Permit CITY OF TIGARD ELECTRICAL PERMIT
111
s. COMMUNITY DEVELOPMENT Permit#: ELC2014-00250
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/14/2014
T I�"�R O g Parcel: 2S101AB02400
Jurisdiction: Tigard
Site address: 7060 SW BEVELAND RD
Project: Tech Heads Subdivision: BEVELAND Lot: 8, PLUS
Project Description: Electrical for TI: (7)branch circuits and(1)low voltage data telecommunications system.
Contractor: SHILOH ELECTRIC Owner: LANFARM LLC
PO BOX 6097 16869 SW 65TH AVE STE 166
SALEM, OR 97304 LAKE OSWEGO, OR 97035
PHONE: 503-588-9205 PHONE:
FAX: 503-588-9205
FEES
Quantity Description Date Amount
1 ea Limited Energy 05/14/2014 $75.00
Specifics:
7 crt Branch Circuits wo/Purchase 05/14/2014 $100.70
Service or Feeder
Type of Use: COM 1 ea 12%State Surcharge- 05/14/2014 $21.08
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $196.78
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty -••- and all other ap•'cable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days o issuance or if work is -fpended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility No•ication Ce' er. Th•.: rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain rules or direct questions to OUNC by callin• 503.232.1'87 or ;10.332.2344.
Issued By: 1!L
/r
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 . 1 FOR OFFICE USE ONLY
City of Tigard S Received 5 Date/B : / I pi en- Permit No.:
E 94 i`1 - 5 G
13125 SW Hall Blvd.,Tigard,O; ti t Plan Review 61,110,901/-1
�
' Phone: 503.718.2439 Fax: F'\,° 960 01 Dart her Permit:
Y
I I Inspection Line: 503.639.4175 �4 Date Ready/By: s. See Page 2 for
I Internet: www.tigard-or.gov NO �`(- `O Notified/Method: Supplemental Information
TYPE OF WORK v�``{��`t1vi ` PLAN REVIEW
❑New construction ition/alteratit�tl p`� uCft Please check all that apply(submit 2 sets of plans w/items checked below):
1F`)�,'
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
Q��` where the available fault current ❑Marinas and boatyards
CATEGORY OF CONSTICI)CTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwellinommercial/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","I-2","1-3",
Job no.: Job site address: O to 0 �,'`i e J I00HP or more. occupancy.
❑
W I ❑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: ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. 1 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'l 500 sq.ft.or portion 33.92 I
Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
A imited energy,multi-family
1111//�jl' IA C cog c Cu u v 4- J residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ 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 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 1 68.54 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,
7A2 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first
branch circuit 56.18 .1 2
Address: Each add'l branch circuit 7.42 L.rL(, 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:SA t /p t tiP�4-`+r , Signal circuit(s)or limited-energy See T
panel,alteration,or extension. _ 1 _ Page 2 .` --2
Address: (' c9 3o K 6, 0 0---7 Each additional inspection over allowable in any of the above
City/State/ZIP' 5 /epLA (0 2 q 7 3 04( Additional g inspection(1 lii() hr min) 66.25/hr
1 Investigation(1 hr min) 66.25/hr
Phone: Q 3) 5gg el d 0 5 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:94 z Electrical L' .. 7-549 Suprv.Licgjq/DS specifically listed(%2 hr min) 90.00/hr
rj urt `I/14, ELECTRICAL PERMIT FEES
Suprv.Electrician 1 r ,required: Subtotal: i 1 S-''7)
Print name: �Q Ia , Arek'g Date /(� I r/ Plan review(25%of permit fee):
_! �I State surcharge(12%of permit fee): 421,r�Y
Authorized signature: TOTAL PERMIT FEE: KG 71f
This permit application expires if a permit is not obtained within t80
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 0521/2013 440-4615T(11/05/COM/WFB
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
7060 SW BEVELAND RD, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00250
Jeff Grove
Violation Summary:
Inspector Contractor