Permit CITY OF TIGARD ELECTRICAL PERMIT
1 1 COMMUNITY DEVELOPMENT Permit #: ELC2013 -00430
Date Issued: 07/24/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: SEG624 •
Jurisdiction:
Site address: SW NO ADDRESS
Project: Walmart Subdivision: Lot:
Project Description: (1) branch circuit for existing service at NW corner of Pacific Hwy and 78th Ave.
Contractor: E C COMPANY Owner:
PO BOX 10286
PORTLAND, OR 97296
PHONE: 503 - 224 -3511 PHONE:
FAX: 503 - 295 -3012
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 07/24/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/24/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 0 9 1 -00 . 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: ,0 �) G 1
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.
Jul. 19. 2013 3:42PM No. 0947 P. 1/1 . -
Electrical Permit Applic : CEIVED r eal< (t1 I I r O\ 1.1
City of Tigard . " . Peewit No.:a-6,4)45 a y3a
11,
i- • 13125 SW Hall Blvd.. Tigard, OR 97L ' 2 2 2013 �'''
Phone: 503.7182439 Fax: 503.598.1960 pet : Other Permit - /�Q /. _DO Q/ ,
Tic r. n Inspection Line: 503.639.4175 CITY OF TI GAR D Da1e Ready/By: kris: e: g See Page 2 for
Internet www.tigard NoriSad/Mahod: Suppkmentallnformadon
TYPE1IG DIVISI01k1
PT:API REVIEW
❑ New construction 181 Addition/alteration/replacement Please check all that apply (sobmit 2 sets of plans wwid:ms chocked below):
❑ Serviee or feeder 400 amps cc more 1:1 Braiding over three stories.
❑ Demolition 0 Other:
where die available WI current 0 Marinas and boatyards.
. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 yoke or ❑ Floating buildings.
❑ 1 - and 2- family dwelling ® Commercial/industrial Q Accessory building
less to and, e exceeds star 1a s. ❑ Commercial gs. agricultural
$ added for all alter iase0�o�. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fite pinup. ❑ lnan 1ation of 150 KVA or
-
JOB ST77: INFORMATION AND.I:OCAT tON ['Emergency sum. larger ely derived system.
in Addition of new motor load of ❑ "A "E ", "1-2 ", "1-3 ",
Job no.: 65469 Job site address: OR99W (41113 Ave 100HP or more. odor.
❑ Six err more maidemial wits. ❑ Reereatiooal vehicle parks.
City /State/ZIP: Tigard, OR ❑ Healthcare facilities, ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldgiapt no -: Project name: Tigard Walmart ❑ service or feeder 600 amps or more.
Cross st tet/dircetions to job site: lk'EE SCRF#iULE. Feb.
• Derv,jeiea I Qtr. I s 1 Tenn I •
New residential single- or multi- family dwelling unit.
•
includes attached garage.
- Subdivision: Lot no.: 1,000 sq. ft or less 168.54 4
Ea addi 500 sq. R or portion 33.92 1
Tax map/parcel no.: ..S7676 4,29 Limited energy. residential 75.00 2
. DESCRIPTION OF WORK. : ' (with above sq. ft.) , ..
` Limited energy, rmilti- family 75.00 2
Modifications to existing traffic signal 9 A/ a) e0 /2^/677Z residential (with above s9. ft.)
-
Renewable Energy a See Pee 2
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER I . . ❑ TEN 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
- - City /State/ZIP: Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, and/or
Phone: ( ) Fax: ( )
relocation
200 amps or less 5936 1
Owner installation: This installation is being made on property that I own which is not 20) amps to 400 amp% 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. .
aol states to 599 amps 168.54 2
Owner signature: Date: Branch circuits— new, alteration, or extension, per panel
A Fe e fir breach circuits with
® APPLICANT ❑ CONTACT' PERSON above service or feeder fee,
Business name: E C Company each branch circuit 7.42 2
B. Fee for branch circuits wuhord
Contact name: Sharma Fullbright service cuutiya fee, fast 1 56.18 5,5,18 2
b
Address: P 0 Box 925 Each add'i branch circuit 7.42 _ 2
City /State/ZIP: Albany, OR 97321 Miscellaneous (servlee or feeder not included)
Each manufactured or modular 67.84 2
Phone: (541) 926-4266 Fax: : (541) 926 - 0165 dwelling, service and/or feeder
W
Reconnect only 67 -84 2 •
E-mail: shannaf)e c - co.com Pimp or irrigation circle 67.84 _ 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: E C Company Signal cimun(s)or!imitad- energy Sec
parcel, alteration, or extension. Page 2 2
Address: P 0 Box 925 Each additional Inspection over allowable In any of the above
City/State/ZIP: Albany, OR 97321 Additional inspection (I hr min) 6625/hr
Ime aagatlon (1 lir min) 6625/ hr
Phone: (541) 926-4266 Fax: (541) 926 industrial plant (1 hr mitt) 78.18/ hr
Inspections for which no fee is
CCB Lic.: 49737 l Electrical l.ic.: - 15c Sup -- rile.: s specifically d (�4 hr
liste min ) 9 hr
e .','ELECTRICAL 1 'r.':FEES, . .-
Suety. Electrician signature, required: Subtotal: 56.18
Print name: William RCoburn Date: 07.19.13 Plan review (25% of permit fee): _
- State surcharge (12% of permit fix): 6.74
Authorized signature: TOTAL PERMIT FEE: 62.92
This permit application expires ifs permit is eat obtained within 180
Print name: Date:
days after it has been accepted as complete.