Permit CITY OF TIGARD ELECTRICAL PERMIT
NI a. ,, COMMUNITY DEVELOPMENT Permit#: ELC2013-00547
TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503 718 2439 Date Issued: 09/16/2013
Parcel: 1S136DD05300
Jurisdiction: Tigard
Site address: 11850 SW 67TH AVE, STE#200
Project: Kronos Subdivision: WEST PORTLAND HEIGHTS Lot: 9
Project Description: Electrical for TI Low voltage for data and fire alarm.
Contractor: ERTELL ELECTRIC LLC Owner: PNWP LLC#2
PO BOX 279 PNWP LLC
FOREST GROVE, OR 97116 6600 SW 105TH AVE#175
BEAVERTON, OR 97008
PHONE: 503-841-4511 PHONE:
FAX: 503-359-5652
FEES
Quantity Description Date Amount
2 ea Limited Energy 09/16/2013 $150.00
Specifics:
20 crt Branch Circuits wo/Purchase 09/16/2013 $197.16
Service or Feeder
Type of Use: COM 1 ea 12%State Surcharge- 09/16/2013 $41.66
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $388 82
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 oth -•plicable la All work wit
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if is suspended for ore the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are - orth in OAR
952-001-0010 through•:' 952-001-0090 You may obtain a copy f-tp s or direct questions to OUNC by•:••• 32 s •
Issued By: ;i Permittee Signature: —/.. 11
OWNER INSTALLATION ONLY
Or
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 503.639.4176 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 Received �(o Permit\\I:\i' A'C y: ei �/3 X7"7- �Gcavi3 d osy 7
It 13125 SW Hall Blvd.,Tigard,OR • '4-3 Plan Review /
4 li ` Phone: 503.718.2439 Fax: 503.4A ': ti5\3 Date/By: Other Permit: (3641,,13-od+er'i
Inspection Line: 503.639.4175 , " N. ® Date Ready/By: Juris: El See Page 2 for
f I C.A K D C§(3 ��� Notified/Method: .L(y Supplemental Information
Internet: www.tigard-or.gov \ ``
TYPE OF WORKi� ��(aV��� PLAN REVIEW
❑New construction .Addition/alterationlila ty 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.
❑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.: I Job site address: /(S b t S� /A 7 r` .100HP or more. occupancy.
4!/ c _
0 Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP�� Ida_ ZZS �7v t z� ❑Health-care facilities. ❑Supply voltage for more than
CJI/` ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: AO Project name: f2 toab S ❑Service or feeder 600 amps or more.
'FEE SCHEDULE
Cross street/directions to job site: Description
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
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
GI, vtzs F" p ,, 4sz . / t�' t ��.11,t residential(with above sq.ft.)K CJ t�"K� !�✓ °�i. Renewable Energy I 0 See Page 2
"1"-41... �f 6i< Services or feeders installation,alteration,and/or relocation
❑ PROPE TY OWNER I ❑ TENANT 200 amps or less 100.70 I 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 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 r 56.18 641a s 2
branch circuit
Address: Each add'I branch circuit i�'j 7.42 Lip.1 2
Miscellaneous(service or feeder not included) .
City/State/ZIP:
—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: �,j�;r-,JTe-e--D-2-1C Signal circuit(s)or limited-energy See
panel,alteration,or extension. Z. Page 2 �r� 2
Address: 2 p, g(7)„, ZtQ Each additional inspection over allowable in any of the above
City/State/ZIP: // / /� Q ( Additional inspection(1 hr min) 66.25/hr
kit 1�s6�a C/V` l e„,../
Investigation(1 hr min) 66.25/hr
Phone:663 )5-14, _ i Fax:(5;63 - - _ S Industrial plant(1 hr min) 78.l8/hr
spections for which no fee is 90.00/hr
CCB Lic.: (go > lectrical Lie.:G g9 > is prv.Lic.• Z S' specifically listed(V2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: / Subtotal: 3L47,14,
Print name: , Date: / Plan review(25%of permit fee):
"���3 .i/WiA , ' State surcharge(12%of permit fee): lit ,66.
..rte
Authorized signa :re: TOTAL PERMIT FEE: 3$g.6-L.
I_,
This permit application expires if a permit is not obtained within 180
Print name: � Q t Date:/6 . - /7 days after it has been accepted as complete.
" Number of inspections allowed per permit.
1:\Building\Permits\ELC_'ermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/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 1kva or less. 100.70 2
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
ElBurglar 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 0)040)
System* •V "solar generation'systems in excess Of-25 kva:
Each additional:-kva,over25 7.42 3
El Vacuum Systems* >100.kva—'no additional charge 0.0 3
Each additional inspection over allowablein 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(Yz hr min)
1 COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES _
Fee for each commercial system $75.00 - V Subtotal:
(SEE OAR 91-8-309-0000) Plan.review,.if required(25%of pennit fee):
State surcharge:(12%of pemit 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.
El Boiler Controls
-❑ Clock Systems
•
M Data Telecommunication Installation
IN Fire Alarm Installation
❑ HVAC .
,❑ Instrumentation
El Intercom and Paging.Systems
El Landscape Irrigation Control*
El Medical V
El Nurse Calls .
•
. ❑ Outdoor Landscape Lighting*
El Protective Signaling V •
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
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2013-10-29 00:00:00
ELC2013-00547
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Electrical
145 A/C or heating unit circui
2013-10-29 00:00:00
ELC2013-00547
CNCL
Wrong inspection
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11850 SW 67TH AVE STE 200, TIGARD, OR,
97223
Commercial - Electrical
135 Low voltage
2013-10-29 00:00:00
ELC2013-00547
PASS
Violation Summary:
Inspector Contractor