Permit CITY OF TIGARD ELECTRICAL PERMIT
1.1 a ' -. COMMUNITY DEVELOPMENT Permit#: ELC2013-00692
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/20/2013
Parcel: 25102AA03301
Jurisdiction: Tigard
Site address: 12345 SW HALL BLVD 32
Project: Tigard Terrace Apartments Subdivision: TIGARD HIGHWAY TRACTS Lot: 24
Project Description: Electrical reconnect only for unit 32
Contractor: Owner: KC TIGARD TERRACE LLC
11030 NW 2ND CT
PORTLAND,OR 97231
PHONE:
PHONE: 503-577-5071
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 11/20/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 11/20/2013 $8.14
Electrical
Type of Use: MF
Class of Work: ALT
Type of Const: -
Occupancy Grp:
Total $75.98
Required Items and Reports(Conditions)
This permit is ': •-• - •'ect 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 wit -.proved •tans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. • TENTION: Oregon la, -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00 -0010 through OAR 952-6% 0090. You obtain a copy of the rules or direct questions to OUNC by calling 503.232.197 or 1.80.332.2344.
Iss -d By: II"��� Permittee Signature: I I 1111-)
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.
Electrical Permit A licatio (VF .FOR OFFICE USEONLY •
City of Tigard Date/B : Permit Permit No.: Ehe, ,/3.�6j�'�
1,11
a 13125 SW Hall Blvd.,Tigard,OR 97223 NOV 2 0 2013 013 Plan Review
C • Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: Julia ® See Page 2 for CITY OF TIG®RDInternet: www.tigard-or.gov Notified/Method: Supplemental Information
rmation
BUILDING n9VISlO
. TYPE OF WORK . PLAN REVIEW
El 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.
❑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","l-2","I-3",
r. -� S ,. Aid/ 100HP or more. occupancy.
Job no.: Joti.siteMaddress: / // 5/�(
lvS�S L/ ❑Six or more residential units. ❑Recreational vehicle parks.
tad �y1 ❑Health-care facilities. ❑Supply voltage for more than
'City/State%ZIP 12 600 volts nominal.
9 ❑Hazardous locations.
Suite/bldg./apt.no.: �Peoject}nature: ��y � �11��p Aft--5 ❑Service or feeder 600 amps or more. -
t ryl 7 C�r�l FEE,SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee._ I Total L_
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.R.or less 168.54 4
Ea.add'I 500 sq.R.or portion 33.92 1
Tax map/parcel no.:
Limited energy,residential 75.00 2
• 1,, / DESCRIPTION OF WORK (with above sq.ft.)
'� C. I�f tel CAL_ 12'2Ct Net,- Limited residential(with ithabovesq.
residential(with above sq.ft.)
75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
(❑:iPiiitiR Y OWNER--) I ❑ TENANT - ' •• 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
CName.'i? ' •&A •
C �(IF} 4 S 401 amps to 600 amps 200.34 2
—Address:,. D t�x 1 CI( 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP',PQQ jifl,/0I O?. Temporary services or feeders installation,alteration,and/or
Phone: �'`/ Fax: relocation
'1-'° )S��—5°9/ I ( ) 3—gg 70 200 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' ❑ jCONTACT 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'l branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
• e mg,serji e a or feeder
Phone:( ) Fax: :( ) Reconnect only 67.84 4i 7 k� 2
E-mail: _ Pump or irrigation ' le 67.84 / 2
' 'CONTRACTOR = , ' Sign or outline lighting 67.84 2
•Business name: Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:( ) I Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: I Electrical Lie.: I Suprv. Lie.: specifically listed(V2 hr min)
ELECTRICAL'PERMIT'FEES •
Suprv.Electrician signature,required: Subtotal: �7 kr
Print name: ll ( : 4ln p Lk/ Date: /)o--i3 Plan review(25%of permit fee):
pState surcharge(12%of permit fee): 8'. f Authorized signature:��/d/ TOTAL PERMIT FEE: l vg ff�l!(((,,,��[CCJJJ����g This permit application expires if a permit is not obtained within 180
Print name: 61 JI C� f t X) Date: days after it has been accepted as complete.
" Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(I1/05/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 Fce • 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
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
❑ Heating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva—no additional charge '0.0 3
ElOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr I
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
ElAudio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
•
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\BuildingWermits\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
12345 SW HALL BLVD 32, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2013-11-21 00:00:00
ELC2013-00692
PASS - No C of O
Violation Summary:
Inspector Contractor