Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit p: ELC2013 00509
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2013
Parcel: 2S113AB00500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD 320
Project: Spec Space Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37
Project Description: Electrical for TI.
•
Contractor: LEAR ELECTRIC CO INC Owner: G&S FC LLC
PO BOX 573 16083 SW UPPER BOONES FERRY RD,
GRESHAM,OR 97030 STE
TIGARD,OR 97224
PHONE: 503-255-0733 PHONE:
FAX: 503-255-0676
FEES
Quantity Description Date Amount
Specifics: 3 crt Branch Circuits wo/Purchase 08/27/2013 $71.02
Service or Feeder
1 ea Signal circuit or Limited 08/27/2013 $75.00
Type of Use: COM -. Energy Panel
Class of Work: ALT 1 ea 12%State Surcharge- 08/27/2013 $17.52
Electrical
Type of Const:
Occupancy Grp:
Total $163.54
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 952-001-0090. You may obtain a copy of •uestions to OUNC by calling 503.232.1987 or 1.800:332.2344. c
Issued By: ���� — — Permittee Signature:• D �
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.
08/22/2013 15:58 5036616389 LEAR ELECTRIC PAGE 02/03
Electrical Permit A ECEIVED lV FoR OFFICE 1:$1.ONLY
City of Tigard AUG 2 2 2013 ,,;, Perittit No.: _ — s- C
I _ n 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review a)
� Y OF TIGARD Other Permit:
Phone: 503.718.2439 Fax: 503.598. .Date/f3 �• '��
Inspection Line: 503.639.4175 Date Ready/By: RIM: 83 See Page 2 for
TIGARD Internet; www.tigard-or.gov BUILDING DIVISION NonfiedlMethod. 27=6 Supplemental Information
TYPE OP WORK PLAN REVIEW
Please check all that apply(submit 2 sets of plans WIitems checked below):
❑New construction Addition/alteration/replacement ❑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 ❑gloating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling 5r.Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: CI Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system,
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑"A","6","1-2","l-3",
�2 1(,0 , See) �QpQ.f'' ./ Si,'0ormo eyes. Recreation
Job no.: l�� P� Job site address: r •.. �,
❑S or more residential amts. ❑Recreational vehicle parks.
City/State/Z1P. `r A 0 ❑Health-care facilities. • ❑Supply voltage for more than
ar 1 "i ��� r s+rr� ❑Hazardous locations. 600 volts nominal.
4 Suite/bldg./apt no.: C Project name: Fu n n r. . ❑Service or feeder 600 amps or more.
- FEE SCHEDULE
Cross street/directions to j•• sites' r a...m ica 1 g x. 1 Fes L ew' I •
/). ' 13 O-'T 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
DESCRIPTION OF WORK
(with above sq.R) 75.00 2
A Limited energy,multi-fared 75.00 2
3 n e• _ /I ` r.Gt f S residential(with above sq.ft.) _
W l� Renewable Enemy , ❑ 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
r
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps _ 301.04 2
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Over 1,000 amps or volts 552.26 _ 2
City/State/ZIP: . Temporary services or feeders installation,alteration,and/or
relocation
Phone:( ) , Fax:( ) 200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not "201 sips 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 ❑ CONTACT PERSON A.Fee for branch circuits with
above service or theder fee, 7.42 + 2
Business name: each branch circuit
B.Fee fbr branch circuits without ��'(
Contact name: service or feeder fee,first , 56.18 La 2
- branch circuit
Address: • Each add'I branch circuit a 7.42 1N,111 2
City/State/ZIP: Each manufactur(service
d or tmodular etder not Included)Miscellaneous
dwelling,service and/or feeder 67.84 2
Phone:( ) , Fax. .( ) Reconnect only 67.84 2
•E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Lear Electric Co.,Inc. Signal circuit(s)or See
Noel. •�-t ---nel.altetatio&or extension. Page 2 ` 5 2
Address:6002 NE I12th Ave Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
_
City/State/ZIP:Portland,OR 97220 Investigation(1 hr min) 6625/hr
Phone:(503)255-0733 Fax:(503)255-0676 Industrial plant(1 hr min) 78.18/hr
inspections for which no fee is
CCB Lic.: 52278 Electrical Lic.: 26-411C Suprv.Li : 3786S specifically listed(i4 hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signani ,required: r " .� Subtotal: t44(,/. 0a.
Print name: David Mufnford D a �-ay13 Plan review(25%ofpermit fe�:
State surcharge(12%of permit fee); ,� 7.51
•
Authorized s'!... attire:.. t / `( ` TOTAL PERMIT FEE: -.�-�'��
•
Print name: David Mumford Date: '.2..z''/3 This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete..'
• Number of inspections allowed per permit. 3
I:\Building\PermitsELG PermitAppl3LR ear.doc Rev 10/21/2.513 440-4615T(11/OS/COM/WEB
08/22/2013 15:58 5036616389 LEAR ELECTRIC PAGE 03/03
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 Desion J Oh. I Fee 1 Total 1 •
Renewable electrical energy systems:
Check Type of Work Involved: s kva or lei _ 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:
❑ 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
OAR 918-309-0040)
• ❑ Heating,Ventilation and Air Conditioning
Solar
OAR
gemeration systems le excess e425 kva:
l
System*
y Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100kva–no additional charge 0,0 3
Each additional inspection over allowable in any of the above:
❑ Other: gaeh additional inspection is 6625/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.001 hr
specifically listed Di hr min)
COA11IIVVIERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system................ $75.00 Subtotal:
r
(SEE OAR 91 8-309-0000) 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
t24, HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
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❑ 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
Reundiaptaarmitatc PermltApp itpar.aaa Rev 05/212013