Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 00225
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/17/2013
Parcel: 1 S135DC00200
Jurisdiction: TIGARD
Site address: 11845 SW GREENBURG RD 120
Project: Spec Space Subdivision: TIGARDVILLE PARK Lot: 8
Project Description: (5) branch circuits and (1) low voltage 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 04/17/2013 $75.00
Specifics:
5 crt Branch Circuits wo /Purchase 04/17/2013 $85.86
Service or Feeder
Type of Use: COM 1 ea 12% State Surcharge - 04/17/2013 $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- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 ►'I - 2..1987 /.8
or 1.800 4 .332.2344..
Issued By: \ -�1 of Permittee Signature: LJ^+ r / �-� � -;-� / ! (/ A
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 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.
Apr 16 13 01:20p Vast Electric Inc. RR 503- 585-8828 p.2
Electrical Permit ApplicatioBECEIVEL.� nn I oIt all I I( b I ,1 (4\l '
City of Tigard AP 1 2013 � `f I 7 //3 9r No.: 3lU13 00 ?-45
13125 SW Hall Blvd., Tigard, OR 97223 Plan RCA C
n Phone: 503.7182439 Fax: 503.598. Other > Permit: U O1
Inspection Line: 503.639.4175 Y OFTIGARD Dale Isis. m See Page 2far
,' ' IN Internet: www.tigard- ar.gov BUILDING DIVISION tidied: Supplemattal lefare,atiao
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sets of pla is whims checked below):
❑ Service or feeder 400 amps or more ❑ Budding aver three stones.
❑ Demolition ID Other:
where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 151) volts or 0 Floating bufdioga.
less to ground, or exceeds 14,000 ❑ Commercial -use agriwlwrai
❑ 1 - and 2- family dwelling ® Cotnmcrcialindustrial ❑ Accessory building amps for an odra mstallalions. building.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Itastallation of 75 RVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
El Addition of flaw motor load of 0' A - ,' E","1 -2 ", "1 -3
Job no.: I Job site address: 11845 SW Creenburg RD t001 - [P or mom. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard OR ❑ 11ealth - care facilities. ❑ Supply voltage for more than
['Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: 120 Project name: ❑Samee or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Orr- I Ike I Teel I •
New residential single- or multi- family dwelling unit.
Iaeludes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 16834 4
Tax map/parcel no.: Fa add, 500 sq. fl. or portion 33.92 1
Limited energy, residential
DESCRIP770N OF WORK (with above sq. R.) 75.00 2
Limited energy, multi- family 75.00 f 2
Tenant improvement residential (with above sq. ft.)
Renewable Energy Q See Page 2 _
Services or feeders installation. alteration, and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 ; 2
Address: 601 amps to 1,000 amps 301.04 1
City/State/ZIP: Over 1,000 amps or volts 552.26 1
Temporary services or feeders installation, alteration, and/or
Phone: ( ) ; Fax: ( ) relocation
200 amps or less 59.36 1
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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
® APPLICANT ❑ CONTACT PERSON A. Fee for brands circuits with '
-
above service or feeder fee, 7.42 2
1 Business name: Vast Electric, Inc. each branch circuit
B. Fee for hand circuits without
Contact name: service or feeder fee, first 1 56.18 56.18 2
branch circuit
Address: Each add'1 branch circuit 4 7.42 29.68 2
City /5tate/ZIP Miscellaneous (service or feeder not included)
Each manufactured or modular
Phone: ( ) I Fax: : ( ) dwelling, service and/or feeder 67-64 2
I Reconnect only 67.84 2
E -mail Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Vast Electric, Inc. Signal circuit(s) or limited-energy
panel, alteration, or extension I Page 2 75 2
Address: 1525 Seattle Slew Dr SE Each additional inspection over allowable in ann of the above
Additional inspection (1 hr rain) 66.25/ hr
City/State/Z1 P: Salem, OR 97317 tl invest gation (1 hr min) 6625/ hr
Phone: (593) 799 -5627 1111' I Fax: ( - 503) 585 -8828 10 , t ` 1 — Ind - plant (1 hr min) 78.18/ hr
Inspections for which no fine is
CCB Lic.: 175531 ✓ • _ ( Electrical Lic.: C -280 .uprv. Lic.: 51865 specifically listed (% hr min) 9000/ hr
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, require � friu AI 41 ilki Subtotal: 160.86
Print name: Tim Vander Stoep Date: • 16/2013 Plan review (25% of permit fee):
State surcharge (112% of permit fax): 1930
Authorized signature: TOTAL PERMIT FEE: 180.16
his permit appEcaMn expires j5- a permit as not obtained within 180
Print name: Date: days after it has been accepted as complete_
• Number of inspections allowed per permit.
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