Permit CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: ELC2014-00230
T iG A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2014
Parcel: 251018801300
Jurisdiction: Tigard
Site address: 11950 SW GARDEN PL 100
Project: Vesta Subdivision: CROW PARK 217 Lot: 1
Project Description: (3)branch circuits and(1)tv cable for TI.
Contractor: FIRST ELECTRIC CO Owner: WALTON CWOR PARK BC 8 LLC
PO BOX 1766 BY EQUITY OFFICE MANAGEMENT LLC
OREGON CITY, OR 97045 PO BOX A-3879
CHICAGO, IL 60690
PHONE: 503-632-8373 PHONE:
FAX: 503-632-7989
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 05/08/2014 $71.02
Specifics:, Service or Feeder
1 ea Signal circuit or Limited 05/08/2014 $75.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12%State Surcharge- 05/08/2014 $17.52
Electrical
Type of Const:
Occupancy Grp:
Total $163.54
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 if work is not started within 180 days of uance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No' ctio Center. Those • s are set forth in OAR
952-001-0010 through OA 8 2- O. You may obtain a copy of the rules or direct qsti OUNC b l' g 53. or 1.800. •2.23... '
Issued By:
OWNER I NSTALLATION 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 RECEIVE • FOR OFFICE USE ONLY
City of Tigard Received 4ft' ��h' DateBy 411091 ,it No. .��/y_�w 02 34
" 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 8 2 14 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Perm /0a7/y..-D00 73
TIGARD Inspection Line: 503.639.4175 CITY OF f1GAR Date ReadyBy: Juris: la See Page 2 for
Internet: www.tigard-or.gov otified/Method: Supplemental Information
TYPE OF WOi;I ~F" N PLAN REVIEW
El
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.
CA GORY 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 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","l-2","l-3",
Job no.:V t 4 Job site address: I Se r (�[ 1 Six or or more. occupancy.
S W de 1 t�l'd ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 1 4 ❑Health-care facilities. ❑Supply voltage for more than
T ;µ( r ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: U is Tf ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
Description I Qry. 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
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited ener .
gy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
�A�QQ (� Limited energy,multi-family 75.00 2
`^ ` 1 S -' M`4 t\Cr�. ") residential(with above sq.ft.)
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone:( ) Fax:( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Branch circuits-new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 7 42 2
each branch circuit
Business name: B.Fee for branch circuits without `Q
service or feeder fee,first
Contact name: branch circuit 56.18 S(O 2
77.42 ( l
Each addl branch circuit 2
Address: Miscellaneous(service or feeder not included)
Each manufactured or modular
City/State/ZIP: dwelling,service and/or feeder 67.84 2
Phone:( ) Fax: :( ) Reconnect only _ 67.84 2
Pump or irrigation circle 67.84 2
E-mail:
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name- F..7 `` �� panel,alteration,or extension. / Page 2 '2 51 2
• I S lv 1 Each additional inspection over allowable in any of the above
Address: p(� BUk t I/0(0 J Additional inspection(1 hr min) 66.25/hr
n Investigation(1 hr min) 66.25/hr
City/State/ZIP: of t° of\ V U 9-1045 Industrial plant(1 hr min) 78.18/hr
Phone:( 3 ) t3�, 3�3 Fax:( �Sc ) 4,3 a- -- q Inspections for which no fee is
specifically listed('h hr min) 90.00/hr
CCB Lic.: i 41 9 l0 Electrical Lic.:(14 —Stcl G Suprv.Lic.: id..) S ELECTRICAL PERMIT FEES pl.-
Suprv.Electrician signature,required Subtotal: `1 I
/ Plan review(25%of permit fee):
Print name: e c(` V v CO3( Date: S( i (0./... State surcharge(12%of permit fee): O u
TOTAL PERMIT FEE: 79 45.5y
Authorized signature:
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 pee permit. 41�_
I:\Building\Permits\ELC-PermitApp.doc 07/01/10 440-4615T(1l/05/COM/WEB / 'ct,k Fr`c_jm % _"ot
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating,Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stcrco Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
ElNurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
Si
Other / [/
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:Building Termits\ELC-PermitApp.doc 07/01/10
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11950 SW GARDEN PL 100, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
June 2, 2014 at 8:02:17 AM
ELC2014-00230
Jeff Grove
Violation Summary:
Inspector Contractor