Permit p CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit #: ELC2013 -00752
Date Issued: 12/26/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 1S136DCO2504
Jurisdiction: Tigard
Site address: 7301 SW DARTMOUTH ST
Project: Lumber Liquidators Subdivision: HUNTER POLLOCK NO.2 Lot: G
Project Description: (1) 200 amp service and (19) branch circuits for TI. Job No. 8404.
Contractor: HILLSBORO ELECTRIC LLC Owner AMERICAN INDUSTRIES INC
21185 NW EVERGREEN PKWY #110 1750 NW FRONT AVE STE #106
HILLSBORO, OR 97124 PORTLAND, OR 97209
PHONE: 503 -439 -9666 PHONE:
FAX: 503 - 601 -3680
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 12/26/2013 $100.70
Specifics: amps or less
19 crt Branch Circuits w /Purchase 12/26/2013 $140.98
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/26/2013 $29.00
Electrical
Type of Const:
Occupancy Grp:
Total $270.68
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 I. , 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 • • •.• 1 9•. '•u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 2.1987 or
Issued By: Permittee Signature: 6i' A L- 7 ° / °4 , (� *
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.
12/22/2013 22:59 FAX el 001
Electrical Permit Applicat j C EIV E D 1 OR ( Ill It I t 'I ONI 1
City of Tigard Dme /� air -7 : ? % e '- mit :AL-C / — 7_Z
13125 SW Hall Blvd., Tigard, OR 97223 2 3 2013 Plan Review Other Permit p„�d�3 — 40/44F y
1 • ' Phone: 503.718.2439 Fax 503,598.1960 DatclBy:_ u(
Inspection Line: 503.639.4175 Date Ready/By lurir ® See Page 2 for
' tl3NIZ.11 Internee www.tigard -orgov CITY OFTIGARDD _ NotifiedJMethod. '77 Supplemental
Type eliP WO DIVISION PLAN REVIEW
Please check all that apply (submit Z testa of plans w /iteme checked below).
New construction ❑ Addition /alteration/repltteeit+cnt ❑ Service or feeder 400 amps or more Q Building over three stories.
❑ Demolition E.] Other: I where the available hull current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION 1 exceeds 10,000 amps at 150 vela or ❑ Floating buildings.
less to ground, or exceeds 14.000 Q Comntercial-use agricultural
1- and 2- family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
0 Master builder ❑ Other: Q Fire pump. ❑ Installation of 150 KVA or
Y ❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ID Addition of new motor load of
10011P or more. occupancy
Job no.: 8404 Job site address: 7301 SW Dartmouth RD ❑ six or more residential units. ❑ Recreational vehicle parks
0 Health - cart faeilibes. ❑ Supply voltage for more than
City /Blatt /ZIP: Tigard OR. 97223 p Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project namc: Lumber Liquidators ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: De+ d ' ; a ' ' p ie1a1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision:
Lot no.: 1,000 sq It. or Iess 168.54 4
Ea add'1 500 sq, ft, or portion 33.92 t
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
- Limited energy, multi - fmily 75.00 2
Tl residcntial,with above sq. rt.) _ _
- Renewable Energy ❑ See Page 2
Services or feeders inatallatlon and/or relocation
2 00 a mps or Iess 1 100.70 100.70 2
❑ PROPERTY OWNER I _ ❑ TENANT • ! .. 133.56 2
201 amps to 400 amps
Name: 401 amps to 600 amps 200,34 2
6 01 amps to 1,000 a mps 301.04 2
Address:
(? L
Over 1,000 or volts 552.26
City/State /ZIP: Temporary services or feeders ltuullation, alteration, and /o
relocation
]'hoot: ( ) Fax: ( } 200 amps or less 59.36 1
Owner installation: This installation is being made on property that 1 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 eztensio� per panel
❑ APPLICANT _1 0 CONTACT PERSON R. Fee fbr btarnch circuits with
above service or feeder fee, 19 7 42 140.98 2
each branch circuit
}3usines5 Warne: _ B. Fee for brunch circuits without
Contact name: service or feeder fee, first 56.18 2
.. brtutch circuit
Address: Each add'l branch circuit 7.42 2
Miscellaneous (service or feeder not Included)
City /State /ZIP: Each manufactured or modular 67,84 1 2
dwellin,scrvtce and/or feeder
Phonc: ( ) Fax ( ) —
Reconnect only 67.84 2
E — Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s) or limited - energy See
Business name: Hillsboro Electric LLC , i panel, alteration, or extension Page 2 2
Address: 21185 NW Evergreen Parkway #110 J , Each additional inspection over allowable In any of the above
Additional inspection (1 hr min) 1 66.25/ hr '
City /State/ZIP: Hillsboro OR.97124 Q 0 Investigation (1 hr min) 1 66,25/ hr
r Industrial plant (1 hr min) 78.18/ hr
Phone: (503) 439 -9666 q-,71.--
; r ,� Fax: (503) 601 -
Inspections for which no fee is 90.00 / hr
CC13 Lic.: 134481 j Electrical Lic.. 34 -499C ESuprv. Lie,: 4941S , specifically listed (V1 hr min) -
_ ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: "1 Subtotal: 241,68
Date: 12 - - Plan review (25% of permit fcc):
Print name: Joey Vltacco State surcharge (12% of permit foe): 29.00
Authorized signature: TOTAL PERMIT CEEB 270.68 •
-
Thta permit application expires if a permit to not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per iierinit
I tBuildie g \Permid'r3..C_PermitAgg_fl.R E doe Rev 0Sn1 ail 11 440.46157(11A5/COM/WEB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7301 SW DARTMOUTH ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2014-01-23 00:00:00
ELC2013-00752
PASS - No C of O
Violation Summary:
Inspector Contractor