Permit (21) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2023-00335
Date Issued: 6/1/2023
T[G AR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BD00100
Jurisdiction: Tigard
Site address: 14640 SW 76TH AVE
Project: Bonita Villa Apartments Subdivision: DURHAM ACRES Lot: 65
Project Description: Electrical associated with building improvements: Unit upgrades,replacing building service,replacing pulls from
meters,replacement of building wiring,and site and stairway lighting upgrades. Fees paid and plan review
completed under ELC2022-00450.
Contractor: JET INDUSTRIES INC Owner: HOUSING AUTHORITY OF WASHINGTON COUN
1935 SILVERTON RD NE 111 NE LINCOLN ST #200-L
SALEM, OR 97303 HILLSBORO, OR 97124
PHONE: 503-798-4445 PHONE:
FAX: 503-363-2622
FEES
Quantity Description Date Amount
Specifics:
Type of Use: MF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $0.00
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 throuah OAR 952-001-0090. You ma tain a c e rules or direct auestions to OUNC by callina 503.23 1987 or 1.800.332.444. ,
Issued By: � .rr/ Permittee Signature:
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.
4/10/23,4:44 PM ExportStreamingHandler.ashx
DocuSign Envelope ID:67ED55C8-52A1-4073-A944-1CAD548991 ED
• Electrical Permit Application MR t)l l let: t sl OM \
City of Tigard �" x r Received ,l // / Permit a Z ,a'
ai ,ytw batclly: fttr/ [��iG�tz✓:�._ J35
IIIa I i 125 SW Hall Blvd.,Tigard,OR 97223 Plan Review l�ell 4,.
8 Phone: 503.718.2439 Fax' 303.598,1960 '1 r r Date;8v. I
S �� Related Penuu u: .s
Inspection Line: 503.639.4175 l'`'1' Ready Dat eel for
It'"RILI), Internet: www.tigard-or.gov rr F17.^y ry NorifredjMet : SuppkmentalInformation
TYPE 0,44{ i �,almat. -PLAN'REVIEW,.
❑New construction Addition/alteration/replacement I Please surd,all that apply(submit j sets of plane wntems checked)
' ❑Se'rvwe ur feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: R t '• ;a . where the available fault current 0 Marinas and boatyards.
- ....
CATEGORY C{)N 1: l yi exceeds 10.000 amps at 150 volts or 0 Hunting buildings.
❑ I-and 2-family dwelling 0 Commercial/indus Ulu.: -- . ilding less to gmrrnd,or exceeds 14,000 0 Commercial-use agricuhumd
amps for all other installations. buildings.
feMulti-family ❑Master builder 0 Other: ❑Fire pump. ❑Installation of ISO KVA or
u JOB 'I;, INFORM/1;0=. Nil,LOCATION 0 Emergency system larger separately derived
#:2110 HWC- ❑Add Lion of motor load of system.fob lob site address 7/� OHPtxmore. ❑.•A" ,E. ,1_Z. '1-3„
MrSix or more residential units occupancy.
City/State/ZIP: Tigard,OR 97224 0 Walk-sanefacilities 0 Recreational vehicle parks
SuileJbldg./apt.4: Project name:Bonita Villa Apartments Pjlaoardous locations 0 Supply voltage for mere than600 volts nominal.
Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCBEDLJL.E"- "
SW 76th Ave,and Bonita Drive Description I �,r• 1 Eacb 1, lutist I
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: Includes attached garage.
1,000 sq.ft.orless 96 168.54 16,179.64 4
Tax map/parcel 5:2S112B000100 1'.a.add]500 sq ft.or portion 33.92 I
BESCRUIT4*-OF WOR
K Limited energy,residential
ADA UNIT UPGRADES,STANDARD UNIT UPGRADES,REPLACE BUILDING SERVICE,REPLACE
(with above sq.ft.)
75.00 2
PULLS FROM METERS,REPLACEMENT OF BUILDING WIRING,UNIT/SITE/AND STAIRWAY Limited energy.multi-family 75.00 1 2
LIGHTING UPGRADES. residential(with above sq.ft.) r ,-,•
tt ..
r, Renewable Energy ❑ See Page 2_
.a.,RROPERTY OWNER '•1"-`- • 0 TENpNT ' Services or feeders installation,alteration,and/or relocation
Name: HAWC AHP4 LIMITED PARNTERSHIP111 200 amps or less 9 100.70 906.30 2
AddressNE LINCOLN ST. SUITE 200-L 201 amps to 400 amps 133.56 2
401 amps to 600 amps 4 200.34 801.36 2
c
`i t�,t�_�SBOFZO, OR
y/Stat�Gi 601 amps to 1.000 amps 301.04 2
hone:P717j` `J03-846-4794Wi1I_ ls@C9.washingl Over 1.000 amps or volts ' 552.26 ii 2
= on.or.us Temporary services or feeders installation,alteration,and/or
I. mail: relocation
wner installation:This installation is being made on property that 1 own which is not 200 amps or less 5936 1
4.
1 ntcnded for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.0& 2
. omen signature: Date: 401 amps to 599 amps 168.54 2..
t Branch circuits-new,alteration,or extension,per panel
® pl!IPIICANT 1:: ❑ COAT(i,FlIt5(ki A.Feetirbranchcircuitswith
s usmess name:PINNACLE ARCHITECTURE above service or feeder fee, 96 . 7,42 712.32 2
each branch circuit
Contact name:RYAN CAIN B.Fee for branch circuits wd/roui
service or Address: branch circuit
fee,first 56.18 2
960 SW DISK DRIVE#101
City/State/ZIP:BEND,OR 97702 Each add'I branch citeuit 7,42 2
Miscellaneous(servke or feeder not included)
Phone:(541 )388.9897 X17 Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.64 2
Email: RYAN@PARCH.BIZ Reconnect only 67.84 2
.a
.z;: CONTRACTOR Pump or irrigation circle 67 84 2
'3-i 67.84 Z,703.04
r
Business name: Jet Industries, Inc. Sign or outline lighting
Signal circuits)or limited-energy ❑ See Page 2 ' 2
Address: 1935 Silverton Rd. NE panel,alteration,orettension. 1
C'il fState!L1P:Salem, OR 97301 Each additional inspection over allowable In any f the above
y , Additional inspection(1 fir min) 66.25:hr
Phone:(503)363-2334 Fax:(503 ) 363-2622 Investigation(1 hr min) to.00""hr
• ' etlndustries.net Industrial plant(I hr min) 78.18/hr
Email: bear.k
�l Inspections for which no fee is
c ifically fisted /z hr mini 90.00/hr
CCB lie.:3944 Electri i 9`9eP� s Suprv.Lie.: 6546S pee
//��
�lr _� ELECTRICAL PERMIT FEES _
Suprv.Electrician signature,required aikt OtthAAStr Subtotal: 20,702.86 _
sreeazottat7t+°' Date: 10/25/2022 I2J Plan Review Required(25%of'permit fee):
Print name: Clint Olheiser
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature: drdyrynawanac-'
ors ry>�tlr" This permit application expire,it a permit Is nor obtained within ISO
Ryan Cain •^^'°'� ""0"' days after it Iws been accepted as complete.
Print name: Date:
Qiav a.aaal.,r.larm + Number of inspections allowed per permit.
l',Bu,ldma\.Parmmnil-:IW"_P emit App_ELa EltE dot Rev 06+17291i 44ll.4 l s'r'(I!;01;C[)SitwER
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