Permit Support Document CITY OF TIGARD ,� ELECTRICAL PERMIT
i COMMUNITY DEVELOPMENT y.
ELECTRICAL
ELC2020-00341
�y Date Issued: 7/6/2020
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 /a7/lw',"L Parcel: 1S136CD02200
Jurisdiction:
Site address: 7850 SW DARTMOUTH ST
Project: Costco Tigard Subdivision: PALMER ACRES Lot: 3
Project Description: Replacing 9 RTU's. 8/27/2020: REPRINT permit to add(1)reconnect for additional RTU.
Contractor: ADK ELECTRIC, INC. Owner: COSTCO WHOLESALE CORPORATION
9000 NE 90TH STREET PROPERTY TAX DEPT 111
VANCOUVER, WA 98662 999 LAKE DR
ISSAQUAH,WA 98027
PHONE:
PHONE: 360-546-5155
FAX: 360-576-6975
FEES
Quantity Description Date Amount
9 ea Reconnect Only 07/06/2020 $610.56
Specifics:
1 ea 12%State Surcharge- 07/06/2020 $73.27
Electrical
Type of Use: COM 1 ea Reconnect Only 08/04/2020 $67.84
Class of Work: ALT 0 ea 12%State Surcharge- 08/04/2020 $8.14
Type of Const: Electrical
Occupancy Grp:
Total $759.81
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-952-001-00 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
v
Issued By: �`."� ,�. ` ,4—,C. [ Lr-4--`- Permittee Signature: ("A! '4/1/6/4 C 7 7-749,d
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.
Electrical Permit Applic%9ti[Dit ECEI V FOR OFFICE USE ONLY
City OWTigard JUL 2 3 2020 Received 3a�Zp 4O Pemdll Al3i
13125 SW Hall Blvd. Tigard,OR 97223 Date/By: V U �( C (N
r g , Plan Review Related Permit k:
Phone: 503.718.2439 Fax: 503.598.19�TY0FTIGARD Date/By:
Inspection Line: 503.639.4175 Read Date/By: / lunis: See Page 2 for
TWARD Internet: www.tigard-or.gov BUILDING DIVISION Notifed/Method�/3 olz j . .ea Supplemental Information
TYPE OF WORK 44- A-4 T72f A/, -PLAN REVIEW
❑New construction A Addition/alteration/replacement Please check all that apply(submit 2 sets of plans iv/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings,
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system, larger separately derived
0 Addition of sew motor load of system.
Job#: M20042 Job site address: 7850 SW Dartmouth St IOOHP or more. ❑"A","B","1-2","1-3",
0 Six or more residential mils. occupancy.
City/State/ZIP: Tigard, OR ❑Recreational vehicle arks.
0 Health-care facilities. P
Suite/bldg./apt.#: .I Project name: Costco Tigard 0 Hazardous locations. 0 Supply voltage for more tbae
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEE0ULE T
Description Qty. Each Total _1 •
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
�
Tax map/parcel#: ..�
Ea.add'!500 sq,ft,or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
�— ----- -� (with above sq ft.) 75.00 2
Add (1) Reconnect to Existing Permit ELC2020-00341
Limited energy,multi-family
F�-� •' residential(with above sq.ft.) 75.00 2
v s•-1-••' /�'Tl�rS Renewable Energy ❑ See Page 2
CI PROPERTY OWNER I Q-,TENANT; - Services or feeders installation,alteration,and/or relocation
Name: . 200 amps or less 100.70 2
Address: 20l amps to 400 amps 133.56 2
401 amps to 600 snips 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
' Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
I: APPLICANT I CT CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: ADK Electric, Inc above service or feeder fee, 7.42 2
each branch circuit
Contact name: Alex Lindberg B.Fee for branch circuits without
service or fe
Address: 9000 NE 90th St branch circuiteder fee,first 56.18 2
City/State/ZIP: Vancouver, WA 98662 Each edit!!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 360)546-5155 Fax: :( 360) 576-6975 Each manufactured or modular 67.84 2
Email: dwelling,service and/or feeder
Alexl@teamadk.com Reconnect only 1 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ADK Electric, Inc Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy ❑ See Page 2 2
9000 N E 90th St panel,alteration,or extension.
City/State/ZIP: Vancouver, WA 98662 Each additional inspection over allowable in any of the above
Additional inspection(I hrmin) 66.25/hr
Phone:( 360) 546-5155 Fax:( 360) 576-6975 Investigation(1 hrmin) 90.00/hr
Email: katrinae@teamadk.com Industrial plant(Ihrnun) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 148882 Electrical Lic.: -934C Suprv.
4853S specifically listed(li hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: /n lei Subtotal: 67.84
Print name: Alan Kangas Date: 07/23/2020 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 8.14
Authorized signature: TOTAL PERMIT FEE: 75.98
This permit application expires if a permit is not obtained within 190 L/
Print name: Alan Kangas Date: 07/23/2020 days after it has beets accepted as complete,
* Number of inspections allowed per permit.
i:1Building1PermitsmLC PermitApp ELR_ERE.doo Rev 06/17/2015 440-4615T(11/05/COMAVER &k