Permit lii CITY. OF TIGARD ELECTRICAL PERMIT•
2 COMMUNITY DEVELOPMENT f Permit#: ELC2012 00715
T tGARL� 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
4 i Date Issued: 12/17/2012
. ,_ 1, Parcel: 2S101CA00200
Jurisdiction: TIGARD
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Subdivision: 1994-025 PARTITION PLAT Lot: 2
Project Description: (2)150 amp feeders and(20)branch circuits. 6/17/13,ADDING(4)200 amp or less services/feeders,(1)201 -
400 amp service/feeder and(55)branch circuits.
Contractor: NORTH RIVER ELECTRICAL CONSTRUCTION Owner: AGILYX CORPORATION
PO BOX 780 7904 SW HUNZIKER ST
BORING, OR 97009 TIGARD,OR 97223
PHONE: 503-658-1911 PHONE: 503-217-3160
FAX: 503-658-8783
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 12/17/2012 $201.40
Specifics: amps or less
20 crt Branch Circuits w/Purchase 12/17/2012 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 12/17/2012 $41.98
Electrical
Type of Const: 4 ea Services or Feeders-200 08/06/2013 $402.80
Occupancy Grp: amps or less
1 ea Services or Feeders-201 to 08/06/2013 $133.56
400 amps
55 crt Branch Circuits w/Purchase 08/06/2013 $408.10
Service or Feeder
1 ea Plan Review Electricial 08/06/2013 $323.57
0 ea 12%State Surcharge- 08/06/2013 $113.33
Electrical
Total $1,773.14
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 -w. All work will
be done in accor.- - wi ...roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is u.pe :ed fo more the 180
days. ATTE "ON: Oregon law equir-. ou to follow the rules adopted by the Oregon Utility Notification Center Those ru-s are set forth in OAR
952-001-0' 0 thro gh OAR 952-001-6!:I. You..btain a copy o the rules or direct questions to OUNC by calling 503.232.1987 r 1.800.3.2. .
Issu-. By: / 4�_•_ - / . 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:
• RACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' a ' Date: ��/ 3
i roigni
LICENSE NO. -/9 V S
C= 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
• COMMUNITY DEVELOPMENT Permit #: ELC2012 -00715
TI G A R. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/17/2012
Parcel: 2S 101 CA00200
Jurisdiction: TIGARD
Site address: 7904 SW HUNZIKER RD
Project: Agilyx Subdivision: 1994 -025 PARTITION PLAT Lot: 2
Project Description: (2) 150 amp feeders and (20) branch circuits. Additional work to be done under separate permit.
Contractor: NORTH RIVER ELECTRICAL CONSTRUCTION Owner: AGILYX CORPORATION
PO BOX 780 7904 SW HUNZIKER ST
BORING, OR 97009 TIGARD, OR 97223
PHONE: 503-658-1911 PHONE: 503 - 217 -3160
FAX: 503 - 658 -8783
FEES
Quantity Description Date Amount
2 ea Services or Feeders - 200 12/17/2012 $201.40
Specifics: amps or less
20 crt Branch Circuits w /Purchase 12/17/2012 $148.40
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 12/17/2012 $41.98
Electrical
Type of Const:
Occupancy Grp:
Total $391.78
Required Items and Reports (Conditions)
This permi issu -• bject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don= in accordance w approved plans. This permit will expire if work is not started within 180 days of issuance, or if work ' s pended for more the 180
days. ATTENTION: Oregon -w -• ire you to follow the rules adopted by the Oregon Utility Notification Center. Tho I are set forth in OAR
952 -0' 1 -0010 thr ugh OAR 952 - • 1 -0091 Yuu may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 1.80. 34 .
Issu • By: I ' ' Lug _ , Permittee Signature: f`
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: • NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' ` ii Au /�/ 7/ A
LICENSE NO. 1 - I I 503.839.4175 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 , mit Orrlcy usu:()Nix
Received of Tigard �v® Permit No.: / ,/ lL S DateB
° 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /_ 1
C Phone: 503.718.2439 Fax: 503.598.1960 Date/By: L.Y 3/l 3 ,iii • Other Permit
f I G A R l9 Inspection Line: 503.639.4175 Date Ready/By: /- C// Lurie: PI See Page 2 for
Internet: www.tigard-or.gov Notified/Method:llJ (a /3 Supplemental Information
TYPE OF WORK c* --w( ,�L�e.� PLAN REVIEW . '
New construction Addition/alteration/re lacement Ple ele a check all apply(submit 2 sets of plans w/items checked below):
❑ ❑ P
❑Service or feeder 400 amps or more 0 Building over three stones.
❑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
❑ I-and 2-family dwelling ❑CommerciaUindustrial ❑Accessory building amps for all other installations. buildings. i
❑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","1-3",
• ��`/ 100HP or more. occupancy.
Job no.: Job site address: Si,.. /7/0 s;,lz��
/ 0 Six or more residential units. 0 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: ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qtr. 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'l 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
"7"-,,:,....s67-// P,�11 , ��„ -s,s �1 : ,�, residential(with above sq.ft.)
G C O/P-� 7 G r Renewable Energy ❑ See Page 2
�( Services or feeders installation,alteration,and/or relocation
0 PROPERTY OWNER ❑ TENANT 200 amps or less LI 100.70 e-/a$7_,YD 2
201 amps to 400 amps i 133.56 )3 '; s� 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 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 extension,per panel
'. • .❑ APPLICANT A CONTACT PERSON _ A.Fee for branch circuits with
. above service or feeder fee, 7.42 42 ;d 2
Business name: �� / each branch circuit S 5 /d�
- ��`-� �� B.Fee for branch circuits without
Contact name: ' service or feeder fee,first
branch circuit 56.18 2
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:(it7.,) d kV /q// 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:/jX/� Ry`-L� �/l�r� ^ 1 (� f,` Signal circuit(s)or limited energy See
• / ` S panel,alteration,or extension. Page 2 2
Address: v v Each additional inspection over allowable in any of the above
®�. 7
City/State/ZIP: /� � Additional inspection(1 hr min) 66.25/hr
. %-70rj 7 Investigation(1 hr min) 66.25/hr
Phone:(,Yv.3 )�,S v _ /_•// Fax:�.3 )/1,0,S—S, .—V>T 3 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.431 e7.7 i. Electrical Lic.::::?_` r. c., Suprv.Lie.:�o—/ e_. s specifically listed(/2 hr min)
Suprv.Electrician signature,required: �y ELECTRICAL-PERMIT,FEES•
Subtotal: 9'/"-/ 17:6'
6
Print name: c�� ,G Date: Plan review(25%of permit fee): --•
""� ��� 4.',•m--r 3 State surcharge(12%of permit fee): // .
Authorized signature: TOTAL PERMIT FEE: -
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit. .
t:\BuildingTermits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-46151(1 I/05/COM/WEB
Electrical Permit Application
City of Tigard Date/By: (� / 7 / Perm No.: �c � / 2_007
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
I I t . \ r 0 Inspection Line: 503.639.4175 Date Ready/By: Innis 65 See Page 2 for
Internet: www.tigard -or.gov Notified/Method: Supplemental Information
/TYP OF WORK PLAN REVIEW
❑ New construction IJ Addition/alteration /replacement Please check all that apply (submit 7 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ 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
El
1- and 2- family dwelling Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: 0 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 -2 ", "l -3 ",
LJ 100HP or more. occupancy.
Job no.: Job site address: /S W • �� ❑ 0 vehicle parks.
aM/ Z Six or more residential units. p
City/State /ZIP: , . d 9 7 ,,.‘2' 3 o Health care facilities. 0 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 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
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 2.„, 100.70 t9,) . 'la 2
❑ PROPERTY OWNER I ❑ 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 11. 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 401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, q D 7.42 i�� fi0 2
each branch circuit eV
Business name: B. Fee for branch circuits without
service or feeder fee, first 56.18 2
Contact name: branch circuit
Each add'l branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular 67.84 2
Y dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited- energy
Business name: A. /a -.'..--C-'14.1."6 ) C � D }Sarlel alteration or extension. Page 2 2
N l V l ach additional inspection over allowable in any of the above
Address: ,U � 4 p, 2 a/Q Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: /, F'r�d 0� Investigation (I hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18 / hr
Phone: (x^03 )6.1 Fax: �J Inspections for which no fee is
g ! `� ?Mil (Sd2) S� 6 specifically listed (Yi hr min) 90.00/ hr
CCB Lic.:J 3 3 y , 3 Electrical Lic.: -S Suprv. Lic.: ,"/ SY ELECTRICAL PERMIT FEES
t ' /IV/ // 3 Subtotal:
Su lerician signature, required: /4„, ! : ��//
Plan review (25% of permit fee): rte
Print name: .S.---e ds Date: /0/ .. 7 / a__ State surcharge (12% of permit fee): 7 '. / `
TOTAL PERMIT FEE: / , 7
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 07/01 /10 440- 4615T(II/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
Fee for all residential systems combined ... $75.00 Description I Qty. I Fee _I Total I •
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:
El Burglar Alarm
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
❑ Heating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
ElOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(%3 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
ElAudio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
El Other
Total,number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
•
FOR OFFICE USE ONLY—SITE ADDRESS:
This form is recognized by most building departments in the Tri-County area for transmitting information.
Please complete this form when submitting information for plan review responses and revisions.
This form and the information it provides helps the review process and response to your project.
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
Transmittal Letter
T I G,A F D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: t DAT
_•'
DEPT: BUILD D;VIS iON
J MAY 082013
4A4: CITY OF TIGARD
COMPANY: BUILDING DIVISI
PHONE: - / °/// By.
RE: 7 70 `� ('_� LC jO (a-( 77/i -
(Site Address) C ) C(Permit Number)
(Project name or subdivision name and lot number)
ATTACHED ARE THE FOLLOWING ITEMS:
Copies: Description: Copies: Description: •
Additional set(s) of plans. Revisions:
Cross section(s) and details. Wall bracing and/or lateral analysis. •
Floor/roof framing. Basement and retaining walls.
Beam calculations. Engineer's calculations.
Other(explain): nn
REMARKS: ( �� •� �eSC � 7 •
FOR OFFICE USE ONLY
Routed to Permit Technician: Date: Initials:
Fees Due: ❑ Yes ❑No Fee Description: Amount Due:
Special •
Instructions:
Reprint Permit(per PE): ❑ Yes ❑No ❑ Done
Applicant Notified: Date: Initials:
(:\Building\Forms\TransmittalLetter-Revisions.doc 05/25/2012
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:
❑ Audio and Stereo Systems*
El Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
❑ 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
n Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Buildin \Permits\ELC- PermitApp.doc 07/01/10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
7904 SW HUNZIKER RD, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2014-04-07 00:00:00
ELC2012-00715
PASS - No C of O
Violation Summary:
Inspector Contractor