Permit (2) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00329
LGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2014
Parcel: 2S112ACO2400
Jurisdiction: Tigard
Site address: 14725 SW 72ND AVE
Project: Alpha Computers Subdivision: FANNO CREEK ACRE TRACTS Lot: 48
Project Description: (1)service and(20)branch circuits.
Contractor: SIMPLY SHOCKING LLC Owner: ALPHA LIMITED PARTNERSHIP
15118 S WOODGLEN WAY 14725 SW 72ND AVE
OREGON CITY,OR 97045 TIGARD,OR 97224
PHONE: 503-504-3095 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 06/17/2014 $100.70
Specifics: amps or less
20 cR Branch Circuits w/Purchase 06/17/2014 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 06/17/2014 $29.89
Electrical
Type of Const:
Occupancy Grp:
Total $278.99
Required Items and Reports(Conditions)
This permit is • s • _ to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done accordance with ap;roved 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 re• - you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 001-0010 thro h OAR 952-001 .090. Y. 1:y obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ssued By: ` 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' , �— Date: 69 97
LICENSE NO. £3 S
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 Applicatioi4EC "lVFa I t/R()I I It I t " ()NI Nl 1
Received _�3�
IN City of Tigard JUN 17 2014 Date/B : Permit No.:fL4 9• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.598 rI Date/B : Other Permit:
1 I(,;\K D Inspection Line: 503.639.4175 t OF 1 AHU Date edimet Ready/By: Sufis: ® See Page 2 for
Internet: www.tigard-or.gov �f I'nhft DONI^P Notified/Method: Supplemental Information
i'V f.,J.i11RC�,lr, 1 1
TYPE OF WORK PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwellingommercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E ,"1-2","l-3",
Job no.: Job site address: /(/#7 Z S sw '1 Z hi Six or or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: T7,4 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more.
——- - . FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total 1
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
,570'I /ate, 4 G/( ; , - h« re (��yfs.(- residential(with above sq.ft.)
/�' Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less / 100.70 /te 70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 1 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or Fee for branch circuits with
A. extension,per panel
❑ APPLICANT ❑ CONTACT PERSON A.
service or feeder fee, to 7.42 g ifQ 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:( ) Fax: :( ) dwelling,service and/or feeder
. Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: / S%•04/.. e Z c Signal circuit(s)or limited-energy See
7 panel,alteration,or extension. Page 2 2
Address: / �8 C44A./4,^�/ (,4// Each additional inspection over allowable in any of the above
f Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: /� b O y
Di�L I G i 0 R 7 7 s� Investigation(1 hr min) 66.25/hr
Phone:(5-0> 5 p y 3 0 7 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: /$f 0/7 Electrical Lie.: C 6-i7 4 Suprv.Lie.: 3/s3 5 specifically listed(V2 hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FLES
/uir Subtotal: cgLt Io
Print name: Sri-" r#T,T,f Date: �' ' ---Plan review(25% permit fee): '
/ State surcharge(12%of permit fee): A5 •17
D
Authorized signature: TOTAL PERMIT FEE: a7g• %/
/� This permit application expires if a permit is not obtained within ISO
Print name: �SO so Z� Date: I 9• /� days after it has been accepted as complete.
!J I • Number of inspections allowed per permit.
I:\Building\Permits\EI-C_Permanpp_ELR_ERE.doc Rev 05/21/2013 4404615T(l1/05/COM/WEB
Location:
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Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14725 SW 72ND AVE, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
July 24, 2014 at 8:29:01 AM
ELC2014-00329
Jeff Grove
Violation Summary:
Inspector Contractor