Permit CITY OF TIGARD ELECTRICAL PERMIT
_ COMMUNITY DEVELOPMENT Permit#: ELC2014-00129
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/19/2014
Parcel: 2S113AB01201
Jurisdiction: Tigard
Site address: 16575 SW 72ND AVE
Project: Routeware Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: (3)branch circuits for TI
Contractor: MOUNTAIN F ENTERPRISES INC Owner: PACIFIC REALTY ASSOCIATES LP
25973 S MOEHNKE LN ATTN- N PIVEN
BEAVERCREEK, OR 97004 15350 SE SEQUOIA PKWY#300
PORTLAND. OR 97224
PHONE: 503-313-0761 PHONE.
FAX: 503-632-5521
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 03/19/2014 $71.02
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/19/2014 58 52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79 54
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 rf work is not started within 180 days of issu- ce, or if work is susp d p for more the 180
days. ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notrfication Center Those rule set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of th• rules or direct questions to OUNC by calling 503.2 '-•87 or 1 80331'23 //
Issued By: rl _ -ermittee S gnature: V` i'l1
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 �1 Received Permit No: p
II 13125 SW Hall Blvd.,Ti ard,OR CY
Date/By: �Q y � )L/.. t A G
C g Plan Review Other Permit: yG.ove�K 7_3
Phone: 503.718.2439 Fax: 503.5 L0�4 Date/By:
I l C;A K U Inspection Line: 503.639.4175 +9 Date Ready/By: turfs la See Page 2 for
Internet: www.tigard-or.gov `►p� l ���V �totified/Method: 7 -Cr Supplemental Information
TYPE OF WORK F-1 0 PLAN REVIEW
❑New construction XrAddition/alteratio C 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: s��/\ 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","I-3",
100HP or more. occupancy.
Job no.: Job site address: iii,, 515" (;,A/ ZA.2±, / _ ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: I)V)e ❑Health-care facilities.
0 Supply voltage for more than
❑1 Oazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: off Gib T r ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: I_ Do1.4i 5,-- 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
Tax map/parcel no.: Ea.add'/500 sq.ft.or portion 33.92 I
Limited energy,residential 7500 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
• ,�tt''��,�� Tx _ 75.00 2
Ca r 4 t r i A6i C-Ira / rc hi A71.4- -.L 411944�j1d tiA .K/ ' residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER 1 ❑ 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:( ) Fax:( ) relocation
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 ❑ 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 5-4, (Y 2
branch circuit
Address: Each add'I branch circuit Z. 7.42 _ S 4,W V , 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:( ) 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 e-fh it..) i-&or_Lve p( 4.447.4_,j f j- N ,i_oetG 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 tove
City/State/ZIP: Additional inspection(I hr min) 66.25/hr
ziitti�zIL. E�4.lc Oil. l cC 4 Investigation(1 hr min) 66.25/hr
Phone:(Sj ) • 1 3 0 i Fax:( 4'.5) la 3z S 5 2. I Industrial plant(1 hr ruin) _ - 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lic.:/ ,qs-2.. Electrical Lie.: 3- 31c-C Suprv.Lie.: 34-2 I S specifically listed('/,hr min)
Suprv.Electrician signature,required: 1 G c/j(,r, ELECTRICAL PERMIT FEES
Subtotal: j( , D 2-
Print name: LIrT-J r 0 Date: s_(y_ / Plan review(25%of permit fee):
State surcharge(12%of permit fee): ' S-Z
Authorized Signature: TOTAL PERMIT FEE: - ,‘c4
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.
I\Buitding\Permits\El.(' PermitApp-ELR ERE doe Rev 0521/2013 440-46151(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 Qt,. 1 Fee I Total I •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva orless 100.70 2
•
5.01 to 15 kva 133.56 2
El 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
❑ 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
charged at an hourly(I hr min) 66.251 hr
Inspections for which no fee is 90.00/hr
specifically listed(A 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.
El Boiler Controls
n Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I f iuilding\Permits\ELC PeimitApp_ELR ERE.doc Rev 05/21/2013