Permit (9) CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: ELC2022-00094
T I CA R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 3/9l2022
Parcel: 1 S 126CC00200
Jurisdiction: Tigard
Site address: 10065 SW CASCADE AVE
Project: Tesla Subdivision: None Lot: None
Project Description: New transformer and vault in collaboration with PGE.
Contractor: JC ELECTRIC INC Owner: 10065 SWC LLC
118 NW 184TH STREET BY ALSTON&BIRD LLP
RIDGEFIELD,WA 98647 BANK OF AMERICA PLAZA
101 SOUTH TRYON ST STE 4000
CHARLOTTE, NC 28280
PHONE: 360-887-7889 PHONE:
FAX: 360-887-5584
FEES
Quantity Description Date Amount
1 ea Services or Feeders-401 to 03/09/2022 $200.34
Specifics:
600 amps
1 ea Plan Review Electricial 03/09/2022 $50.09
Type of Use: COM 1 ea 12%State Surcharge- 03/09/2022 $24.04
Class of Work: ALT
Electrical
Type of Const:
Occupancy Grp:
Total $274.47
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 throuch OAR 952-001-0090. You may obtain a coov of the rules or direct Questions to OUNC by callino 503.232.1987 or 1.800.332.2344.
Issued By: Edga.rolo Mal40"-ado Permittee Signature: .S,e-s-a-pr-it-4 1-i,ow
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.
,71'
rjr
Electrical Permit Application +--�•i.. 1-.,1. , I 1 ; I 1 ;: :I.I 1
City of Tigard `; i S. '.' • �lri. t4tmit s �i,.,. vuU t)
- 13125 SW Hall Blvd.,T- OR 97223 Ham
Li
V
iardB gPe uan ts® IYmd.or4ov � ; : t a _ i.�l rt., ►,br'�. Ruled Pamk Y:.. A >4A.tQ
Phone 503.718.2439Line' i ., l
Email Ti uildin T' )(My cabt . A.i as Page for
Inspection Line 503.639.4175 Internet vvww.ti 4r NaaiftedlNetlnd: i . 1 Sapp1 .aW totarmaioe
TYPE OF WORK 11bvyx r IIIF PLAN REVIEW
❑New construction }yAddition/aiteratiort/ placement Hesse s ecamsl:thxtapply(subed2ams Oilier wTtemlchecked)
❑Demolition r Other Qgervice a Ender 400 amps re more ❑Building over Outs stones:
_...._ _.... where the meat le fault current ❑MOANS and boatyards
CATEGORY OP COMB rRUCTION exceeds 10.000 amps at 150 volts or 0 Flosdng buildings.
❑1•and 2-family dwelling ®Corn cial/industtial 0 Accessory building ion to ground,or exceeds 19,000 ❑Commercial-use agricultural
❑Multi-handy 1,L.I,Master builder 0 Other arts omfor au other installations. Installation
building,.
CI pomp. ❑Imtalueon of 150 KVA or
JOE SITE Rt1FORMATION AND LOCATION Q Ieewgency system larger aepanlely delved
❑Addition of new motor bad of system.
lob#: lob site address: IUoG f S VljraP"stal C .1.-e. 100HP or more
r--_ r"a Q sue or more inideatial units. occupancy.
CitylSraterifP: at a ['>i 1g 3 _ _.. . ❑Health-cam faeiulies- Q Recreational vehicle parks.
Suite/bldg./apt.#: -I Project name: ` r t7r 49Le( ids ❑" s!medal. ❑supply voice for mote than
---- - ❑Service or fonder d00 amps or roam. 600 volts nominal.
C7oss street/directions to job sits C'PPee' ' FEE SCHEDULE
��Y' ..-D,alp4o1 --- .1.Visa 2146 I dam '(
___..__. New resideatlol single-or multi-fondly dweil lag unit.
} Subdivision: Lot#: Ineluda attimbed garage.
— _ —•. 1,000 sq.R.or las 168.54 4
kt.Tax map/pan:el#:
Ea add.!500 an ft.or Patton 33.92 1
Li- oncRIrnON OF WORK Limited taut resideadd .__,..___I
_ -.a�� hh dhow se,.ftl
75.00 2
' � tf� tr y�sKf w6t ,'x_�olw�pwAl�f (w
iimitaa coffin mnR9 famly MO 2'
ti eY'!, rai�riaiswidtsboveaq
a PROPERTY OWNER I g g1yy Renewable]g..nn' Q See Page 2
f�_ __ Services or folders imtallgtlssy�ahanNoa,aadfer rd.eatiaa
Name _IliI19 pie
1. T eri/ 400 amps or less t00.70 2
—� 2Dlatapea ADO amp� 1333E 2
Address: S'� PAC - d+.I
40t amps to600amps / _ 200.34 in) ?fa 2
i GSty/State/ZIP: ;iy t o, NY I c4Zu2 601 amp m 1,000.mps _ 301.04 2�
hone:(;1G) Q?'& vet/- .. • ova 1,Ooo.mpersvolts 1 552.26 2
. •
ry
__ __._ Temporary sekesofKadernbasmWtler,almaderyandkr +
Email. rLlls[+sey 42,i,k,(4,4+ `1nlONf rdondoa
^' Owner Installation:This instal ation is being made on property that)own which is not 200 seers or lean 5936 1
intended for sale,lease,tent,or exchange,according to ORS 447,449,670,and 701, 201 amp 0o 400 amps 125.08 2
Owner signature ., pate:_ 401 amps to 599 crops 168.54 2
,_. _...—- AT
ATAPPI I CANT ] coNrACi PERSON Branch&rides- alteration,or eMeasles,Tt•panel
A.Fee fix lamtdn circuits with
Business name: d / /4, above service or feeder for, 7.42 2
--- �ry _ Jr3c each branch circuit
r...4... Contact nmsra #,,i,t,,„,41-
`.i se a car orfeederrirook without
- !—
tilt .B.Fee far branch ee,creaks wlthour
branch circuit
'Addles& sof - Poch 'add brawl circuit 56.18 2
city/Ste ciZlI' yoyl gLif',1 G , _ 7:4z 2
-7 MUcdlaneoua(spoke or feeder feet Waded) __
Phone:(gyp) lJ'Vi�►-�i��„/p Eacimmmfaoosredormodulr 67.84 2
Email: dv_alphK,=vice and/or feeder
j
,l4tflse oil .elleir'iwro i• Cdv�AI_ _-_ _._:.- -, Reamed 67.84 2
~ CONTRACTOR __-._
v .-__.. ..:.._.. �-7 .. Pomp or irrigation circle 67.84 2
iBusiness name: / l 1k`b Sign or outline lighting 67.64 2
'._r 7 Signalcucuii(a)orlimitedsoergy ---
` s
�. F Address' �i ht v2 el attend• a extension. 0 See Page 2 2
. r sty+State/ZIP: _ ♦u., _,,,p •? �,a � �+ _. Eaeb additional lns�ecttoa ever afowabk in at4 of the above
_. 9•t�a�.�'1�{:O a g .. \.J alTi tOM.I_.__ _. Additional inspection(1 hr n n) .- 66.25J hr
Phone:( ) 1�liar St NUN
.. hwatigatiaa(l hr min)_... -- 90.00/hr ...._,
i� .. . ___:_..._. Industrial pima tihrnrin) 78.18Ihr
Email: Ck— .,....,. PI I Inspections which 90.001h
CCB Lic,: %\IN Electrical f&l. .Lic.: y `% s ^c'ti,an,listed Oh termini
— -- ELECTRICAL PERMIT no
Suprv.Electrician signature,requited: Subtotal: AC,,it'!
Print nets: pale O Plan Review lfagalised(25%of permit fx�! Ise.
stala sumbargie(125cof permit see): tl Ql{
Authorized signal= TOTAL PERMIT FEE:-1r.I 71', l'i
� TDB permit apple.Me expire Hs permit b sot obtdord alibis I
� r f/-a
Print name: v/ DaI0404#5..2,pZ.Z days after It bar boo accepted as complete.
4 Number of inspections allowed per permit.
1:t wile& a ittELC_PadtApp, LJJgLdac pas 1MN2017 410.461510 VIBMOIMAVER
rl—
Electrical Permit Applications- `� .. FOR OFFICE USE O\I 1
City of Tigard Daceived 00J
c ` 11 '� By: O / io� Permit#:
II • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r �
g Phone: 503.718.2439 Date/By: / �� Related Permit#: uQ�2r�ay
Email: TigardBuildingPermits@Tigard-or:gov , . , Ready Da y: /II larb, ® See Page 2 for 0
TIGARD Inspection Line: 503.639.4175 Internet: www.tigard-or.gov ,Nyootified/Method: 4/3. Vie. 1G? Supplemental Information
TYPE OF WORK t�F ..m,,,C,�`rf 14._ PLAIt REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
Service or feeder 400 amps or mom 0 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ I-and 2-family dwelling Commercial/industrial ElAccessory building less to ground,or exceeds 14,000 ❑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 LOCCATION 0 Emergency system. larger separately derived
(,0'06' <Gds(, 100
0 Additionm new motor load of system.
Job#: Job site address: / t(/ 10oFIP or more. ❑"A","E"."1-2","1-3",
r': 0 Six or more residential units. occupancy.
City/State/ZIP: 1i/ (�� a 3 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: '�Lit-- �(etj?. t.0{ � 0 Hazardous locations. 0 Supply voltage for more than
�G ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: v/)2/2!/� FEE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Ft Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
\l l 1'.44,- f✓xiii +"'ker ®OC� �'�f tad; j1/,eallWitA ✓Vn Limited(with above
sq. lti
energy,multi-family 75.00 2
!r7 fresidential(with above sq.ft.)
�t� Renewable Energy 0 See Page 2
PROPERTY OWNER
1 ElTENANT Services or feeders installation,alteration,and/or relocation
Name: �M je /0 200 amps or less 100.70 2
Address: 'ri/2 S ` D� /'►�ql/L_ -� 201 amps to 400 amps 133.56 2
r�
401 amps to 600 amps / 200,34 ),,?kJ 2
[1� City/State/ZIP: ( .gab ,,M f�/ 420 601 amps to 1,000 amps 301.04 2
Phone:(11`) g-Fg — crier/ Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: 0444 bcuksf-0(Xiwk,„/-5 .7,Coaf relocation
v Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
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 '®CONTACT PERSON Branch circuits-new,alteration,or extension,per panelJEC
��t A.Fee for branch circuits with
Business name: ��yyy�g- (/'r vW7rll�f L above service or feeder fee, 7.42 2
eacll�/ tri���n Feehor brch anch
'U Contact name: R/"L�J I m� �,/ B.Fee far branch circuits without
L'9� Address: 3'Dei 17iswq iN! C' 3vv servicernh circuit
fee,first 56.18 2
branch circuit
City/State/ZIP: yg,,pn t cry✓ - 3 Each add'I branch circuit 7.42 2
/ Miscellaneous(service or feeder not included)
Phone:($lp ) •3 4' .- 2 t.` Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: ��,1"'t' �ei✓f. (p
�t�ltG ���C��a'sz t�iG�*�~ Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: rop Sign or outline lighting 67.84 2
Signal circuits)or limited-energy
Address: panel,alteration,or extension. ❑ See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(I hr min) 66.25/hr
Phone:( ) 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 Lie.: Electrical Lie.: Suprv.Lie.: specifically listed('G hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
r all
Print name: Date: ❑Plan Review Required(25%of permit fee): di
State surcharge(12%of permit fee): ( Oil
Authorized signature: TOTAL PERMIT FEEM)-7S1. L.l 7
This permit application expires if a permit is not obtained within 180
Print name: (tricjel, Date4i13 r- pZ 2 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:11tuilding'Yamits1ELC_PermilApp_ELR_ERE.doc Rev 10/26/2017 490-4615T(I1/05/COM/WEB
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 Qty. I Earn I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 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
El 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 an of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(I 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:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
n Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
l:lBuilding\Permils\ELC_Pe mitApp_ELR_ERE.doc Rev 10/26/2017