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Permit l CITY OF TIGARD ELECTRICAL PERMIT il '. ! COMMUNITY DEVELOPMENT Permit #: ELC2013 00141 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/04/2013 Parcel: 2S102AC01100 :; Jurisdiction: Tigard - Site address: 12564 SW MAIN ST 100 Project: Spec Space Subdivision: BURNHAM TRACT Lot: 1 ' Project Description: (3) feeders, (25) branch circuits and (1) low voltage for data. • Contractor: PRECISION NW ELECTRICAL Owner: MAIN STREET LLC & 12020 SE ANNA CT DUDUNAKIS, MICHAEL P DAMASCUS, OR 97009 2839 SW SECOND AVE PORTLAND, OR 97201 PHONE: 503 - 413 -9870 PHONE: FAX: 503 - 594 -2873 FEES Quantity Description Date Amount 3 ea Services or Feeders - 200 03/04/2013 $302.10 Specifics: amps or less 25 crt Branch Circuits w /Purchase 03/04/2013 $185.50 Type of Use: COM Service or Feeder • Class of Work: ALT 1 ea Signal circuit or Limited 03/04/2013 $75.00 Energy Panel Type of Const: 1 ea 12% State Surcharge - 03/04/2013 $67.51 Occupancy Grp: Electrical Total $630.11 • 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 acc 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. A TION: Orego law -.0 es •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 010 through OAR 952 -.:a 1 -009 ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Iss ed By: .. • / ei / Permittee Signature: AL. I � �J ♦ - 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' - . I �, ( I . - ` / Date: wv - - — - - - _ 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. I. Electrical Permit Applicati Crl - Received FOR OFFICE USE ONLY • 9 City of Tigard DateB : , s � � Permit No.: '- 4 , 4 6_0 0 / ° 13125 SW Hall Blvd., Tigard,OR 9722,31 p 4 2013 Plan Review C Phone: 503.718.2439 Fax: 503.598.1Y60 " Date/By: Other Permit: T IG A R D Inspection Line: 503.639.4175 � ( Date Ready/By: Loris HI See Page 2 for Internet: www.tigard- or.gov CITY 1 � I �I l1r+ Notified/Method: Supplemental Information ,. , p rat !rjr :ht TYPE OFiIV� til` Ii.)rVi PLAN REVIEW ❑ New construction ,ddition /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 stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. 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 JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "I - ", 100HP or more. occupancy. Job no.: Job site address: 1'2_5 (.. 4... S'S ) ' ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: • -� / © ❑ Health -care facilities. ❑ Supply voltage for more than 1 ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: '5101..e._ 1 PerCe ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qtv. 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 168.54 4 Ea. add'I 500 sq. ft. or portion 33.92 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 Limited energy, multi- family 75.00 2 2 1 c C � � ( L ! {- 6)09-7-11.- residential (with above sq. ft.) " J Services or feeders installation, alteration, and/or relocation LO' Jc t . -- -T .- V y� '\ /∎ n 1 200 amps or less 3 100.70 g , a. 2 ❑ PROPERT OWNER ❑ • T • EN ' AN ' T 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 Temporary services or feeders installation, alteration, and /or City/State /ZIP: 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 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: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 25 each branch circuit 7.42 !8S • Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'l branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) Ci /State /ZIP: Each manufactured or modular 67.84 2 ty dwelling, service and/or feeder Phone: ( ) 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 t Li � � panel, alteration, or extension. Page 2 7 2 Business name: , l �� t� Each additional inspection over allowable in any of the above Address: i To 9 C E A c Additional inspection (I hr min) 66.25/ hr City/State /ZIP: r A � �A/ (7� (� ' /� Investigation (I hr min) 66.25/ hr ��'�� W r J , LM.. — 1 1 Industrial plant (I hr min) 78.18 / hr Phon ) 44"R .— 1 l 7 0 Fax: (5 ) gg4,--2.� -3 5 Inspections for which no fee is 90.00 / hr specifically listed CA hr min) CCB Lic.: I tb3 1 8 Electrical Lic.: 0 Suprv. Lic. 03C ELECTRICAL PERMIT FEES _ Suprv. Electrician signature, required: ,���, >L , t j� o Subtotal: 5' .. ;∎•∎ (J Plan review (25 /o of permit fee): Print name: , t , ON A ✓ Date: 3_4_ /t _ 1 5 State surcharge (12% of permit fee): 6 7.5 � TOTAL PERMIT FEE: /„ 3 0 _' .1 Authorized signature: (� (� '� A Q�/� /`�� This permit application expires if a permit is not obtained within 180 Print name: r��A l M �/L���` v" ' O Da te: __ 4. — 1.. dape after • Number of inspections allowed d been accepted as complete. l d per permit. r:\Buitding\Permits\ELC- PermitApp.doc 07/01/10 440 -46t5T(11 /05 /COM /WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information 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 Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE,OAR 918 - 309,0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems • Data Telecommunication Installation Q ..;Fire Alarm Installation ❑ HVAC • ❑. Instrumentation ❑ Intercom and Paging Systems • ❑ Landscape Irrigation Control* -❑.• Medical ❑ Nurse Calls 1 ' 1 " ❑ Outdoor Landscape Lighting* ., ❑ Protective Signaling ❑ Other Total number of commercial systems: • *No licenses are required. Licenses are required for all other installations ? ' 1:\ Building \Permils\ELC- PermitApp.doc 07/01/10 • Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 12564 SW MAIN ST 100, TIGARD, OR, 97223 Commercial - Electrical 195 Misc. inspection 04/15/2013 00:00 ELC2013-00141 PASS Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 12564 SW MAIN ST 100, TIGARD, OR, 97223 Commercial - Electrical 115 Electrical service 03/21/2013 00:00 ELC2013-00141 PASS Violation Summary: Inspector Contractor Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 12564 SW MAIN ST 100, TIGARD, OR, 97223 Commercial - Electrical 115 Electrical service 03/21/2013 00:00 ELC2013-00141 PASS Violation Summary: Inspector Contractor