
E -mail: rdoane(alcochraninc.com Plump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Same as applicant Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (I br min) 62.50
CCI3 Lic.: 72942 I l Electrical Lie.: 37 -546C Suprv. Lic.: 3447S industrial plant per hour 73.75
5 V'-1 (� ELECTRICAL' PERMIT FEES' -.-
Suprv. Electrician signature, required:
Subtotal: 326.35
Print name: Kenneth Kato Date: 8/5109 Plan review (25% of permit foe):
State surcharge (12% of penult fee): 39.16
Authorized signature: TOTAL PERMIT FEE: 365.51
Print name: I This permit application expires Ns permit is not ebtaiard within 180
Date: _ days after it Ism beat accepted as complete.
C OCt 1, {Q ✓1 1 lA. t -
Electrical trical Peymit Application 666 1��� 999 R!E I FOR OFFICE USE ONLY
ill j ��� O
City Of Tigard Date /By Permit No l �(
: ;n 13125 SW Hall Blvd., Tigard, OR 97223 JUL 15 2009 Received
Plan Review
Pl e. 1O3 639.4171 Fax: 503.598 1960 Date /By Other Permit
TIGARD Ii;;=pection Line: 503.639 4175 CITY OF TIGARD Date Ready /By: runs I ® See Page 2 for
Internet. www tigard-orgov
BUILDING Notified/Method: ( C Supplemental Information
1
x;a.. TYPE .OF WORK..... ..- ...... ::. :i PLAN REVIEW =:
q .
Please check all that apply (submit 2 sets of plans w /items checked below)
❑ New construction 'Addition /alteration /replacement
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
x. -:, ; ,-,::,::, ,. fi .. :- - AS (V f, or •...., .......<......,, .. exceeds 10,000 amps I50 volts o Floating buildings
...�.�,�:..: CA TEGORY OFD CONSTRUCTION<;...:;;.•:' :.�:.. ' P s
:.;.
" less to ground, or exceeds 14,000 ❑ Commercial-use agricultural
❑ 1- and 2- family dwelling Q"fommercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation of 75 KVA or
�: Emergency system larger separately derived system
::.. JO::S.I.ILE : NIiORMATION ANDS 041cioN
:.:: :•,:�':: €�::€T�rrr,a B
a . . .:..... I : ��. ,::. d.... :...:- .: :,.. '. . " . ..::: ❑ Addition of new motor load of .. .< _
Job no.: Job site address: I l ro (o S E\ J Pu ifl C. H WV. IOOHP or more. occupancy.
V ❑ Six or more residential units ❑ Recreational vehicle parks
City /State /ZIP: 1' card , Ole, q 7 2-23 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: Key exa n k,- Ti ga.rct ❑ Service or feeder 600 amps or more.
, ;: . FEE SC HEDULE %,:',....:,. .; Cross street/directions to job site: Description ., I Qty. i Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145 15 4
Ea. add'( 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: residential
.; : . 75.00 2
^p .: ,, , :, ;�: � Limited
ft)
5:��"•DE "WORT{'::::: � � . with above sq.
Limited energy, multi- family 75.00 2
Li au sec( tenant i m p Yv veme,rrri- residential (with above sq ft )
Services or feeders installation, alteration, and/or relocation
: ::
� . 'p'. 200 am to or less p 80.30 2
.PROPERTY:"OWNE . .retl
❑ � TEN'A � 201 amps to 400 amps 106.85 2
Name: Kevf 401 amps to 600 amps 160.60 2
ll 601 amps to 1,000 amps 240.60 2
Address: 2.O2 3 Ortar I O 5t. 1-44-h Floor Over 1,000 amps or volts 454.65 2
City /State/ZIP: Cleve land OH 44 I I Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
:: s" . ❑ : APPLICANT:c : p „
" _ N , . :r:. : .:;. CQNTACT, ERSON..�� above service feeder f
ce or eeer ee,
�:: _ « b 6.65 2
each branch circuit
Business name: \ io,co 'jc> B. Fee for branch circuits
Contact name: C,hr( Scar t-
without service or feeder fee, 4685 2
rJ first blanch circuit
Address: 2.50 e.. e -ocy ‘ 5} . Sur 1 1150 Each add'( branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: C,Ol urrl btS, OH 43 2IS Each manufactured or modular 90 90 2
( Col y )1437 ?i (6 ) 43 dwelling, service feeder
Phone: `'' F ax:: Reconnect only 66 85 2
E -mail: Q' hf 1 S . ScinrO.Y1� V�GOl7S • (• Orr, Pump or irrigation circle 53.40 2
�, `:' ::.. '.; ':::: .: z:. .:.CONTRACTOR ' ".a . �.. 7,45,45k :
.. ' .. Sign or outline lighting 53.40
Signal circuit(s) or limited-
Business name: '"rte energy panel, alteration, or
Address: extension. Descnbe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (I lir mein) 62.50
CCB Lie.: Electrical Lie.: Suprv. Lic.: Industrial plant per hour 73.75
P v ::: :: r.' - :g>.ELECTRICAL PERMIT: FEES' ' :;::.. . es:
Suprv. Electrician signature, required: Subtotal:
Print name: Date:
Plan review (25% of permit fee):
State surcharge (12% of permit fee)
Authorized signature: / r / ! TOTAL PERMIT FEE �1 �, ?...,8
This permit application expires if a permit is not obtained within 180
Print name: „• I' A N Date: 1 / days after it has been accepted as complete.
• Number of inspections allowed er permit ` S 0
I• Bwldmg.Permits.ELC- PermitApp 05.'23:06 440- 4615T(11'05 /COM'WEB k' a 10 - 0` 3 t J
7. 15 -69 n� ui_