Permit CITY OF TIGARD ELECTRICAL PERMIT
111-111 2: COMMUNITY DEVELOPMENT Permit#: ELC2013-00468
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/07/2013
Parcel: 1S126BC01506
Jurisdiction: TIGARD
Site address: 9020 SW WASHINGTON SQUARE RD 350
Project: Primary Residential Mortgage Subdivision::CONDO,THE SUPPLEMENTAL PLAT Lot: 25-4
Project Description: (2)branch circuits for TI
Contractor: R C COSTELLO ELECTRICAL CONT INC Owner: WISCO REAL ESTATE EQUITY FUND I
PO BOX 336 1501 SW TAYLOR ST STE 100
AURORA, OR 97002 PORTLAND, OR 97205
PHONE: 503-982-7400 PHONE:
FAX: 503-982-7400
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 08/07/2013 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/07/2013 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in actor•-S-- • •.roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATT ON: Oregon law equir•- to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-c/10 through OAR 952-001-0•:1. You m. btain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is ed By: / / / Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' YQ� Date: 17/3
LICENSE NO. 3 9/ 54/5
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Electrical Permit ApplicaticRE ,,IvED rok 'I�IC E I-sE(Nl_V
City of Tigard l�i� gif�� Permit No.: e _A13—oa 6 Da u •
• 13125 SW Hall Blvd.,Tigard,OR 972#I G `1 ° '2 Plan Review
1111 �u �)�$ �U
Phone: 503.718.2439 Fax: 503.598. 960 ni► Date/13 : Other Permit: .5 .
I.I�_ 1z D Inspection Line: 503.639.4175 CITY OFTIGt>�W Date Ready/By: turfs: RI See Page 2 for
Internet: www.tigard-or.gov pulp 1 i GDNISIOI�L Notified/Method: Supplemental Information
TYPE O PLAN REVIEW
❑New construction L JAddition/alteration/replacement Please check all that apply(submit a 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.
CATEGQRY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
,LtJ/ less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling CommerciaUindustrial ❑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","1-3",
Job no.: Job site address: (� �+/ I /. ' L hi 7t /�. ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: J [[[... ❑Health-care facilities. ❑Supply voltage for more than
"� ❑Hazardous locations. 600 volts nominal.
ui ldg./apt.no.: 3' Q.._pp Project name: i m t r�' -We 5 a ,lilt I ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: M o r-I a 9 k Description I pry. I Fee. I Total I •
9 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 7500 2
L.�rA/1<i (^1 r/..r 1'FS Zr I. 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 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 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 extension,per panel
❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first I 56.18 CS C.1 b 2
branch circuit _
Address: Each add'I branch circuit ' 7.42 'I.t I L 2
Miscellaneous(service or feeder not included)
City/State/ZIP: 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: R C Cos f e i iu Dori r c.4 I C.04-frAc-(1,i Signal circuit(s)or limited-energy See
f panel,alteration,or extension. Page 2 2
Address: --pv!J -&a xL ..? �a Each additional inspection over allowable in any of the above
City/State/ZIP: �; Additional inspection(I hr min) 66.25/hr
/ Jd'�f d\ C)- -17002- Investigation(I hr min) 66.25/hr
Phone:(c 3)f7< , --,t40 , Fax:(50 3) 9 2 ---)1.10 / Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: S7I-10 2 Electrical Lic.: 3 -34?J'`,2 c Suprv.Lic.:3 324 5 specifically listed(Vs hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: e.,....----- �_ _ Subtotal: 6 3 , 6,0
Print name: --)?C er" r e.-,)41 /f Date: g J J , / /3 Plan review(25%of permit fee):
State surcharge(12%of permit fee): (og)
Authorized signature: TOTAL PERMIT FEE: It aBi
This permit application expires if a permit is not obtained within 18yp-�
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\ELC PermaApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(I1/0S/COM/WEB