Permit ,1111 CITY OF TIGARD ELECTRICAL PERMIT
_ COMMUNITY DEVELOPMENT Permit#: ELC2022-00556
Date Issued: 8/17/2022
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S114AC00500
Jurisdiction: Tigard
Site address: 16585 SW 92ND AVE
Project: CBG SW 76th Subdivision: EAGLE VIEW ESTATES Lot:
Project Description: Replacing(2)200 amp service panels,and 15 branch circuits.
Contractor: JARMER ELECTRIC INC Owner: CBG SW 76TH AVENUE
5105 SW 45TH AVE#200 15962 SW BOONES FERRY RD STE 202
PORTLAND, OR 97221 LAKE GROVE, OR 97035
PHONE: 503-246-5381 PHONE:
FAX: 503-244-8037
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 08/17/2022 $201.40
Specifics:
amps or less
15 crt Branch Circuits w/Purchase 08/17/2022 $111.30
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 08/17/2022 $37.52
Type of Const: Electrical
Occupancy Grp:
Total $350.22
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 OA 001-009 You av o tain a v of t rules or direct:: oehmnai2
.800332.2344.Issued By: :
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'N 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.
D
Electrical Permit Applicatioi ECEI V E® f(Ht 0i.I.I( I I SI.()NI 1
City of Tigard B ��� ' I. Nal-0e 5
AUGry y I�
71I3125 SW Hall Blvd..Tigard.OR 97223 C A ! '''' Plan Review Related'Pit�:
Phone: 503.718.2439 Fax: 503.598.1960 DatcBy:
Inspection Line: 503.639.4175 ,;ITY OF TIGARD Ready Datel3y. luti> H See Page 2 for
Elt,ARI1 Internet: wvvw.tigard-or.gov ;BUILDING DIVISION Nutlfled/Method' , Supplementallnfonoation
TYPE OF WORK PLAN REVIEW
ONew construction ❑ X Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w'items checked)
0 Service or feeder 400 amps or more 0 Building rater three stones
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS'RUCTiON exceeds 10,000 amps at 150 volts or ❑Floating buildings
® 1-and 2-family dwelling El Commercial/industrial 0 Accessory building less to ground,or exceeds 14.c)0(l ❑Cammarcial use agricultural
amps for all other installations buildings.
❑ Multi-family ❑ Master builder ❑Other: 0 Fite pump. 0 installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION D Emergency system. larger separately denved
0 Addition of new motor load of system
Job If: Joh site address: 16585 SW 925d Avenue l001lP or more ❑"A" "E' `t-2"."t•?".
0 Six or more residential units. occupancy.
City/State;Z1P: Tigard,OR 97224 ❑Health-care facilities. 0 Recreational vehicle parks.
Suiterbldg./apt.#: Project name: 0 Hazardous locations 0 Supply voltage for more than
i Eagle View Estates Lot 3 (0O volts nominal
❑Service or feeder 600 amps or more
Cross street/directions to job site: SW 92"and SW Waverly FEE SCHEDULE
nrscriptioe I Oty. J Each i Total I '
Ness residential single-or multi-family dwelling unit.
Subdivision: Eagle View Estates Lot#: 3 includes attached garage.
I.000 sq.fl.or less 168.54 4
Tax mapiparcei#: WCTM 2S 112CD. fax Lot 00400 Ea add't 500 sq.Il or portion 33 92 t
DESCRIPTION OF WORK Limited energy,residential
(with above sq.fl.) 75.(i0 2
=- - - Limited energy.muIti fa nvil 75.00 0
a.....o. .--- I n/0 ft 4 e /d — residential(with above sq.ft.)
V1 �` Renewable Ene v ( I See Page 2
al PROPERTY OWNER 1' El TENANT I Services or feeders in stallation,alteration,and/or relocation
Name: CBG SW 76th Avenue,LLC 200 amps or less ip._. 100.70 ad IA 2
Address: 201 amps to 400 amps 133 56 2
151 10 SVI Boones Ferry Road.Suite 500 401 amps to 600 amps 260 34 2
City/State/ZIP: Lake Oswego,OR 97035 601 amps tot 000 amps 301.04 2
Phone:( 503 ) 9569307 Fax:( 1 Over 1.000 amps or volts 55226 2
sear ti,cano v x Temporary services or feeders installation,alteration.and/or
Email: pyixl •corn 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: 40!amps to 599 amps 168.54 2
Branch circuits—new,alteration.or extension.per panel
f' :APPLICANT ❑ CONTACT PERSON I
A Fee for branch circuits with
Business name: CBG SW 76th Avenue,LLC above service or feeder fee, i 5 7,42 I 30 2
".B.
each branch circuit
Contact name: Sean O'Neill B.Fee Tor branch circuits without
15962 Boones Ferri.Road Suite 200 service or ftxder fee.tint 56 18 2
Address: branch circuit _
City/State/ZIP: Lake Oswego,OR 97035 Each add'I branch circuit _ 7.42 2
Miscellaneous(service or feeder not included)
Phone:( 503 ) 9569307 I Fax: :( ) Each manufactured or modular 67.84 2
dwelling.service and/or feeder
Email: searnu;canopypdx.com Reconnect 6784 2
CONTRACTOR_ ^ —Pump or irrigation circle 67 84 2
Business name:Jartner Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:5105 SR'45t`'Avenue# 100 panel-alteration.or extension. ❑ See Page 2 2
Each additional inspection over allowable in any of the above
City/Stater/JP: Portland OR 97221 Additional inspection(1 hr min) 64.25/hr
Phone:(503 )246-5381 l Fax:( I Investigation(1 hr min) 90 00/hr
Industrial plant(I hr mini 78.1&'lu
Entail:tim!a jarntez.com / Inspections for which no fee is
90 0n!lir
CCB Lic.:6924 Electrical Lie.:2 /44C _J Suprv.Lic.:6365S specifically listed(V:hr mini -
ELECTRICAL PERMIT FEES
Sups.Electrician signature.required: L^`i Subtotal:
Print name:Tim Jarmcr / Date: 5/7 -5 _ n Plan Review Required(25%of permit fee):
T /// State surcharge(12%of permit fee):
t
TUTAL PERMIT FEE:
Authorized signature: This permit application expires if a permit is not obtained within 180
Print name: Sean 0'Nei 1 1 Date: 08/08/2022 days after it hart been accepted as complete.
Number of inspections atknred per permit
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