Permit CITY OF TIGARD ELECTRICAL PERMIT
. • ` g >'- C OMMUNITY DEVELOPMENT Permit #: ELC2013 00113
T [ GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 2S115BA02500
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY Q1
Project: Starbucks Subdivision: 2004 -015 PARTITION PLAT Lot: 1
Project Description: (1) branch circuit for future equipment
Contractor: LIN R ROGERS ELECTRICAL CONTRACTORS Owner: SN PROPERTIES PARTNERSHIP
2050 MARCONI DRIVE SUITE 200 1121 SW SALMON ST
ALPHARETTA, GA 30005 PORTLAND, OR 97205
PHONE: 770 - 772 -3472 PHONE:
FAX: 866 -496 -7839 .
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 02/14/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/14/2013 $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 jf 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 • 52- 001 -00 You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 or 1.800.332.2344.
Issued By: Ill ! .d k _ Permittee Signature: 0 )J 4PPe -/ 64-n o/(j
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.
RECEIVED
Electrical Permit Application FEB 1 4 2013 I ()IZ ()II I( I: I tie 1) \I.1
City of Tigard Received PeNo.: �l�3O( 3 -Om : 13125 SW Hall Blvd, Tigard, OR 97� P a n R
Pernik
11111 Phone: 503.718.2439 Fax: 503,598.11} ' OF TIGARD Plan Date/13 : Other Pe®it
Tit: r ,.., Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By. - t0 ® See Page 2for
w
Internet: ww.tigard- or.gov Notified/Method: ( Supplemental Information
❑ New • construct I Addit ion / alterat /replacement �e checi� 141 Ibat apply (submit 2, sets plans Wiioem �e below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
where the available fault =rent ❑ Marinas and boatyards.
-. ' : ' T . ,r r exceeds 10,000 amps at 150 volts or El Floating buildings-
. �._ — ^ ----_ less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2 -family dwelling W ` ommercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi Family 0 Master builder ❑ Other ❑ Fire pump. ❑ Installation of 75 KVA or • r ._ ❑ Emergency system. larger separately derived system.
_. _ _ ._ _ _.. , _ _ : ` ;" 0 Addition of new motor load of 0 ' ", "F', "I- 2 ", "1_3 ",
Job no.: Job site address: 16200 SW Pacific Highway t or in occupancy.
Occlle
ID Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage foe more than
❑ Hazardous locations. 600 volts nominaL
Suite/bldg./apt no.: Al I Project name:Starbudcs LaBoulange ❑ Service or feeder 600 amps or more.
it_ :: _N '' ,'
Stl3fbudcs
Cross street/directions to job site: Deteripttsa Qty. Fm Taut •
SW Durham Rd. New residential single- or multi - family dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea_ add'l 500 sq. N. or portion 33.92 1
Tax map /parcel no 2S115AB01901 _ Limited energy, residential
�� 75.00 2
... .". .` _ ,.. ._. _.. ...._ :: _,.._. T 5 - (with a ovesq.R)
Limited energy, multi - family
Install (1) 120V 20A circuit for future equipment. residential (with above sg fl.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
: � w x ; t a '".fi t ° . i li 3 201 amps to 400 amps 13356 ' 2
401 amps to 600 amps 20034 2
Name: Starbudcs Corporation
601 amps to 1,000 amps 301.04 2
Address: 2401 Utah Avenue South Over 1,000 amps or volts 552.26 2
City /State/ZIP: Seattle, WA 98134 Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( 206 ) 318 -1575 Fax: ( ) 200 amps or less 59.36 1 I 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 1 66.54 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
_ Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
1 t * a , n F ri ' above service or feeder fee
..4.,! -' __ _._.._ w_..,_.. 7 ' __ il �
_a. --, i,._ ! { �_. s ..,T'_ . _._- _._..� t`-x_ each branch circuit 7.42 2
Business name: Lin R. Rogers Electrical Contractors, Inc. B. Fee for branch circuits without
service or feeder fee, first 1 56,18 2
Contact name: Alyssa Coursey brands circuit
Each add'l branch circuit 7.42 2
Address: 2050 Marconi Drive Suite 200 Miscellaneous (service or feeder not included)
"
City/State/ZIP: Alpharetta, GA 30005 Each manufactured or modular 67 84 2
dwelling, service and/or feeder
Phone: ( 770 ) 772 -3472 Fax :: ( 86¢ 496 -7839 Reconnect only 67_84 2
E 1 t e Pump or irrigation cirde 67,94 2
;c: Yr _ y a 3 , , h ; L ! - ` t _ Sign or outline lighting 67.84 2
S a. s r a r rL }! -_ +re v+ e Signal circuit(s) or limited-en
Business name: panel, alteration, or extension. Page 2 2
Lin R. R. •ens Electrical Contractors, Inc.
Each additional inspection over allowable in any of the abov
Address: 2050 Marconi Drive Suite 200 Additional inspection (1 hr min) 6625/ hr
Investigation (1 he ruin) 6625/ hr
City /State/ZIP: Alpharetta, GA 30005 Industrial plant (1 hr min) 78.18/hr
Phone: (770 ) 772 -3400 Fax: ( 864 496-7839 Inspections for which no fee is 90.00 / hr
cificall listed 'h hr min
CCB Ltc.:118038 Electrical Lic.: 37 -727C Suprv. Lie 4292S .., : _ ;. : :.�., _ it', T _ 'a?;.� r i -...r.
Subtotal: $56.18
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Paul Howell Date: 2 -13 -13 Stare surcharge (12% of permit fee): $6.74
■ Authorized signature: Ar r TOTAL PERMIT FEE:
$62.92
t _ Th is permit ap plication 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.
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