Permit CITY OF TIGARD ELECTRICAL PERMIT
2.. COMMUNITY DEVELOPMENT Permit#: ELC2013-00554
T E GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/19/2013
Parcel: 1 S135DD01000
Jurisdiction: Tigard
Site address: 11760 SW HALL BLVD
Project: WELLS FARGO Subdivision:\RBER TRACTS NO 16 TO NO.40 INCL Lot: PTS 19
Project Description: (1)branch circuit for television.
Contractor: PARKIN ELECTRIC INC Owner: WELLS FARGO BANK NA
14001 FIR STREET BY DELOITTE TAX LLP
OREGON CITY,OR 97045 PO BOX 2609
CARLSBAD,CA 92018
PHONE: 503-657-4958 PHONE:
FAX: 503-557-1059 .
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 09/19/2013 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/19/2013 $6 74
Type of Use: COM Electncal
•
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 OAR 952-001-0090 You may obtain a co ,=s or direct questions to OUNC by calling 503 232 1987 or 1 800 332 2344
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.
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.
From 09/17/2013 14:40 #014 P.002/002
Electrical Permit Application `+ FOR OFFICE USE ONLY
City f Tigard �` e� Received
r y g J Reteiv : r i1/ Permit No: a:Cc, b/ -doS-
13125 SW Hall Blvd.,Tigard,OR' K Q
.1111111
a_ Phone: 503.718.2439 Fax: 503. .,ate" .p �' ® Place Review Other Permit:
b DateB :
TI G A R D Inspection Lute: 503.639.4175 c� ��� 11: See Page 2 for
FE Internet: www.tigard-or.gov `t\ 1 IIM\�\I C� Supplemental Information
5z(:::::;',-;. 1:.. _ �.., �,� �';rG'�`S3y-,','.y!,•"l61S.�13y�FU`�d�i' -l�•. r...•��tik L.:::"; �:i :("'_ _ _ � �S<" _ __ _ __
•'�'r `,:: .=':• :,......,,..... .._ .�.f�``°�� (`�°',"..rrr�.._,,: � r:j:':.<. :w,:::r;:sx:'���;•zi:-��1=:,::s:p :BEYIEWf%;;'.`:,.:,..-_, ;.,_�
❑New construction �(Addition/alteration/ . tVnt Please check all that apply(submit 1 sets of plans whtems checked below):
❑Demolition ❑Other: !� ❑Service or feeder 400 amps or more ❑Building over three stories.
_ t _ w where the available fault current ❑Marinas and boatyards.
`;> S av ^a .y:l`';x01, .RY•'t� r:t' 1V '1Ri� I;;: i`>'c"'n•wr..
._ .. � r,�: 4T�'0 _ ,;:,��, C7�QN=•;ihy ��..y}:y���r,.�,��+%.t exceeds 10,000 amps at 150 volts or ❑Floating buildings.
::' :_"•, ` less to ground.or exceeds 14,000
❑ 1-and 2-family dwelling �Commercial/industrial ❑Accessory building ❑Commercial-use agricultural
ry g amps for ail other installations buildings,
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 75 KVA or
larger separntely denved system''i,=; i," =P;� ? M1 ^� 1:04v�, ✓ "rQSltalg?-Ii .' li. ❑AEme
ddir Boano( wem otorloadof
❑,•A•..,L"„I.2„,.I•}..
Job no.: o_g 1g3 Job site address:1/7&D 5ffJ /'////v� Iixor or more Recreational/'_ ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: /�/i r// ❑Health-care facilities. ❑Supply voltage for more than
JC1 ff11"�� ❑Hazardous locations. 600 volts nominal
Suite/bldg./apt.no.: Project name: Wells ❑Service or feeder 600 am p or more.
Cross street/directions to job site:
P...i. "': '.r?-;`? FEE`,S•,C D,ULE
DOcrtpion 1 Qty. 1 Fee. ,1•• •Total, "1.1•
New residential single-or multi-family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1.000 sq,ft.or less 168.54 4
Tax map/parcel no.: - Ea.add'l 500 sq.ft.or ponion 33 92 1
Y Limited energy,residential
•:i: ":f.,=':'''‘:::'` C „C^•.:i^,.�,:. '1': 7 00
>' .DESCRIRTION't)F WQ :�:t; r(t".•. , .. 5. 2
, RK��=;?;,- Y?. =,,,µ• with above s
/ �J o p/ Limited energy,multi-family 2
G< i/ W.&. ) Ri,exr' (z&t f() � residential(with above sq.ft.) 75.00
Services or feeders installation,alteration,and/or relocation
r 200 amps or less 100 70 2
"i2'•' Op ..,�.z '4"•n"�^'.,:::jnr �r�i'"•,7a�;:Tit :1 f r„+-..• ,ice ”,'S,.,.t• am 10 00 4 S
fi;:p �"^QfY OWI!IIE�R'fi#_= * *� :' ., 1;, AT1gT.t :yea°''(`= 201 a m
-��3'z;=;� T�,:.,..,..,.,}` • a�-•Jib,};a„ Rs P• 13156 2
Name: 401 amps to 600 amps 200.34 2
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:( ) Fax:( ) 200 amps or less 59.36 I
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 Sa 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with -
t''55;4"s'',..;�.�T•+; r"pp Cm ?hg.- {Y_'iit:trilt;,c: h iT *s 0-$SR:ti-:=',' aebaob reaservch ic ec iorr c ft ee der fee.
742 2
Business name: B.Fee for branch circuits without
service or feeder fee,first
Contact name: branch circuit / 56.18 Jzp/P 2
Each add'I 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-mail:
Pump or irrigation circle 67 84 2
;;: .., :;" ;;'r' {: c; ry„ . '..r.:s>,. Signor outline lighting 67 84 2
'' "i=='7 ::= `- Signal circuit(s)or limited-energy
Business name:Parkin Electric panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 14001 Fir Street Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Oregon City,OR 97045 Investigation(I hr min) 66.25/hr
Industrial plant(1 hr min) 78.18/hr
Phone:(503)657-4958 Fax:(503)557-1059 Inspections for which no fee is 90
CCB Lic.. 3515 Electrical specifically listed('h hr min
cal Lic.: 34-4C Suprv.Lic,: 4241-S �:;;�_°YZ'Y,'a )
4_�t..t1�EGR°.[tICA1;ilBRM:IFEES,.,';:'&`.._7'-:', "I'','-:....,:::;,
Suprv.Electrician signature,required: ,,2� Subtfee): �o.
Plan review(25%of permit fee):
Print name: David B Parkin Date: State surcharge(12%of permit fee): 6.71/
Authorized signature: TOTAL PERMIT FEE: (047.%a f//
This permit application expires if a permit is not obtained within 180
Print name: days after it has been accepted as complete.
Date:
• Number of inspections allowed per permit
1:1Building\Permus\ELC•PermitApp.doc 07A1/10 d40-4615T(t1A5/COM/vEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11760 SW HALL BLVD, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2013-10-29 (null)
ELC2013-00554
PASS - No C of O
Violation Summary:
Inspector Contractor