Permit q CITY OF TIGARD ELECTRICAL PERMIT
1111 IL COMMUNITY DEVELOPMENT Permit#: ELC2014-00049
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/10/2014
Parcel: 1 S 126DB02800
Jurisdiction: Tigard
Site address: 9370 SW GREENBURG RD A
Project: Dr.Gebeau Dental Subdivision: 1991-018 PARTITION PLAT Lot: 1
Project Description: (1)feeder and(36)branch circuits for dental office
Contractor: TIMBERLINE ELECTRICAL CONTRACTORS Owner: FRANKLIN COMMONS ASSOCIATES, LLC
9414 SW BARBUR BLVD,#100 BY NORRIS&STEVENS
PORTLAND, OR 97219 621 SW MORRISON STE 800
PORTLAND, OR 97205
PHONE: 503-459-4089 PHONE:
FAX: 503-254-4227
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 02/10/2014 $100.70
Specifics: amps or less
36 crt Branch Circuits w/Purchase 02/10/2014 $267.12
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Plan Review Electricial 02/10/2014 $91.96
Type of Const: 1 ea 12%State Surcharge- 02/10/2014 $44.14
Electrical
Occupancy Grp:
Total $503.92
Required Items and Reports(Conditions)
This permit i ' ' ct to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don accordance with proved 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 lain requii: you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 01-0010 thro gh OAR 952-001 I:•0. • 'ly obtain a copy of the rules or direct questions to OUNC by calling 503.232.1'. /. 344.
Is ued By: �, / 7I64(--1 f Permittee Signature: Lam'/
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: /6
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 Anplica CEIVEI�
City of Tigard 11,, Received
IN 'a 2322 25 S W Had Blvd.,Tigard,OR 97223 Dete/By. �/ Permit No.: `/�_ ,(�,�D'if
g Plan Review _ `�"
g Phone: 503.718.2439 Fax: 503.59�Q60 5 201() Date/By� /bl/Lf c/t' Other Permit: 04dly. S
I Inspection Line: 503.639.4175 Date Re / June: H See Page 2 for
Internet: www.tigard-or.gov , ' 1
Notified/Method: / / Supplemental Information
TYP s • s• . I t ■ �,)7 lV ! ./<__ PLAN REVIEW
❑New construction ®Addi ,?:A n u t• 7 •, : '-r.'!a 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 dgrived system.
❑Addition of new motor load of ❑"A","E","l-2 `I-3",
Job no.: 1 Job site address:9370 SW Greenburg Rd. 100HP or more occupancy.
❑Six or more residential units. ❑Recreational vehiclt parks.
City/State/ZIP: Tigard Ore 97223 ❑Health-care facilities. ❑Supply voltage for*tore than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name:Dr Gebeau ❑Service or feeder 600 amps or more
FEE SCHEDULE street/directions to lob site: IIEDU LE Q Fee
1 Total 1 ,
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'/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
Dental TI 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 f' 100.70 /oC.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/StateJLlP: 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,per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A Fee for branch circuits with
above service or feeder fee, 34 7.42 �`4�/_7/s" 2
Business name: each branch circuit 7
B.Fee for branch circuits without
Contact name: service or feeder fee,fast ry 1 30.115 SA Ig 2
branch circuit }ny Q_Q_
Address: Each add'!branch circuit L 35 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Each manufactured or modular
Phones( ) I Fax::( ) dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Timberline Electrical Contractors Signal circuits)or limited-energy ' See
panel,alteration,or extension. Page 2 2
Address:9414 SW Barbur Blvd Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZAP.Portland,Ore 97219 Investigation(1 hr min) 66.25/hr
Phone:(503)4594089 I Fax:(503)254-4227 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 160037 1 Electrical Lie.: 26- 21 C 1 Suprv.Lie.: y 5755 specifically listed C i hr min) 90.00/hr
i, ELECTRICAL PERMIT FEES
Suprv.Electrician signature,regal • /d�/// Subtotal: 3+57 3 $=2-
Print name: 1 4d Date: 2.5.2014 Plan review(25%of permit fee): -7Sc99 9�'y�o
)[ State surcharge(12%of permit fee): -37-9+ q(q. ef/
Authorized signature:✓ TOTAL PERMIT FEE: -43.1-76-503,9-Z
This permit application expires if a permit is not obtained within 180
Print name: Date:
days after it has been accepted as complete.
Number of inspections allowed per permit. Ose
l:\Building\Peat ts\ELC_Pennit, pELR_ERE.doc Rev 05/21/2013 440-46151(11/05/COM/WEB
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
9370 SW GREENBURG RD A, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
2014-04-29 00:00:00
ELC2014-00049
PASS - No C of O
Violation Summary:
Inspector Contractor