Permit CITY OF TIGARD ELECTRICAL PERMIT
8 : COMMUNITY DEVELOPMENT Permit #: ELC2013 00188
T E G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/26/2013
Parcel: 1 S135DC00200
Jurisdiction: TIGARD
Site address: 11845 SW GREENBURG RD 100
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: (5) branch circuits and (1) low voltage permit 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:
FAX: 503 - 585 -8828
FEES
Quantity Description Date Amount
1 ea Limited Energy 03/26/2013 $75.00
Specifics:
5 crt Branch Circuits wo /Purchase 03/26/2013 $85.86
Service or Feeder
Type of Use: COM 1 ea 12% State Surcharge - 03/26/2013 $19.30
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
•
Total $180.16
Required Items and Reports (Conditions) '
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OAR 9 2- 01- 0099 .. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332
.
Issued By: t Ju J Permittee Signature: OM APPuer'T�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
4.
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
Electrical Permit Application t'S
RECEIVED FOR OFFICE. E. ON L'
lig .. • X(D Permit No.: , / 3 i "
C1 of Hall Blv Tigard. OR 97223 DatclB (3 t CAD 0 r
13125
e� M AR 2 6 201 Plan Review Other Permit:
Phone: 503.71824 Fax: 503.598.1960 Date/B .
T I G A K D Inspection Line: 503.639.41 Dare Ready/tSv Fit SS rage 2 For
Internet: w'ww.tigard or.gov CITY OFTIGARD Notificd/Mcthod: Supplemental Information
TYPE OF wt$WLUING DIVISION PLAN REVIEW
❑ New construction ® Addition /alteralion/replacement Please check all that apply (submit a sets of plans w /items checked below).
❑ Demolition ❑ Other: where Service or feeder 400 amps or mote ❑ Budding over three stories.
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds ]0,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ l- and 2- family dwelling ED Commercial /industrial ❑ Accessory building amps for all other installations. buildinps.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system" larger separately derived system.
❑ Addition of ocw mctor load of ❑ "A ", - E ", 'I - °, "I - ",
100HP or more. occupancy.
Job no.: Job site address: 11845 SW Greenburg Road
❑ Sic or more residential units. ❑ Recreational vehicle parts.
City; State /ZIP: ['Health facilities. ❑ Supply voltage for more than
❑locations. llaaardous loc G00 ions nominal,
Suite/bldg. /apt no.: 100 I Project name: SP 6e, 51;1 L ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: oeresiption
I Qtr• 1 Pea 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
Tax map /parcel no.: Ea. add'I 500 sq. fl_ or portion 33.92 1
Limited energy, residential
75,00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75,00 2
Tenant improvement 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
Name: 401 amps 10 600 amps 200 34 2
601 amps to 1.000 amps 301.04 ; 2
Address: Over 1,000 amps or volts 552.26
Temporary services or feeders installation, alteration, and/or
City/State /ZIP:
relocation
Phone: ( ) I 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 sale, leas:, rent, or exchange, according to ORS 447, 449. 670. and 701.
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
ria APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
• Business name: VaS.{. � ki'.C.4 1 ( , 1(., rl�# B. Fee [orbrancli circuits without
service or feeder fee, first 1 56.18 56.18 2
Contact name: branch circuit
Each add'I branch circuit 4 7.42 29,68 2
Address: Miscellaneous (service or feeder not Included)
City/Stale/ZIP: Each manufactured or modular 67.84 2
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 circuits) or limited-energy
Business name: Vast Electric, Inc. panel. alteration, or extension. 1 Page 2 75.OU 2
Each additional inspection over allowable in any of the above
Address: 1525 Seattle Slew DR SE Additional inspection (I hr min) 6625/ hr
City/StateJZIP: Salem, OR 97317 Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: (5D3) 799 -5627 Fax: (1 - 503) 585 - 8828 Inspections for which no fee is 90.001 hr
specifically listed ('' /, hr mi _
CCI'3 Lie.: 175531 Electrical Lie.: C - 280 Suprv. Lie.: 5186S ELECTRICAL P FEES
Supt', Electrician signature, required- Subtotal: ' 160.86
�. )4i... Plan review (25% of permit fee):
Print name: Tim Vander Stoep Date: 3/26/2013 State surcharge (1 2% ofpermit Fee): 1 19.30
TOTAL PERMIT FEE: 1 80.16
Authorized signature:
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: I Date: • Number of inspections allowed per permit.
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