Permit CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC2014-00116
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/12/2014
Parcel: 2S101 CA00200
Jurisdiction: Tigard
Site address: 7910 SW HUNZIKER RD
Project: Terrafirma Subdivision: 1994-025 PARTITION PLAT Lot: 2
Project Description: (5)branch circuits.
Contractor: DICKINSONS ELECTRIC Owner: WALL STREET INDUSTRIAL LLC
8449 SW BARBUR BLVD A RICHARD VIAL EXECUTIVE CENTER LLC
PORTLAND, OR 97217 7000 SW VARNS ST
PORTLAND. OR 97223
PHONE 503-246-3550 PHONE.
FAX 503-213-6049
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 03/12/2014 585 86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/12/2014 510 30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total S96 16
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 thg_ulax Qr direct questions to OUNC by calling 503.232.1987 1.8 .33 344
Issued By: /i/ - 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:
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 Application `� FOR OFFICE USE ONLY
City of Tigard Received II '° .. F e 3%1,2",.1 ! Permit No.: EGG [ -t (1,t//�
i 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review `
e Phone: 503.718.2439 Fax: 503.59x I gx,r i 2�, Date/By:
Other Permit 41 Inspection Line: 503.639.4175 1 Date ReadyBy: Jurir 0 See Page 2 for
I l('A K I t Internet: www.tigard-or.gov Pia NoliliedlMethod: (Q Supplemental Information
A i►
TYPE OF WOR • A PLAN REVIEW
tl
1:1 New construction Addition/alteration/replacemt:nt
Please check all that apply(submit 1 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
❑ I-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","I-3",
Job no.: Job site address: 9/ .p .7,14-4-y-- I OOHP or more occupancy.
❑
... ❑Six or more residential units. Recreational vehicle parks.
City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: '��►'>,-z 'I rrr—tt ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I "
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: l,ot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion .. 33.92 1
Tax map/parcel Ito.: _ Limited energy,residential , 2
DESCRIPTION OF WORK (with above sq.ft.) 75.00
;- Q Limited energy,multi-family 75 00 2
.J lL 1i �,s W �dy�.-e_ residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
20I 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: ( ) 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 J 2
Owner signature: Date: Branch circuits—new,alteration,or extension r panel
❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: /''t`C� ic i r y .549-1/ each branch circuit
B.Fee for branch circuits without
Contact name: kJ- service or feeder fee,first
/ 56.18 2
■ branch circuit ,, [
Address: g4.14 ai igce,v t// v 6 &d Each add'I branch circuit Lt 7.42 .(4." 2
�c) Miscellaneous(service or feeder n included)
City/State/ZIP: P� � i0� 67.84 2
Each manufactured or modular
Phone:( N 6 3 6--5-67 Q Fax: :(604,4 13 hex I, dwelling,service and/or feeder
+,, Reconnect only 67.84 2
E-mail:�r!4�tf1/(,�ea(i� ` S jhrjs�r 1� i '�j7 Pump or irrigation circle 67.84 2
JJ CONTRACTOR Sign or outline lighting 67.84 2
/� `-G� `A , Signal circuit(s)or limited-energy See
Business name: ( rL U�1
/ i panel,alteration,or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66 25/hr
City/State/ZIP: Investigation(I hr min) 66.25/hr
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78 18/hr
•
Inspections for which no fee is 9000/hr
CCB Lie.:6 � Electrical Lk' f(J(,[.Suprv.Lic.%�� specifically listed(V2 hr min) _
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,require
Subtotal: 75—, i„-c.
/�� r Plan review(25%of permit fee):
Print name:ILK [� (� f (,� Dates/ 'Z
�f v 'C State surcharge(12%of permit fee): (Q. 3L'
Authorized signaiStf : — TOTAL PERMIT FEE: 4f(,. ic,
This permit application expires if a permit is not obtained within ISO
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
f Mudd ing\Perm its\ELC_PermitApp_ELR_ERE.doc Rev 05/2112013 440-461ST(I1/05/COMIWEB
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 Bescripriu• 1 Qty. I Pee 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
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
>l00 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 over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection Is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is
specifically listed(%I hr min) 00/hr
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.
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1.\Building\PermitslELC_PermitApp_ELR_ERE.doc Rev 05/21/2013