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Permit a CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT Permit #: ELC2013 00240 T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2013 Parcel: 1 S135BD00100 Jurisdiction: Tigard Site address: 9600 SW OAK ST Project: Plaza West Subdivision: ASHBROOK FARM Lot: PTS 5 & Project Description: (2) branch circuits to connect (2) rooftop HVAC units Contractor: DYNALECTRIC Owner: SUN LIFE ASSURANCE CO OF CANADA 5711 SW HOOD AVE BY NORRIS BEGGS & SIMPSON PORTLAND, OR 97239 121 SW MORRISON ST #200 PORTLAND, OR 97204 PHONE: 503 - 226 -6771 PHONE: FAX: 503 - 226 -7720 FEES Quantity Description Date Amount 2 crt Branch Circuits wo /Purchase 04 /29/2013 $63.60 Specifics: Service or Feeder 1 ea 12% State Surcharge - 04/29/2013 $7.63 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $71.23 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 85 - 001 -00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Old 4PPO C,7 Issued By: Permittee Signature: 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. Thls 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. 26. 2013 1: 07AM No, 1253 P. 2 Electrical Permit ADO iF Wit EIVED •FOR OFF • OFFICE USE ONLY 171 City of Tigard Raeeived 13125 SW Hall Blvd., Tigard, oljq 232 9 2013 oarero : 9 ) 3 Fermi( Ne. -get 30 13_ cva4,a Phone: 503.718,2439 Fax; 503.598.1960 Plan Review TIGAAD Inspection Line: 503.639.417 Da : O ther Permit: +)1. n OFT Dale R eady /By; See Paget for Internet: www.tigard-or.gov j� I'� DING DIVISION Notified/Med�od: Supplemental Information r ! • . TVA t ii1 VI'OR i .• .; PLAN' REVJEl1r ❑ New construction Addition /alteration /re lacement Please check all Om apply P Addition/alteration/replacement AP r (submit Z see of laps vv/items c hecked below). — Q Service or feeder amps or more ❑ Building over three stories, ❑ Demolition ❑ Other: where the available fault current ['Marinas and boatyards. CATEGORY OF ' CONSTRUCTION ; • . f exceeds 10.000 amps at 1S0 volts or ❑ Floating buildings, Y dwelling Commer /indust ❑ Ac cessory b uilding less to groun other rose exceeds 14,000 dwellin 12 Commercial -use agricultural D 1 and 2 for all other installations, buildings. El Multi family ❑ Master builder ❑ Other: ❑ Fire pump, ❑ !mutilation of75KVAor :,' JOIi' SITE II\'1'ORA4ATION AND LOCATION ❑Emergency system. larger separately derived system . A ❑ Addition of new minor load of ❑ "A•', "E ", "1 -2", "Jr .. Job no, - /I S D + .Cob Site address: 9 ,54) U S7 IOW or more, occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parka. City/State/ZIP: � f A. ID Heath - care facilities. • ❑ Supply voltage for more than ❑ Hazardous locations, 600 volts nominal. Suite /bldg. /apt, no.: Project name: z ���� ❑ Service or feeder 600 amps armors. Cross Street/directions to job site; FEE SCHEDULE Oejeription . . I Qty. I Fee. I Tora — New residential single- or multi - family dwelling unit. Includes attached garage, Subdivision: + Lot no.: 1,0004 I1. or less 168,54 q Tax map /parcel no.: Ea. add'I 500 sq. 11. or portion 33,92 I DESCRIPTION OF WORK Limited energy. residential (with above sq. it) 75,00 2 Limited energy, multi - family r 0 %•0 ♦1 A residential (with above sq. ft,) 75.00 2 - Renewable Energy ❑ See Page 2 • Services or feeders installation, alterat A nd /or relocation _ LI _PROPERTY OWNER Q. TENANTI 200 amps or less 100.70 2 Name: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 City /State /ZIP: Over 1.000 amps or volts 552.26 2 - Temporary services or feeders i nstallation, alteration, and/or Phone; ( ) F ax: ( ) relocation Owner installation: This installation is being made On property that 1 own which is not 200 amps or less 39.36 1 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 201 amps to 400 amps _25.08 401 amps to 599 amps 168.54 1 22 — Owner signature: Dr anch circnits -new, alteratio or etetensima per panel .0 APPLICANT . KCONTr1CT PERSON A. Fee for bmnch r ffeeder with above service or feeer fee. Business name: 7 42 • �, / each branch circuit 2 B. Fee for branch circuits without Contact name: (Qt.-/, service or feeder fee. first ■ f` branch circuit 56.18 2 7 Address: Each add'I branch circuit ��� .42 7 yq 2 City /State/ZIP: nliscellaneons (service or feeder not Included , Phone:r f / �� Each manufactured or modul e _ ;533) ,C� . !; .7 Fax: ( ) d wellin ,service and/or feeder 67.84 2 E-mail: Reconnect only 67.84 2 Pump Or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 Business name: ' 2 ti i► Al le / S c or limited limited-energy p anel eltenlion, orextensio Address: n. page 2 y L.. � —Sly d � CQ Each additional Inspection over allowable in any of the above City /State/ZIP: ©" / � / eA 9 7� Additional inspection (I hr min) 66.25 /hr - (- investigation (I hr min) 66.25/ hr Phone: ) Fax: ( -- Z2 ) O� e~ / , . Industrial plant (1 hr min) 78.18/ tar fin El ect rical Lie.: . ::-r Inspections for which no fee is 9 � � Suprv. Lie.; � ( s cificah • listed (/ hr min) 90.00 / hr CCB Lic.: Suprv. Electrician signature, required: a � - 1 . • i ELECTRICAL PERMIT TEES Subtotal: i' ! n Print name; lY Dal 1 t i .__ Plan review (25 ° r6 of permit fee): 1 State surcharge (12% of permit fee): 7 / & fit Authorized signaltl �� / ' __ TOTAL PERMIT FEE: /. Print name: � 1JA1 / flits permit np expires if n permit is not obtained within 180180 u '" cla nncr it has been accepted en complete. s I , i!uildingV'ermi [ sIELC Permitppp 010917.doc • N of inspections allowed per permit. 140.46a$T( I 1/05 /CQM/WEB Apr. 26. 2013 7: 07AM No. 1253 P. 1 q Dynaleotric Company ' Dynalectric 5711 SW Hood Avenue Portland, OR 97239 An EMCOR Company Phone: 503.226.6771 Fax: 503.226.7818 ccb: 66793 Faxsimile Number of pages including this cover sheet: 3 Date: 04/26/13 To; Electrical Permit Dept Tel: Company: City of Tigard Fax: 503 -596 -1960 From: Lynne McEachern Message: Following is an electrical permit application and credit card authorization form to be Processed Thank you. Dyna -019 Rev, 02/17/04