Permit •
CITY OF TIGARD ELECTRICAL PERMIT
e COMMUNITY DEVELOPMENT Permit #: ELC2013 -00322
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2013
Parcel: 2S112AA00300
Jurisdiction: Tigard
Site address: 14200 SW 72ND AVE
Project: Gerber Blades Subdivision: MILLMONT PARK Lot: 49
Project Description: (1) service, (11) branch circuits and (1) low voltage for data.
Contractor: BECK ELECTRIC INC Owner: GERBER LEGENDARY BLADES
15600 SE FOR MOR CT #B 14200 SW 72ND AVE
CLACKAMAS, OR 97015 PORTLAND, OR 97223
PHONE: 503 - 656 -7396 PHONE:
FAX: 503 - 656 -4397
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/10/2013 $100.70
Specifics: amps or less
11 crt Branch Circuits w /Purchase 06/10/2013 $81.62
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Signal circuit or Limited 06/10/2013 $75.00
Energy Panel
Type of Const: 1 ea 12% State Surcharge - 06/10/2013 $30.88
Occupancy Grp: Electrical
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Total $288.20
Required Items and Reports (Conditions)
This permit is i •'-ct 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 . roved • ;ns. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. • ENTION: Oregon law - quires to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-1 thro gh OAR 952 -• • •090. Y may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.8.0.332.2344.
/ (
Is.uedBy: " _` Permittee Signature: V
/ 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' • I / , Date:
LICENSE NO.
Call 603.639.4175 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 FOR OFFICE USE ONLY
City of Tigard � � J� Date /B _ 0 .3 � 1 ,44 4 0 /5 -- ‘ 20 3.?�
X11 ►� LLii Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 D Plan Review
Phone: 503.718.2439 Fax: 503.598.1960. Date /B Other Permit:
I' I c. R D Inspection Line: 503.639.4175 , I : N 1 0 , 013 Date Ready /By: Juris: El See Page 2 for
Internet: www.tigard or.gov Notified /Method: Supplemental Information
TYPE OF a III i Of IIG� PLAN REVIEW
a
❑ New construction YAddition /altera is l O l� N Please check all that apply (submit 2 sets of plans w /items checked below):
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 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
of n
❑ Addition of new w motor load of ❑ "A ", "E ". "I - ". "I - ".
Job no.: Job site address: y.2 0 0 Sid ?a n i A.v e • occupancy.
o or r or more. more residential units. ❑ R ecre
nal vehicle parks.
City/State /ZIP: Po „ ftt c/ 0 . 57•7,2 ; V ❑ ❑ Health-care za do facilities. ❑ Supply 0volts voltage for more than
_ Hazardous locati 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
q
Cross street directions to job site: e 4_ / 7 Z rt. o J_ 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. fl. or portion 33.92 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. fl.)
Limited energy, multi - family 75.00 2
et.e.atil ca 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 0 100.70 /0C). ./\=) 2
201 amps to 400 amps 133.56 2
Name: [
PX �p I/ & (�q c+ CS 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
i Y zov sw I)? , r !� � ` e -
Over 1,000 amps or volts 552.26 2
City/State /ZIP: ro v _. c, OA. 7 7 )- _ t/ Temporary services or feeders installation, alteration, and/or
Phone: (5b3) ( ( / & / Fax: (50 3) IA* - NO s// relocation
200 amps or less 59.36 I
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 ex tension, per panel
❑ APPLICANT (CONTACT PERSON A. Fee for branch circuits with -
above service or feeder fee,
Business name: ( e,_ L. times each branch circuit i 7'42 et : a 2
- (
B. Fee for branch circuits without G
Contact name: tri v. z - gir 4 e vv Lc, c_k service or feeder fee, first 56.18 2
branch circuit
Address: /I,f 700 .g !.J 1 2. n 44-v -e-. Each add'I branch circuit 7.42 2
City/State /ZIP: pp .‘, ( Miscellaneous (service or feeder not included)
/'fJ ...4 L f . eL I o rt. Each manufactured or modular
dwelling, service and/or feeder 67.84 2
Phone: (5 ) S 5 0 �-Q4 ,1. e Fax: : (503 ti.ra 7, _ / )_e7 t.
Reconnect only 67.84 2
E - mail: fl'tattic. . h&2_,(i Cut. -t 6) gerhf. 5 :lCet,r • cow Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal circuit(s) or limited - energy See !�(,
F �'u ' t pane a or extens / P age 2 7 7 2
Address: 15400 S ' ro r Pn' a r c -. S e. e . Each additional inspection over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: ,, E ri G &. 0. ri, e. c, / t 9 r' 0 / ' :o 4.2 3 Investigation (I hr min) 66.25/ hr
Phone: (503) r ,5 J - 17 6 Fax: ( ) Industrial plant (1 hr min) 78.18/ hr
Inspections for which no fee is
CCB Lie.: � 6 1 I lectrical Lic.:3 5G Suprv. Lic.: 0 � /� specifically listed (%: hr min) 90.00 / hr
ac• // /(b O f ELECTRICAL PERMIT FEES Ac"7. ''
Suprv. Electrician signature, equired: Subtotal:
` Plan review (25% of permit fee): s/ . ��' �; �
' -
Print name: Chz f/ / h �� Date: 6 . /(j , se
i ! State surcharge (12% of permit fee): --e
Authorized signature J TOTAL PERMIT FEE: a
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This permit application expires if a permit is not obtained within 180
Print name: 46,, „ Le. 5 Q j I s 7' Date: t, -/O -i,3 days after it has been accepted as complete. 2.D
:/ ' Number of inspections allowed per permit. ; Egg
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Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
l RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined $75.00 Description I Qty. I Fee I Total
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems*
15.01 to 25 kva 200.34 2
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
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
OAR 918- 309 -0040)
❑ Heating, Ventilation and Air Conditioning
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
n
Each additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly (I hr min) 66.25/ hr 1
Inspections for which no fee is - 90.00/ hr
specifically listed (' /2 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
❑ Audio and. Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
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*No licenses are required. Licenses are required
for all other installations
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