Permit CITY OF TIGARD ELECTRICAL PERMIT
111111 _ COMMUNITY DEVELOPMENT Permit#: ELC2014-00385
j G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/15/2014
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Parcel: 2S 102AA00490
Jurisdiction: Tigard
Site address: 12085 SW HALL BLVD 130
Project: Arellanos Sports Bar Subdivision: TIGARD HIGHWAY TRACTS Lot: 13
Project Description: (2)branch circuits for new lights and outlets.
Contractor: OREGON ELECTRICAL REMODELS Owner: HALL STREET CROSSING LLC
PO BOX 2513 BY MR&MRS ROGER W TOM
CLACKAMAS, OR 97015 8067 SW RIGERT COURT
BEAVERTON,OR 97007
PHONE: 971-645-6825 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 07/15/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/15/2014 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 don 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: Ore n law =•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 01-0010 through OAR 942-1% -0.90. •u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 2344.
Is ed By: \ ,� _L _Q� Permittee Signature: Y. ri'YViO.✓
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 _ l UR (lI l 1( 1 1 ,,l. ON l.'Received
it City of Tigard Et �� Date/B : 7®E Permit#: tr�C, d —eU jes-
•III 13125 SW Hall Blvd.,Tigard,OR, 0 EID Plan Review
s Phone: 503.718.2439 Fax: 503.598.1960 O 14 Date/B : Related Permit#: / �j/S3
Inspection Line: 503.639.4175 j ` 15 2014 Date/By: Juris: 0 See Page 2 for
I I(i A R D Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE Oar ®>i! I PLAN REVIEW
� t-
2/New construction El Add itiot l r tpl Ce Please check all that apply(submit 2 sets of plans w/items checked):
❑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.
❑ 1-and 2-family dwelling ❑Commercial/industrial El Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
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
❑Addition of new motor load of system.
Job#: Job site address:
I LO ss s(,l) 1.4A 11 g I u tI 100HP or more. ❑"A„ "E„ 1.2„"I_3„
❑Six or more residential units. occupancy.
City/State/ZIP:
T I G a r d Q f 9 7 Z Z3 ❑Health-care facilities. ❑Recreational vehicle parks.
Q ❑Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: 3 U Project name: 11 r e I I c np S S p p f f Rex ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: I FEE SCHEDULE
Description I Qty. I Each 1 Total I
1-1 UJ`/ 9 9 New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 l
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
I Z tirty uu4le4s canc.) I:C�k S;,iQ QPQ!r1(ri Limited energy,multi-family
�J d r residential(with above sq.ft.) 75.00 2
12/TENANT Renewable Energy El See Page 2
❑ PROPERTY OWNER Services or feeders installation,alteration,and/or relocation
Name: f r e 11 G n n s Ma r R c.1 L L L 200 amps or less 1 00.70 2
201 amps to 400 amps 133.56 2
Address: I?O 85 S W 1-1c,11 131 u cj S u:4-. 13 L 401 amps to 600 amps 200.34 2
City/State/ZIP: -i- ;C{G r j Or r q- 2 2 3 601 amps to 1,000 amps 301.04 2
Phone:(p / Fax: Over 1,000 amps or volts 552.26 2
7 1 ) (�Lie_ �' Z 5 (503) 4 9 S Temporary services or feeders installation,alteration,and/or
Email:
relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
APPLICANT 1 LEI CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: rr11 above service or feeder fee,
1-1 T U Ct I d s S PQ r.S Qa r each branch circuit 7.42 2
Contact name: C)m4 r B.Fee for branch circuits without
1l re
Address: service or feeder fee,first 1 56.18 '54.4 2
12OaG SW 1-IaII Blur/ Su;te 130 branch circuit
Each add'I branch circuit 1 7.42 74)-1 2
City/State/ZIP: -T J'c�c�rev Q r
d Miscellaneous(service or feeder not included)
Phone:(c17I ) 6 t.1 S- 68 25 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
IJ rCgAn F lecir,'cc1 Remoc/e is
rJ Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: p o RO X as 13 panel,alteration,or extension. g
City/State/ZIP: Each additional inspection over allowable in any of the above
C 1 G c h y;mG4 ( i- 936/S Additional inspection(1 hr min) 66.25/hr
Phone:(qi( ) 61-1 5- G8 as Fax:( ) Investigation(1 hr min) 66.25/hr
b Industrial plant(1 hr min) 78.18/hr
•
Email: 1(411 , 1� 11 t,t Inspections for which no fee is 90.00/hr
CCB Lic.: 1 518(3 ii` Electrical Lic.:c 6 '11 Suprv.Lic.: 55 33 d5 specifically listed CA hr min) Y
ELECTRICAL PERMIT FEES : . ;, :::•,:
Suprv.Electrician signature,required: @ ✓ Subtotal: ,3. ep0
Print name: j c)k n G e o r q eS ate: —4 if - of ❑Plan Review Required(25%of permit fee):
C State surcharge(12%of permit fee): 7 43
Authorized signature: 'la e TOTAL PERMIT FEE: 7 .a 3
This permit application expires if a permit is not obtained within 180
Print name: O M rsS Cl re 1I n»c+ Date: 3- 14 - 19 days after it has been accepted as complete.
• Number of inspections allowed per permit.
I\Building\Permits\ELC_PermitApp_ELR_ERE docx Rev 04/21/2014 440-4615T(I1/05/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
Description I Qty. I Each I Total I •
Fee for all residential systems combined: $75.00 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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%2 hr min)
ELECTRICAL PERMIT FEES
COMMERCIAL WORK ONLY:
Fee for each commercial system: $75.00 Subtotal l(peter t. Page 1):
�' • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ 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
1:1 Building\Pmnits\ELC_PennitApp_ELR_ERE.docx Rev 04/21/2014
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
12085 SW HALL BLVD 130, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00385
Chip Barnett
Violation Summary:
Inspector Contractor