Permit 14 CITY OF TIGARD ELECTRICAL PERMIT
4.'. COMMUNITY DEVELOPMENT Permit#: ELC2014 00208
T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/30/2014
Parcel: 2S1 11 ACO2700
Jurisdiction: Tigard
Site address: 14650 SW 97TH AVE
Project: Twality Middle School Subdivision: PINEBROOK TERRACE Lot: 67
Project Description: Replace existing condensing unit with like kind.
Contractor: A+ELECTRICAL SERVICES INC Owner: TIGARD TULATIN SCHOOL DISTRICT
PO BOX 446 6960 SW SANDBURG ST
SCAPPOOSE,OR 97056 TIGARD,OR 97223
PHONE: 503-284-7300 PHONE:
FAX: 503-813-2087
FEES
Quantity Description Date Amount
1 ea Services or Feeders-201 to 04/30/2014 $133.56
Specifics: 400 amps
1 ea 12%State Surcharge- 04/30/2014 $16.03
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $149.59
Required Items and Reports(Conditions)
This permit is ' -•-• su•le • the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done i• accordance with ap•k•v:' pThis permit will expire if work is not started within 160 days of issuance, or if work is suspended for more the 180
days. • TENTION: Oregon law -squires yo o follow the rules adopted by the Oregon Utility Notification Center./ Those rules are set forth in OAR
952-0.1-0010 thro •h OAR 952-0'1-0090.Alu obtain a copy of the rules or direct questions to OUNC by calling 03.232.198 •r 1.800.332 44.
Is ued By: Q__,16/4.,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' ' _ td►1 . t. A �
� re-t _ Date: ly fir/
7
LICENSE NO. 5 2jios---S
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 ApplicalEIVEP tOIR OFFl( f. I SI ONI.\
City of Tigard RDeacteemived fffjla�� Permit No.: EL_e 1 ---‘4,1e5
• 13125 SW Hall Blvd.,Tigard,OR Aft 3 0 2014 Plan Revie
a Phone: 503.718.2439 Fax: 503.598.1960 r Date/By: Other Permit:
I i \it l, Inspection Line: 503.639.4175�ITY OF l IGARD Date Ready/By: kris. HI See Page 2 for
Internet: www.tigard-or.gov l� C Notified/Method: Supplemental Information
7'XI'E`gili�DIVISK A PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction dAddition/alteration/replacement
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEG9RY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
El 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
7. 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.: e Job site address: �/ �7 Six or or more. occupancy.
1 �b G� W AVM_ ❑Six or more residential units. ❑Recreational vehicle parks.
� ❑Health-care facilities. ❑Supply voltage for more than
�
City/State/ZIP: L „...r, l 0 2 ''1 2-2-‘71 ['Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: I Project name: r /r ❑Service or feeder 600 amps or more.
�'� `J FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
5 l J f SyJ /'1��, �D�K 4j Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 1
Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
Ra'PPI.44, RAF !'F,P c_.41 L.LF!! e_ nt f>2: 5-Ei� residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
�� Services or feeders installation_alteration,and/or relocation
C3"PROPERTY OWNER I 0 TENANT 200 amps or less 100.70 2
�_ 201 amps to 400 amps 133.56 /3,35/i, 2
Name: /t..'.t_,f T) �/bp? E St't.frinn c._ 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: t�`t '(—Tse I LA-� �j 2..1.4.ES each branch circuit
c7 B.Fee for branch circuits without
Contact name: CV ,TAJ�1 service or feeder fee,first
/.✓t
branch circuit 56.18 2
Address: 'pc) K L[,,44 Each add'l branch circuit 7.42 2
City/State/ZIP: . " 7 ` /74_ 970,6t Miscellaneous(service or feeder not included)
7 C� /°wsG Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Phone:( 3 ) 2_04,7 30 0 I Fax: :( ) s13- 2,13FJ c�? Reconnect only 67.84 2
E-mail: .71–poi i9 APLIACSFJ E1'7/L-I C.4 c_..?DX. , C j Pump or irrigation circle 67.84 2
CONTRACTOR , Sign or outline lighting 67.84 2
Business name: C,� Signal circuit(s)or limited-energy See
•� 136,✓4— 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(1 hr min) 66.25/hr
Phone:( ) I Fax
(t ) Industrial plant(1 hr min) 78.18/hr
7 J( j� Inspections for which no fee is 90,00/hr
�I1�CB Lic.:!674gCi Electrical Lic.: • S pry .c.: specifically listed(V2 hr min)
l t} ! f ELECTRICAL PERMIT FEES
; Suprv.Electrician signature,required: 't/ �0 //fib •
Subtotal: f
33.5
Print name: l f 1.���Y Date: .e./7;127/71 Plan review(25%of permit fee):
State surcharge(12/o of permit fee): i6,e3
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained withi 180
Print name: 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(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 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to zs 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 over25 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) 66.25/hr •
Inspections for which no fee is 90.00/hr
specifically listed(%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.
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\Building\Permits\ELC_PermitApp_ELR_F.RE doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14650 SW 97TH AVE, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00208
Jeff Grove
Violation Summary:
Inspector Contractor