Permit CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: ELC2013-00542
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2013
Parcel: 1S 135DD01800
Jurisdiction: Tigard
Site address: 11565 SW HALL BLVD 180
Project: Bella Institute Subdivision: METZGER ACRE TRACTS Lot: 32
Project Description: (40)branch circuits for TI to create new beauty school
Contractor: ALL ELECTRIC Owner: PANG, KEIKO TR
4676 COMMERCIAL ST,#183 46-442 HOLOLIO ST
SALEM,OR 97302 KANEOHE, HI 96744
PHONE: 503-851-1704 PHONE:
FAX: 800-851-2549
FEES
Quantity Description Date Amount
40 crt Branch Circuits wo/Purchase 09/12/2013 $345.56
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 09/12/2013 $41.47
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $387.03
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 -001-0.�1. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: AE / mrz - 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:
CONTRACTOTA•ATION ONLY
SIGNATURE OF SUPR.ELEC' / Date: r 2 743
LICENSE NO.
C 1 503.639.4 b 1:00 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 RECEIVED l.olz OI IICE USE ONLY
City of Tigard Received �.
® / Permit No 476,20/.5—d��
II
a 13125 SW Hall Blvd.,Tigard,OR 97223 1 2 2013 Plan Review
a Phone: 503.718.2439 Fax: 503.598.1960"'- Date/By: Other Pend 0204g _DQ/A/f
I'1G A K D Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Jurrisyt la See Page 2 for
Internet: www.tigard-or.gov Notified/Method: /l6- Supplemental Information
ill TYPE OF DING DNISION
PLAN REVIEW
•
❑New construction Addition/alteration/replacement Please check all that apply(submit 2 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
❑ 1-and 2-family dwelling .% Commercial/industrial ❑Accessory building amps for all other installations. buildings.
El 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.: 1 Job site address: SG S 5d,/ hmx4 Jl� Six or or more residential occupancy.
(J ��❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 7/ 6IQ D ❑Health-care facilities. ❑Supply voltage for more than
/�L ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: //f) Project name: gat /4457/4 9�,4�❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: A6,// 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.)
-— 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:( ) I 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 i i 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension, er 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 / 56.18 2
branch circuit
Address: _ Each add'I branch circuit
5,� 7.42 2
City/State/ZIP: Miscellaneous(service or feeder no included)
Each manufactured or modular 67.84 2
Phone:( ) I 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: ,/ EL E 6-/ R/ L Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: Y67-4, CL i w{D C / / it-7i./9 y Each additional inspection over allowable in any of the above
i! ✓ Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: 5"AC£ () '7,SV-� Investigation(1 hr min) 66.25/hr
Phone:(�3 J g 51--/-1–o Vgl Fax:(---).--- — Industrial plant(1 hr min) 78.18/hr
S i Inspections for which no fee is 90.00/hr
CCB Lic./✓3 9 5 2j I Electrical Lic.2y_y S tprv.Lic.: yi 2 t' specifically listed(%z hr min)
Suprv.Electrician signature,required: / ELECTRICAL'PERMIT FEES
,�/� ` S Subtotal: 3!�S�
Plan review(25%of permit fee):
Print name: �oN TE Date: -� �/ State surcharge(12%of permit fee): L//, y7
Authorized signature: vi,,......21-
! K� / TOTAL PERMIT FEE: �rT ,03
r� This permit application expires if a permit is not obtained within 180
Print name: evo ' g ^L fg Date: —1°.�/ ) days after it has been accepted as complete.
J '' G j�/C �/ • Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
may,
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
1 ,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
❑ 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
El Heating,Ventilation and Air Conditioning, OAR 918-309 0040) '
System*
)Solar generation systems in excess of 25 kva:
Each additional kva'over25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
1=1 Other: additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(%: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
• i ,
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other •
Total number of commercial systems:
*No licenses are required. Licenses are required I .
for all other installations •
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
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
11565 SW HALL BLVD 180, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2014-02-21 00:00:00
ELC2013-00542
PASS - No C of O
Mirrors not done. Permit finaled. New permit required when more work done.
Violation Summary:
Inspector Contractor