Permit n CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2012 00531
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/13/2012
Parcel: 1 S135DA03900
Jurisdiction: Tigard
Site address: 11155 SW HALL BLVD 43
Project: St. James Apartments Subdivision: METZGER ACRE TRACTS Lot: 19
Project Description: Reconnect only
Contractor: VAST ELECTRIC Owner: KAULUWAI CORPORATION
1525 SEATTLE SLEW DR. SE 2445 -A MAKIKI HEIGHTS DRIVE
SALEM, OR 97301 HONOLULU, HI 96822
PHONE: 503 - 566 -7274 PHONE:
FAX: 503 - 585 -8828
FEES
Quantity Description Date Amount
1 ea Reconnect Only 09/13/2012 $67.84
Specifics:
1 ea 12% State Surcharge - 09/13/2012 $8.14
Electrical
Type of Use: MF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 OAR 9 2 01 -009 . You may obtaai py of the rules or direct questions to OUNC by calling 503.232.1987
ITT1. 2.1987 or 1.800.332..2344.
Issued By: �_4,Ltit PermitteeSignature: �/&% p� `� 170 &1
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 503.639.4176 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.
Sep 13 12 07:50a Vast Electric Inc. 503- 585 -8828 p.2
0114
Electrical Permit Application __ RE I OR OFFICE t'SE ONLY
City of Tigard Received No.
1
13125 SW Hall Blvd., Tigard, OR 97223
SEP 13 2012 • .e/ q1/562.- Eu� ►� - ooS 3 i
C Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 • //� bate/By.
1 G :A Inspection Line: 503.639.4175 _ CITY ! OF TIGAR I Date Ready/By. ® See Page 3 for
Internet: wtcw.tigard- or.gov i it 9 1 , _Noti5ed/Method I/ (1 Supplemental Information_
TYPE OF WORK PLAN REVIEW
❑ New construction ® Add itionialterationlreplacement P chi all that apply (submit 2 gas of plasm w /items checked below):
❑ Service or feeder 400 amps :r mere ❑ Building over three stories.
❑ Demolition ' ❑Other. where the available fault avrenn ❑ 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 agricuhural
❑ 1- and 2- family dwelling ❑ Commercial!industrial ❑ Accessory building amps fur all other installations_ buildings.
® Multi family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ lastallation of 75 KVA or
JOB SITE INFORMATION AND LOCATION - ❑ ❑ Addition system. larger separately . derived system.
of new tooter load of ❑ "A ", "E", `I - .. , 13 .
Job no.: I Job site address: 11155 SW Hall Blvd I00HP or more. occupancy.
❑ Sic or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: Tigard OR 97223 ❑ Health-care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 wilts nominal.
Suite/bldg./apt. no.: *43 I Project name: ❑ Service or feeder 600 amps r more.
job site: Description FEE SCHEDULE
Cross street/directions to
j I Qty. I Fee. I Total I.
Ncw residential single- or multi - family dwelling snit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. fl or.less 16834 14
. Ea. odd'l 500 sq. fl or portio 1 33.92 I
Tax map/pareel no.: Limited energy, residential 75.00 i 2
DESCRIPTION OF WORK (with above sq. R.)
Limited energy. multi- family 75.00 : 2
Reconnect . residential (with above sq. IL)
Services or feeders installation, alteration, and/or relocation
200 amps or less 100.70 2
❑ 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 i 552.26 2
Temporary services or feeders installation, alteration, and/or
City /Statc!ZIP: relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 I
Owner installation: This installation is being made on property that 1 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 i
Branch circuits- new, alteration, or extension, "der panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ 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
Contact name: 7\•i branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: A , 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 I 67.84 67.84 2
E - mail Pump or irrigation circle 67.84 2
: Sign or outline lighting • 67.84 2
CONTRACTOR ■ Signal circuit(s) or tinted cncrgv
Business name: Vast Electric, Inc. pawl, alteration, or extension. _ Page 2 2
Each additional inspection over aRowable in any of the above
Address: 1525 Seattle Slew Dr SE • Addit inspecti (1 hr min) 6625/ hr i
City/StateiZiP: Salem, OR 97317 Investigation (1 hr min) / 66.25/ hr
Industrial plant (1 heroin) 78.18 / hr
Phone: (503) 799 -5627 Fax (503) 585=8828 Inspections for which no Ice is
specifically listed (5i hr min) • 90.00/ hr
CCB Lic.: 175531 Electrical Lie.: C -280 liuprv. Lie.: 5186S ELECTRICAL PERMIT FEES
�/ �n Subtotal: 67 ,
Suprv. Electrician signature, required (64:,,,.. Plan review (25% of permit fee):
Print name: Tint Vander Stoep °' Date: ' • 3/2012 State surcharge (12%ofpenult fee): 8.14
•
Authorized signature: TOTAL PERMIT FEE: 75.98
This permit application expires ids permit is not obtained within 180
days after it ban been accepted as complete.
Print name: Date: • Number of inspections allowed per permit.
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