Permit 1111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2013-00494
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/20/2013
Parcel: 2S 101 DA00100
Jurisdiction: Tigard
Site address: 13010 SW 68TH PKWY 100
Project: US Bank Equipment Finance Subdivision: VARNS ACRES Lot: 9
Project Description: Electrical for network room.
Contractor: COCHRAN INC Owner: PACIFIC NW PROPERTIES LIMITED PA
7550 SW TECH CENTER DR#220 STERN FAMILY LIMITED PARTNERSHIP
TIGARD, OR 97223 STERN, HELEN R REVOCABLE TRUST
6600 SW 105TH AVE#175
BEAVERTON,OR 97008
PHONE: 503-234-6564 PHONE:
FAX: 503-238-2098
FEES
Quantity Description Date Amount
9 crt Branch Circuits wo/Purchase 08/20/2013 $115.54
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/20/2013 $13.86
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $129.40
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 952-001-0090. You ma a copy of the rules or direct questions to OUNC by calling 503. .1987 or 1.800.3 2.2344.
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Issued By: / ,,_. ---a...... _ _ `� Permittee Signature: (,,
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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.
01 11:55:52 08-15-2013 2/2
Electrical Permit Application -. ' ID i- 4 ' `'' ,. `_ ` '-..,'"4,,
e ,„� l'OR,nEF1C FrhSC ON GI' ' i ', ,;h ' ,(. : �
City of Tigard Received a/B `. PenmtNe
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n 13125 SW Ilan Blvd.,Tigard,O v ..4 Plan Review
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.'' n , Phone: 503.718.2439 Fax: 503.'`8.196 c �® llateB : Other Permit: 8t4 I `
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r:-1:'t'-I-RD, Inspection Line: 503.639.4175 P l� 0� Date Ready/By: Jens: O See Paget for
Internet: www.tigard-or.gov ^i� 1 AS� Notified/Method: "---1-47 Supplemental Information
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TYPE OF W O- PLAN REVIEW
❑New construction ®Addition/alterll11711acement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Demolition ❑Other:
D ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
-
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
TII I00HP or more. occupancy.
Job no.: Job site address: 13010 SW 68 Parkway
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Tigard 97223 ❑Health-care facilities. '❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:US Bank Network Room ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross streeUdirections to job site: oe.rrlo oa 1 Qtr. I Fee. I Total I •
New resldeutitd single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.It.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
Install circuits for outlets in new network room residential(with above sq.Il.)
Renewable Energy ❑ 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 2
Over 1,000 amps or volts 552,26 2
City/State/ZIP: 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 branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B.Fcc for branch circuits without
Contact name: service or feeder fee,first 1 56.18 56.18 2
branch circuit
Address:
Each add'i branch circuit 8 7.42 59.36 2
City/Stale/LIP: Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:( ) Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:
Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Cochran Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:7550 SW Tech Center DR Each additional inspection over allowable in any of the above
City/State/ZIP:Tigard,OR 97223 Additional inspection(1 lir min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:(503)234-6564 Fax:(503)238-2098 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:1 Akk-Z Electrical Lic.:3-7—9k{ -(„Su•rv.Lie.:3y1�-�c specifically listed(V,hr min) 90.00/hr
Suprv.Electrician signature,required: ( ELECTRICAL PERMIT FEES
C ` `k Subtotal: 115.54
Print name: Ken Kato Date: 8/15/2013 Plan review(25%of permit fee);
' State surcharge(12%of permit fee): 13.86 /
Authorized signature: TOTAL PERMIT FEE: 129.40 �'
Print name: Thts permit application expires If n permit is not obtained within 180
Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
1:\Building\Pennits\ELC_PemdtApp ELR ORE.doe Rev 05/21/2013 440-46151(11/05/coM/wEB