Permit n CITY OF TIGARD ELECTRICAL PERMIT
NI a COMMUNITY DEVELOPMENT Permit #: ELC2013 -00251
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/01/2013
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 for remodeling restrooms on 5th floor
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 05/01/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 05/01/2013 $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 OA 2-001-0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 A l I 1987 orr1.8800 ;
Issued By: i'2�C�Gl e t�GC /l Permittee Signature: D/V L(C 4 t f 7
0 Q-
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.
May, 1, 2013 9.530 RECEIVED No, 1268 P. 2/3
Electrical Permit Application FO OFFICE USE ONLY
City of Tigard 0 Received
MAY 1 2013 Date/B ' t i a Sx PenniLNo.! ? Xi( 3 1
- 4 13125 SW Hall Blvd., Tigard, OR 97223 - Ian ' eview
t Phone: 503,718.2439 Fax: 503.598.19 0 Date/13 ; Other Permit:
TIGARU Inspecllon Line: 503.639 C ITY OI+TIGARD DuloReady/9Y: El See Paget for
Internet: www.ligsrd- or,gov BUILDING DIVISIO i NolifiediMethod: Supplemental information
t . 1
❑ New construction (r Addition/alteration /replacement Plea:r check all that apply (submit a sets of plaits wilt mils checked below):
0 Service or feeder 400 amps or more ❑ Building over three stories.
Q Dtm ❑ Other: where the available fault current Q Marinas and boatyards.
igin i , A , ,,4n- .^ []
exceeds 10,000 amps al 150 volts or Floating buildings. i.:';', „ nl ' ea ` ' , - ' , vom it B ,i.,', 0:, , It l) � , . �y s "5"' , a ' less to round or exceeds 14,000
In
dwelling B Q Commercial-use agricultural - and 2-family g [E�Commcrctalhndustnal l Accessory building amps for all other installations, buildings. •
�,-1 Multi- family p Master builder 11 Other: • ❑ Fire pump. ❑ Installation of 75 KVA or
, A ,ta r . , ❑ timer enc
:;,,;,;,)1.',.., ..L T,I,,,t s r ) I b 1�0 , A . � b 14 1 0 r °�� g y new system, larger separately derived system.
td:' 0 of new motor load of d "A ", "H ", "1 - ", ` °l - ",
Job no. / /e 2 •, Job site address: q(�� .set.., e.-- e.-- ' ... � 100HP or more. occupancy.
❑ Six or more residemial units, Q Recreational vehicle parks.
City /State /ZIP: CP/4S ❑ Health •earn facilities. 0 Supply voltage for more than
1 p Hazardo locations, 600 volts nominal.
SuiteJbldg. /apt. no.• roject name: / ❑Service or r feeder 600 amps or more
Cross street/directions to job site: oescnpaon w. Pee. Twill
New residential single- or multi - family dwelling unit.
• — Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fl. or less 168.54 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.92 1
`4, Limited energy, residential
°Vrar - k i 6,•1 eN !7 t�^
r :. � � y }; b�SC121,( da ' O ORK�;+ >� ' ^ +, a' c ,i , ° „ ;t t i y nS�* (with above sq. R.) 75.00 2
Limited energy, multi -family 75.00 2
_residential with nb ovo
^f ' ' ItcnchtibleEner ': ❑ .See Pagi2
�4 - `
v �/ � • Services or feeders installation, alteration, andlor relocation
' V1 d it t et i h- E M1 6 • E `, �' # i ;:.!:''', 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 2
Over 1,000 amps or volts 552.26 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) l) 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 flops to 400 amps I 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
p i; ,? i Bit A 'p;. I t ti i t I `10RNTA PFI SU(V ?, A. ke forbrauch circuits with
abovo scrvico or feeder fee,
Business name: / each branch circuit x.4 2
��
B. Fee for branch circuits without
Contact name: .5z0l, Ca l.5e yl service or feeder fea first 56.18 /S 2
branch circuit
Address; Each add'I branch circuit / 7.42 7.4/A 2
Miscellaneous (service or feeder not included)
City /State /ZIP: µf-
Each manufactured or modular
Phone: L 3 67 •6 77/ ( ) dwelling, service andlor feeder 67'84 2
Fax:'
._, Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
° ♦ M1
I
,f;�`l -., � . ,�a -. ., . ' f : #. �:. � _ Sign or outline lighting 67.94 2
Business name. 4 _ „�' i„1� a.
(rf� Signal circuit(s) or limited-energy
A or -' - X � panel, alteration, or extension. Page 2 2
Address: 7// S� c / Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection (1 hr min) ry 66.25/ hr
�A �h /y ( / A IZA.,5 Investigation (1 hr min) 66.25/ hr
Phone: ( - :,,,. i 77 Fax: ( . 54 1.t , ' ” Industrial plant (1 hr min) 78.18 / hr
Inspections for which no fee is
CCB Lic.: l� ( ' Electrical Lic.: _ ,- -d, Suprv, Lie.: s�eeificall listed ('/� hr min 90001 hr
Suprv. Electrician signature, required: - t WI V u 5. 6.,,,
• _ - .,a, a. Subtotal:
Print name: ell? c1 n Dale. i / Plan review (25% of penult fee):
- Slate surcharge (12% of permit fee):
Authorized signature t� .4, J., 1 TOTAL PERMIT FEE: 7/, 3
This permit application expires If a permit' Is not obtained within I80
Print name: Cw' h g i�l�� Date: t'5 /g3 days after It has been accepted as complete.
e Number of inspections allowed per permit.
1:113uitdinglPermiislELC_Permii App_0409 L Lace 440-461 5T(1 I /a6 /COM/WEB
May. 1. 2013 9:53AM No. 1268 P. 1/3
Dynaleetrlo Company
Qynalectrlc 5711 SW Hood Avenue
Portland, OR 97239
An EMCOR Company Phone: 603.226.6771
Fax: 503.226.7816
ccb: 66793
Faxsimile
Number of pages Including this cover sheet: 3
Date: 5/1/13
To: Electrical Permit Dept Tel:
Company: City of Tigard Fax: 503 -598 -1960
From: Lynne McEachern
•
Message:
Following is an Electrical Permit Application to be processed.
Thank you
Dyna -019 Rev. 02/17/04