Permit n CITY OF TIGARD ELECTRICAL PERMIT
111 • -- COMMUNITY DEVELOPMENT Permit #: ELC2013 -00365
Date Issued: 07/01/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 7/01/2 C04500
Jurisdiction: Tigard
Site address: 7555 SW TECH CENTER DR A
Project: LaCie Subdivision: TECH CENTER BUSINESS PARK Lot: 1
Project Description: (1) 200 amp service and (50) branch circuits for TI of office and warehouse.
Contractor: VIKING ELECTRIC INC Owner: SUMMIT PROPERTIES INC
4326 SE WOODSTOCK BLVD SUITE 518 5550 SW MACADAM BLVD STE 205
PORTLAND, OR 97206 PORTLAND, OR 97201
PHONE: 503 - 775 -3479 PHONE:
• FAX: 503 -772 -0105
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 07/01/2013 $100.70
Specifics: amps or less
50 crt Branch Circuits w /Purchase 07/01/2013 $371.00
Type of User COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 07/01/2013 $56.60
Electrical
Type of Const:
Occupancy Grp:
Total $528.30
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 -0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. `/
Issued By: Permittee Signature: /� `� "G " C `��U ^ ■
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 603.639.4176 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.
r'r f ► . __. . _ . _ .... _. _ ... _
Electrical Permit Application JUN 2 7 2013 l FOR- OFFIC1 SE ONE)
i� - City of Tigard TIGARD t f Permit ��°� ,,3 ._ '•
13125 r � 1 ' // SW Hall Blvd., Tigard, OR " "' ' . OF Plan Review
Phone: 503.7182439 fax: 503 o Date/B.: I Other Peru ,020 /3 .0009
TIGARD Inspection Line: 503.639.4175 i NG DR/lS9 ®N DateReady/I3y: IIM EI See Page 2for
Internet www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit l sets of plans w/iterns checked below):
El Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition El 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 aericul Ural
❑ I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
1=I Multi-family El Master builder 0 Other ❑ Fire pump. ❑ Installation of 75KVAor
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A" "c" "1 2" ' 1 -3 '
�"
Job no.: I Job site address: 7 5 5 5 5W 7rch 0 -4/ " Gr • 100HP or more.
❑ Six or more residential am occupancy.
units. ❑ Recreational vehicle parks.
C1 /State/ZIP: ❑ Health -care facilities. ❑Supply voltage for more than
{ K ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: L,•/f- O ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street /directions to job site: Description
104. I Fee 1 Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4 ^
Ea. add'l 500 sq. ft or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) %5-00 2
Limited energy. multi-family 75.00 2
0 C T. 3e .,'rys• wait-hot/9z— (,>/0" \ residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less ( 100.70 )0 7A 2
❑ PROPERTY OWNER I til 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 1,000 amps or volts 552.26 2
City /Stale /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps w400amps 125.08 2
intended for sale. lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 559 amps 168.54 2
Branch circuits— new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with I
above service or fender fed 2
❑ APPLICANT ❑ CONTACT PERSON each branch circuit 7.42 �7 I
Business name: B. Fee for branch circuits without
service or feeder fee, first
56.18 2
Contact name: brand circuit
Each edd'l branch circuit 7.42 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
E Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: • i , 1 % l .6%r••kt:•� panel, alteration, or extension. Page 2 2
t--� `t_ Each additional inspection over allowable in any of the above
Address: 1..-1:—)) --, C �.' \O,
�/ � ;' �q Additional inspection (I hr min) 66.25/ hr
. . `� Investigation (l hr min) 66.25/ hr
City /State/ZIP: 01 . ,, r .
‘ l ` ��-J Industrial plant (1 hr min) 78 181 hr
(4" Phone: ) 7 ` � 1 1 Fax: (� �: 5) '7 GiCi Inspections far which no fee a
J 90.00/ hr
specifically listed (V, hr min)
CCB Lic.: r 1 Electrical Lie.:' Suprv. Lic.: - 5+, ELECTRICAL PERMIT FEES
Suprv. Electricians a 1, required: � � II` Subtotal: 17 ,
ti/ti- _...k. Plan review (25% of permit f
I Print name: i 0 l ,� Jt Date: Stale surcharge (12% of permit fee):
TOTAL PERMIT FEE: S 2,Z , ?3 0 1
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Number of inspections allowed per permit. t7 r /1
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