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Permit CITY OF TIGARD ELECTRICAL PERMIT V III s COMMUNITY DEVELOPMENT Permit#: ELC2014-00398 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2014 Parcel: 1 S135DC03000 Jurisdiction: Tigard Site address: 11575 SW GREENBURG RD 22 Project: Four Oaks Apartments Subdivision: FIRDALE-UNRECORDED Lot: 7 Project Description: Electrictal reconnect for unit#22 Contractor: Owner: KEN CONDO'S LLC 16835 SW IVY GLEN ST BEAVERTON, OR 97007 PHONE. PHONE: 971-226-0205 FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 07/21/2014 $67.84 Specifics:, 1 ea 12%State Surcharge- 07/21/2014 $8.14 Electrical Type of Use: MF Class of Work: OTR Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) This permit is is t 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 rdance with roved 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. AT ENTION: Oregon la re• =s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001 010 through OAR 952-00 •090.lYo• ay obtain a copy of the rules or direct questions to OUNC by calling 503.232 or 1 2.2344. Issue y: c 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' 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 CEIVf FOR OFFICE USE ONLY City of Tigard Received•111 13125 SW Hall Blvd.,Tigard,OR 97223 JUL 7 1 ?(?,; DateB : T � „/ —Gb39? I Plan Review Related Permit#: Phone: 503.718.2439 Fax: 503.598.1960 Date/B Inspection Line: 503.639.4175 CITYOF 1'IGApr>, Ready Date/By: Jurir ® See Page 2 for I I r' \I`l� Internet: www.tigard-or.gov ��f7LJ Notified/Method: Supplemental Information TYPE OF ��'"" " PLAN REVIEW El New construction ❑Addition/alteration/replacement Please check all that apply(submit 1 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 ❑CommerciaUindustrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. El 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: 55.-- ( kk >l Z- `t S� Z J 100HP or more. ❑••A„ ••E•, ••1_2„ '•l_3" ❑Six or more residential units. occupancy. Ci t /State/ZIP. j/ p p L 7 z Z ❑Health-care facilities. ❑Recreational l vehicle parks. Suite/bldg./apt.#: q Project name: /�'� (J S 413 ❑Hazardous locations. ❑Supply voltage for more than l/LTF ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: - Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 ��' -w �/ Limited energy,multi-family 75.00 2 I residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ❑ PRO ERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 1-�.e/v C r- d05 �L / 200 amps or less 100.70 2 Address: It 6 3 S sc./✓ IAA( C�•1 e'( S t' 201 amps to 400 amps 133.56 2 Y 401 amps to 600 amps 200.34 2 City/State/ZIP` ✓ D c '"7)e0 601 amps to 1,000 amps 301.04 2 Phone:Ft 7 i ) ZZ(o 'Z —0o 5 Fax:( ) / Over 1,000 amps or volts 552.26 2 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 El APPLICANT 1 ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel - A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit City/State/ZIP: Each add')branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: £j744 2 Reconnect only 67.84 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy / panel,alteration,or extension. ❑ See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 66.25/hr Email: Industrial plant(1 hr min) 78.18/hr • Inspections for which no fee is specifically listed A hr min 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: � y ( � - ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: ("7. fr 4 Print name: Date: ❑Plan Review Required(25%of permit fee): ----- State surcharge(12%of permit fee): 8",/4" Authorized signature. �� • TOTAL PERMIT FEE: —76'.gQr This permit application expires if a permit is not obtained within 180 Print name(A,^. --� g n S�h�e,�L Date: 7 _L I_ I i * days after it has been accepted as complete. 1 y Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.dace Rev 04/21/2014 440-46I5T(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 Description I Qly. I Each I Total I • Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva orless 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 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(Enter Page 1): y • Number of inspections alllowed owed per pennit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls n Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n 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:\Building\Permi ts\ELC_PermitApp_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 11575 SW GREENBURG RD 22, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2014-00398 Herb Stabenow Secure open light box Violation Summary: Inspector Contractor