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Permit
Electrical Permit Application Dae/B . � ��IlFlcu. USE ONLY —' - ©oa/O MilICity of Tigard RECEIVED Received CS'l/l�i' permit# 13125 SW Hall Blvd.,Tigard,OR 97223 a� Plan Review 1�', Phone: 503.718.2439 Fax: 503.598.196�PR 2 el 2020 Date/B : Related Permit*I: t Inspection Line: 503.639.4175 Ready Dar :y: 10 See Page 2 for TIGARD Internet: www.tigard-or.gov Notified/Method: tv 3 i5M1111 Supplemental Information CITY OF TIGARD �i �,r TYPE OF VaillikpiNii DIVISION fir} A(, /f�L -LAN REVIEW El New construction ElAddition/alteration/replacement `�' Please check all that apply(submit 2 sets of plans w/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. ❑ 1-and 2-family dwelling X❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: I Job site address: 12100 SW Scholls Ferry Rd looHP or more, ❑"A","E","l-z",ut-3", City/State/ZIP: 9 Tigard,OR 97223 0 Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: Chase Bank Tenant Improvement ❑Hazardous locations. 0 Supply voltage for more than p 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: corner of SW Scholls Ferry Rd&SW 121st Ave., FEE SCHEDULE in the former 7-11 space,adjacent to Scotty's Description I Qtr. I Each I Total I * , 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#: 1 S134BC00100 Ea.add'1500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Interior tenant improvement; Remodel the former 7-11 to become a bank. Minor exterior Limited energy,multi-family work: painting&storefront replacement. Remote ATM at SE corner of shopping center. residential(with above sq.ft.) 75.00 2 Renewable Energy ID See Page 2 El PROPERTY OWNER I [ TENANT Services or feeders installation,alteration,and/or relocation Name: Joe Hernandez,VP-Chase Bank 200 amps or less 2 100.70 201.40 2 201 amps to 400 amps 1 133.56 133.56 2 Address: 24085 El Toro Road, Floor 2 401 amps to 600 amps 200.34 _ 2 City/State/ZIP: Laguna Hills,CA 92653 601 amps to 1,000 amps 301.04 2 Phone:( 602 )703-3816 Fax:( ) Over 1,000 amps or oohs 552.26 2 Temporary services or feeders installation,alteration,and/or Email: joe.m.hemandez@jpmchase.com relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 t 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 ❑ APPLICANT PM Design Group I ® CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fcc for branch circuits with above service or feeder fcc, 6 each branch circuit 1 7.42 452.62 2 � Business name: Contact name: Elizabeth Cole B.Fee for branch circuits without Address: 19120 SE 34th St.,Suite 115 service or feeder fcc,first 56.18 2 branch circuit ity/State/ZIP: Vancouver,WA 98683 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( 614 )212-4330 I Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: ecole@pmdginc.com Reconnect only 67.84 2 CONTRACTOR to Pump or irrigation circle 67.84 2 Business name: 'pt.-- in .1 a rG ir. Inc Sign or outline lighting 3 67.84 203.52 2 1 \ l Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: 204� �e 7b-,n Gl - panel,alteration,or extension. City/State/ZIP: a Each additional inspection over allowable in any of the above \/G�11CCA1�/el'i t).�a �w Additional inspection(1 hr min) 66.25/hr Phone:SC-'2 ?C)t — ei ini I Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: I Electrical Lie.: I Suprv.Lic.: specifically listed(1/2 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: SEF' ,A1, e) A P Subtotal: $991.10 Print name: Date: ❑Plan Review Required(25%of permit fee): $247.78 State surcharge(12%of permit fee): $118.93 Authorized signature: '��' K Cr_ TOTAL PERMIT FEE: $1,357.81 This permit application expires if a permit is not obtained within 180 Print name: Elizabeth Cole Date: 4/13/2020 days after it has been accepted as complete. Number of inspections allowed per permit. I:\g Ter ryryryaaastELC PermitApp_E ; Rev ON /J? i ,p fl4t ST(IU05/ M/wEB iti Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I QIv. Each I Total j * Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: s kva or less 100.70 2 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: Each additional inspection is 66.25/hr I El Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page I): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation HVAC ❑ Instrumentation ❑ Intercom and Paging Systems l Landscape Irrigation Control* n Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations 1:\Building\Peamds\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 Electrical Permit Application FOR OFFICE USE uNLl• City of Tigard Received 13125 SW hall Blvd.,Tigard,OR 97223 Detail 1Phone 503.718.2439 Fax: 503,598.1960 P Date/8 :Review Related Pent*fit ticnttn inapo tonLiao; 503.639.4175 Ready D e'By: � is See Page2for Interne: www.tigard•or.gov Notified/Method: Supplemental lafermatloa • TYPE OP WORK PLAN REVIEW ❑New eonstraotion Addition/elteration/replaceMent Please check all that apply(submillects of plans u•/hems checked): ❑Service or feeder 400 amps or more ❑Building over three statics.❑Demolition 0 Other: f`' where the available fault mutant 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or 0 FIoating buildings. ©1-and 2-family dwelling til Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-we meriwhural 0 Multi-family 0 Master builder El Other: amps For all other installations. buildings. _ ❑Fire pump. ❑Installation of ISO KVA or Is , JOB SITE.INFORMATION AND LOCATION ❑Emergency system. larger separately derived a A, Sob# IObsi1eaddr address: S4r Sotl ollS MJ' I'd D Addition of new motor load of system `� 100111P or more ❑"A, E',"1.2""l3", .11• City/State/ZIP: T'T o r a, a q -zZ 3 ❑six or more residential�d� u«pansy. ' , ❑Health-care facilities ❑Recreaional vehiok park.. .,� Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more.than 0 Service or feeder 600 amps or more. 600 vo]ta nrmtiaal. Cross street/directions to job site: FEE SCHEDULE ,, Description wveI Qq. I Each I Total I • New residential single-or multi-famIy dwelling unit Subdivision: Lot#: includes attached garage. .r : Tax map/parcel#: 1,0004 R.or less 16854 4 Ea.add'1500 sq.R.orportion 33.92 1 DESCRIPTION OF WORE'. Limited energy,residential t r (with above R.) 75.00 2 0�'L ,A' T•Cr)Q -1- !iN f6Ve vt4.^^T t , . Limited energy,multifamily(with 75.00 2 lasidenti al(w above sq.It) ' [].PROPERTY OWNERRenewable Energy © See Page 2 I -0 UNA" -• - Services or feeders installation,alteration,and/or relocation Name: 200 amps or less _ 100.70 2 ,. Address: 201 to 400 ore R. ps 133.56 2 7. 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Ovux 1,000 amps or volts 55226 2 Email: - Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that 1 own which is not 200 amps or less 5936 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 asps to 400 amps 125.08 2 Owner signature; Date: 401 amps to-599 amps 16 .54 2 ❑'APPLICANT .cor,crALT'P'ERSON Braneti circuits-sew,alteration,or extension,per panel ""�� .y- ®'' A.Fee for branch cacaos with. Business name: Prim O ��ear L., .Z.r f above senice or feeder fie, / each broach circuit 7.42 2 Contact name: �R"rr4 Pr M R Lf•t tS rl�O $:Fee for breach circuits wlrFwrt - Address: /SOg( VV g/S'1^ service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: f/Grkout/Q-✓ ( e�� wilco Eachedd'Ibrartchcircuit 7.42 2 Phone:(5oS ) 2+t- tr!03 Miacellaneom(service or feeder not Included) Fax::( ) Each manutbemrod ormadular tt dwelling,service and/or Reeder 67,64 2 Email: 4eudel rC.s)(:M02I�t_kr«. bra Reconnect only 67.84 2 CONTRACTOR , , .- . . Pump or irrigation circle 67.84 2 Business name: 'Prim 0 ,L. (C.tri ri C r .__Tel C.,-.. Signor outline lighting r 67.84 2 I Signal circuit is)or limited-euergy Address: / S a_4. Ng S/S a-- A//g panel,alteration.or extension. ❑ SeePage 2 2 City/State/ZIP;/SfatrJZIP; G{$�CoL.- Additional Each additional inspection over allowable In any of the above tY Udn LOUV t.�r uric inspection(1 hr min) 66.25/hr Phone:(cal ) Lc I- r(03 Fax:( ) Investigation(1 hr min) 90.00/br Email; davld Qr 1�/�M D6j t r ar+� Industrial plant(I hrmin) 711,181hr .J Inspections for which no fee is CCB Lie.:2193",O Electrical Lk.: (_i31y 5 Suprv,Lie.: 3 >,t-.`S sperlGcally listed ehhrmin) 90.001hr ELECTRICAL PERMIT FEES . I. Suprv.Electrician signature,required: ' , r a �v �`''/�e a. Qf Subtotal: � x Print name:noel aid £r:r.e._ Date:9l/1V2Z, 0 Plan Review Required(25%of permit fcc): State surcharge(12%of permit foe): Authorized signature: v )'f t f•1 ^ { p//////,2e TOTAL PERMIT FEE: This permit application expires If a permit is not obtained within 180 ' Print name:Ar1�/m 4644�/C-0 Date: 0// days after It ilea been accepted as complete. Number of inspections allowed per permit l:itivadinglPcrmiletELC ernuiApp LIf ERR.duc Her 06/17/7015 440-461 ST(1 I/0S/C0MiWa0 Branden Taggart From: Branden Taggart Sent: Wednesday,June 3, 2020 5:25 PM To: 'Elizabeth Cole' Subject: Chase Bank Electrical Permit: ELC2020-00210 - 12100 SW Scholls Ferry Rd Attachments: Branden Taggart2.vcf; ELC2020-00210 Electrical Permit Invoice.pdf; Electrical Permit Application.pdf Hi Elizabeth, The Electrical permit for Chase Bank is ready to issue now. The balance due is$1,357.81, and I have attached an invoice above for you to reference. The permit fees can be paid online through our website: https://aca.accela.com/tigard/Default.aspx. From there, click on the Building tab, enter the permit number (ELC2020-00210) in the Record Number field, and click Search. Once paid, please notify us at TigardBuildingPermits@tigard-or.gov, and I will place this permit in the conference room adjacent to the outer Permit Center lobby for pickup between the hours of 8:00 a.m. and 5:00 p.m., Monday through Thursday. We are closed on Fridays. Also, face masks and social distancing are required when entering the Permit Center. Please note that contractor license information and a Supervising Electrician's signature are required prior to the issuance of this permit. I have attached the Electrical Permit Application above for the Supervising Electrician's signature. Thank you, Branden Taggart ligg City of Tigard Senior Permit Technician Community Development 13125 SW Hall Blvd Tigard, OR 97223 (5031718-2449 brandent@bgard-or.gov 1