Permit CITY OF TIGARD ELECTRICAL PERMIT
liAli _ COMMUNITY DEVELOPMENT ELECTRICAL
ELC2013 -00210
TI G A R. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/08/2013
Parcel: 1S134AA01800
Jurisdiction: Tigard
Site address: 10200 SW NIMBUS AVE G4
Project: Spec Space Subdivision: IKOLL BUSINESS CENTER, TIGARD Lot: 2
Project Description: (6) branch circuits
Contractor: WINNER ELECTRIC INC Owner: HANSON, RONALD D
5950 SW PROSPERITY PK ROBINSON, CONSTANCE A
TUALATIN, OR 97062 ROBINSON, CHESTER TRUST ET AL
203604 EAST FINLEY RD
KENNEWICK, WA 99331
PHONE: 503 - 638 -5028 PHONE:
FAX: 503 - 638 -4242
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo /Purchase 04/08 /2013 $93.28
Specifics: Service or Feeder
1 ea 12% State Surcharge - 04/08/2013 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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. A ' 'TION: Ore, •. law req ' - you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -.010 through OAR 95 001 -r •0. You ma obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue. By: /� / � - Permittee Signature: Al E / Ad,. . F2.- s
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 / 1 )wnl �S( S Date:
LICENSE NO. w((�//� U
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.
Electrical Permit Applicatio l OR O t ,t: t)\,\
City of Tigard C � � Received ,; MO: i Permit No.: &%6 al 5 04.
IN 13125 SW Hatt Blvd., Tigard, OR 9/2)1 Plan Review
. Phone: 503.718.2439 Fax: 503.598.1 96APR 0 8 Date/B : Other Permit:
2013
Ti ,\ }, TT Inspection Line: 503.639.4175 Date Ready/By: lugs: ® See Page 2 for
Internet: www.tigard-or.gov CITY OF TIIGAR�D Notified/Method: Supplemental Information
TYPE OF 219E DING 11IVISIS Ile Please check all that apply (submit 22 REVIEW
of p
❑ New construction Vg Addition/alteration/replacement 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 0 "A ", "E ", "1-2", "1 -3",
Job no.: I Job site address(*44,v or more. occupancy.
+ 5 Id, 4/ °r'� ❑Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: Rl PL'i 4 Neta 00/ ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: G' /i Project name: . . 7 e 't is $ c.g5 -P 'j,yz - ❑ Service or feeder 600 amps or more. FEE SCHEDULE
Cross street/directions to job situ j1.1r r �7l,a, r
job � 1 GP tL V �n /1/ /tv• iga Description I OIY. 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
Ea. add'1500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Unn Limited energy, multi-family 75.00 2
t.AJ ry p� ,S' e+w6 Re nti residential (with above sq. ft.) -
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER ❑ TENANT 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 I,000 amps or volts 552.26 2
City / State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 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, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 61,4 2
Contact name: branch circuit
Each add'] branch circuit 5 7.42 3"), /c) 2
Address: Miscellaneous (service or feeder not included)
City /State /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 circuit(s) or limited- energy
Business name: ` L panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: (5q60 S 1A Pecs Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
City / State/ZIP: r / b Cl, `j06 Industrial plant (1 hr min) 78.18 /hr
Phone: ( ) 4 sS 5 8 Fax: (x1t.; ) 6sic yc) i f l Inspections for which no fee is 90.00 / hr
specifically listed (%2 hr min)
CCB Lic.: J ii-75 t.j Electrical Lic.: 314,./60,c_ Suprv. Lic.: g 'S ELECTRICAL PERMIT FEES
Subtotal: 9 'a g
Suprv. Electrician signature, required: t
tit);-k. 4 Plan review (25% of permit fee):
Print name: C� L,Sii , S Date: t _ State surcharge (12% of permit f i 1. I q
TOTAL PERMIT FEE: / c 4 46, q7
Authorized signature: This permit application expires if a permit is not obtained Within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
1: LC- Pdmi$Apiador 07/0I/10 440- 4615TO /105/COM/WEB