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Permit
1 // 1 7/. 2.- tiny /e"/lii iil . CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2011 -00600 131 25 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/26/2011 , ., . . Parcel: 25101 CB00400 Jurisdiction: Tigard Site address: 12700 SW HALL BLVD D Project: Oregon Aqua Farms Subdivision: 2007 -064 PARTITION PLAT Lot: 1 Project Description: (1) service and (6) branch circuits. 2/17/12, REPRINTED permit to include (1) additional feeder. Contractor: KALEO ELECTRIC LLC Owner: TCTPI LLC PO BOX 22104 4260 GALEWOOD ST, STE A MILWAUKIE, OR 97269 LAKE OSWEGO, OR 97035 PHONE: 503 - 341 -0897 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 10/26/2011 $100.70 Specifics: amps or less 6 crt Branch Circuits w /Purchase 10/26/2011 $44.52 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 10/26/2011 $17.43 Electrical Type of Const: 1 ea Services or Feeders - 200 02/17/2012 $100.70 Occupancy Grp: amps or less 12 12% State Surcharge - 02/17/2012 $12.08 Electrical Total $275.43 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty ode• and all ether 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 issu: nF , 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 ,. en -r. /fhose rules are set forth in OAR 952 - 001 -0010 through OAR 2- 001 -0090. Yo m r direct questions to OUNC by calling 503.23; 'r orb :00 332.2344. Issued By. Permittee Signature: / Agolorgill..- 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: 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. CITY OF TIGARD ELECTRICAL PERMIT gi 11111 f COM MUNITY DEVELOPMENT P ELC2011 -00600 Date Issued 10/26/2011 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 25101 C600400 Jurisdiction Tigard Site address 12700 SW HALL BLVD D Protect Oregon Aqua Farms Subdivision 2007-064 PARTITION PLAT Lot 1 Project Description (1) service and (6) branch circuits Contractor KALEO ELECTRIC LLC Owner TCTPI LLC PO BOX 22104 4260 GALEWOOD ST, STE A MILWAUKIE, OR 97269 LAKE OSWEGO, OR 97035 PHONE 503 -341 -0897 PHONE FAX FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 10/26/2011 $100 70 Specifics' amps or less 6 crt Branch Circuits w /Purchase 10/26/2011 544 52 Type of Use COM Service or Feeder Class of Work ALT 1 ea 12% State Surcharge - 10/26/2011 $17 43 Elecincal Type of Const Occupancy Grp Total $162 65 Required Items and Reports (Conditions) 1 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty I and other applicable law At work will be done i ccordance wi approved •fans This permit will expire if work is not started within 180 days of issua „ , or if ork is suspended for more the 180 days ENTION Oregon -w • uir .s ou to follow the rules adopted by the Oregon Utility Notification C. ter hose rules are set forth in OAR 952 -00 -0010 through OAR 952 -05 -0090 Y -y obtain a copy of the rules or direct questions to OUNC by calling 503 232 i 1 or .00 332 2344 Issu d By ifs.. - Siall11111 i/ �il -�o , / 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 1 CONTRACTOR INSTALLATION ONLY • SIGNATURE OF SUPR ELEC' a 0 t 41 , ,` Starer Date 14G/i 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 Electrical Permit Application ONLY' City of Tigard R eceived t� 4,-- { Permit No.: ° 13125 SW Hall Blvd., Tigard, Oa` r ©�1- Plan Review ac)// �C3 �DJ" '- C : Phone: 503.718.2439 Fax: 503!598.1960 1 Date/By: Other Permit: Inspection Line: 503.639.4175 T LG A R D C C�� Date Ready/By: 7uris. ® See Page 2 for Internet: www.tigard- or.gov �1 � c .\Q Notified/Method: 7 p Supplemental Ioformat3on TYPE OF WoOR v) PLAN REVIEW �► ❑ New construction ❑ Addition/alter Please check all that apply (submit 2'sets of plans w /items checked below): t ..replacement ``�p 0 Service or feeder 400 amps or more 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 ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION. AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "1 - ", � /, � �%/ , � C � . �� J 100HP or more. occupancy. V Job no.: Job site address: ��? j /T ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: /� q/{ /� �� 5 ❑ Service or feeder 600 amps or more. v FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I . 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 n( a i r I y r) 9 O„ t l a ��`1� / residential (with above sq. ft.) �' Services or feeders installation, alteration, and/or reloc 200 amps or less 1 100 70 / 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation, alteration, and /or City/State /ZIP: relocation Phone: ( ) Fax: ( ) 200 amps or less 59.36 1 201 amps to 400 amps 125.08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Branch circuits.— new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, first 56.18 2 Contact name: branch circuit Each add'I branch circuit 7.42 2 Address: Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 67.84 2 Phone: ( ) Fax: : ( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: Sign or outline lighting 67.84 2 CONTRACTOR Signal circuit(s) or limited- energy Business name: panel, alteration, or extension. Page 2 2 Each additional inspection over allowable in any of the above Address: Additional inspection (1 hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) 66.25/ hr Industrial plant (1 hr min) 78.18/ hr Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr specifically listed (% hr min) CCB Lic.: Electrical Lc.: Suprv. Lic.: ELECTRICAL PERMIT FEES Suprv. Electrician signature, r uired: Subtotal: l (11 1 74) Plan review (25% of permit fee): Print name: Date: (I q/! -1 - State surcharge (12% of permit fee): ti,, cS y- `, f/ TOTAL PERMIT FEE: 10_ , Zr Authorized signature: ( This permit application expires if a permit is not obtained within 180 Printiname: � r Date �/ j days after it has been accepted as complete. { ! 4 l) Number of inspections allowed per permit. C\ Building \Permits\ELC- PermitApp.doc 07/01/10 440- 4615T(11 /05 /COM/WEB Electrical Permit Application FOR OFFICE„ USE ONLY • - Received n /- � e,, /C t/1 City of Tigard Received �9 A0 /0 ( J4/ Permit No h �/ frc ) 'ec 13125 SW Hall Blvd , Tigard,OR 97223 Plan Review : 0 '• Phone 503 718 2439 Fax 503 598 1960 Date/By Other Permit ions ® See Page 2 for r TIGARD Inspection Line 503 639 4175 Date Ready/By g Internet www tigard -or gov Notified/Method Supplemental Information / TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans whims checked below) ❑ New construction © Addition /alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stones ❑ Demolition ❑ Other where the available fault current ❑ Mannas and boatyards CATEGORY OF CONSTRUCCION exceeds 10,000 amps at 150 volts or 10 Floating buildings / less to ground, or exceeds 14,000 ❑ Commercial -use agricultural Irk ❑ I - and 2- family dwelling Commercial /industrial ❑ Accessory building amps for all other installations buildings ❑ Multi- family ❑ Master builder ❑ Other ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMAL ION AND LOCATION ❑ Emergency system huger separately Uciivcd system ❑ Addition of new motor load of ❑ "A ", "E ", "l- 2 ",'9 -3 ", Job no Job site address 'te y's y� a / , /+, A5K: 100HP or more occupancy /l/1/ ' 4LJ ••4 /I I , V4I D 9 ❑ Six or more residential tints ❑ Recreational vehicle parks City /State /ZIP i n4U V p ❑ Health -care faint ies ❑ Supply voltage for more than _/ 7 r Hazardous al on ❑ Hardous locs 600 volts nominal Suite /bldg /apt no Project name / x ❑ Service or feeder 600 amps or more S '1P v imp ~ I � FEE SCHEDULE Cross street/directions to job site Description .I O4r I Fee f Total I • 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'l 500 sq ft or portion 3392 I 'fax map /parcel no Limited energy residential DESCRIPTION OF WORK (with above sq ) 7500 2 R Limited energy, multi- family 75 00 2 ri rO s IAA a awl CC. IS py tnP s to chi /15' S ratui e residential (with above sq ft ) Services or feeders installation, alteration, and/or relocation e<MO le 200 amps or less 1/ r 100 70 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133 56 2 Name 401 amps to 600 amps 200 34 2 601 amps to 1,000 amps 301 04 2 Address Over 1,000 amps or volts 552 26 2 City/State/ZIP Temporary services or feeders installation, alteration, and /or y relocation Phone: ( ) Fax ( ) 200 amps or Is 59 36 1 201 amps to 400 amps 125 08 2 Owner installation: This installation is being made on property that I own which is not intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701 401 amps to 599 amps 168 54 2 Branch circuits — new, alteration, or extension, per panel Owner signature Date A Fee for branch circuits with APPLICANT ❑ CONTACT PERSON above service or feeder fee L 7 42 Al q 5- 2 each branch circuit o Business name B Fee for branch circuits w about 32F�>C7N Q IAEL FH 2p/S (L service or feeder fee, first 5618 2 Contact name AA/40 /r r-' branch circuit L/ 2 Each add'I branch circuit 7 42 2 Address ) a„�00 `�I,4,) 1N°,il 1J Lie) Sb —e) Miscellaneous (set ice or feeder not Included) Cll /Stale /ZIP / "-- --t Each manufactured or modular y l . C j k'' oft, �-'� "9ZZ,'� dwelling, service and/or feeder 67 84 2 Phone - (i3) i Q3.5 y4 t Fax ( ) Reconnect only 6784 2 E PA LIZ,t+AA.P O t ,� �/� Pump or irrigation circle 67 84 2 — 1L1 `✓ (' 4`4 L. - (_-1 iQ v Sign or outline lighting 67 84 2 CONTRACTOR Signal circutt(s) or limited- energy Busmeaa name /(A 4, ( / f L 5 - R • ,, t 4 l c - panel, alteration, or extension Page 2 2 f+ _ Each additional inspection over allowable in any of the above Address ov`./ Additional inspection (l hr mm) 6625/hr • City /State /ZIP Po 10 c2a 1k)' am` / tea J�(, / 7��y Investigation (I hr mm) 6625 /hr t: r / Industrial plant (1 hr mm) 78 18/ hr Phone (5-63) 3 i j ( — 0 in ) Fax ( 744ti inspections for which no tee is 90 00/ hr specifically listed (h hr min) Cell Lic / tot 5-3? Electrical Lie 1 Supry Lie 1 0 36 ELECTRICAL PERMIT FEES ta Subtotal 191 r e 7 ,1 4 ., Supry Electrician signature required Plan review (25% of permit fee) Print name State s urcharge (12% of permit fee) — 4. Cr") G PG ' IdJ +J at Date y� /Z e� 20 /I I i * / TO1AL PERMIT FEE 16;165 Authorized signature /� (.� • ` (his permit application expires if a permit is not obtained within 180 i _� _ Print name / Date days after it has been accepted as complete S I/ a Number of inspections allowed per permit 11Budding\Permns'ELC- PermitApp dw /01/10 440- 4615T(I 1 /05 /COS1M'EB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* n Heating, Ventilation and Air Conditioning System* n Vacuum Systems* n Other COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918 309 - 0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n C • lock Systems n Data Telecommunication Installation ❑ Ore Alarm Installation ❑ NVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n M • edical El N urse 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 Pernws\LLC- PermirApp doe 07/01/10