Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00417
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07129/2014
7IC;ARD Parcel: 2S102CC00500
Jurisdiction: Tigard
Site address: 13500 SW PACIFIC HWY 30
Project: 'chi Teriyaki Subdivision: FREWING'S ORCHARD TRACTS Lot: 15
Project Description: (1)200 amp panel and(6)branch circuits for TI
Contractor: HUNGNAM OH ELECTRIC Owner: ROIC OREGON LLC
10580 SW 82ND AVE 8905 TOWNE CENTRE DR, STE 108
TIGARD. OR 97223 SAN DIEGO, CA 92122
PHONE: 503-381-4910 PHONE:
FAX.
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 0712912014 5100.70
Specifics; amps or less
6 crt branch Circuits w11'urchase 0712912014 544.52
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 07/29/2014 S17.43
Electrical
Type of Const:
Occupancy Grp:
Total S162.65
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 issuance. or if work is suspended for more the 180
days. ATTEN Z'15jeg law requires you to follow the rules adopted by the Oregon Utility Notification S•iit)er. Those rules are set forth in OAR
952-001-00 through 95 001- 90. You may obtain a copy of the rules or direct questions to OUNC by calling 503 23 /9B or 1 800 332.2344
Issue By: f .— Permittee Signature:
e
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intenaed for sale lease or rent
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' e----.70.--12( 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 ApplicatRECEI V EP FOR OFFiC'F 1'SF. (i i
City of Tigard i P it No Eke ,/
11111 • 13125 SW Hall Blvd.,Tigard,OR 97kIt 2 9 Z014 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/13 : fir'Pena: ,L "oev7—+
A
TIGARD
Jirtspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: lour ® See Page 2 far
Internet: www.tigard-or.gcw R�i��[1� DIVISION Notified/Method: Srppleocntallnforreatlsn
• 'ITpE"LlF'�Dl V ISION PLAN REVIEW
❑New construction .e-Addition/alteration/replacement -- -- Please check all that iumly(submit j,sets of plans whams checked below):
El Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
. CA , t .Y or CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-ask agricultural
❑ 1-and 2-family dwelling 1'I Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Fire imp ❑Installation of 150 KVA or
•JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor toad of ❑"A","l","I-2","I-r'.
Job no.: Job site address: 1 ooHP or more. occupancy.
e• _ _ ❑six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 0 Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
SuitelbldgJapt no.: Project name: Ter i li k t 4 0 Service or feeder 600 amps or more.SCRILITILL
..«.
VA FEE.
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: LOW sq.tt or less . 168.54 4
Tax map/parcel no.: Ea.edd'I 500 sq.ft.or potion 33.92 I
Limited energy,residential
75.00 2
_DESCRIPTION OF WORK i (with above sq.ft.)
Limited energy,multi-family
T J I. t o )'j residential(with above sq.II) 7500 2
' Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or_relocation
❑ PROPERTY OWNER , ❑ 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
City/StatelZlP: Over 1,000 amps or volts 552.26 2,
Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation 200 amps or less 59.36 I
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,per panel
ITAPPLICANT I 0 CONTACT PEII SON 1 A Fee for branch circuits with
above service or feeder fee, ,F ,
Business name: 1 ham 0 k E,e -t►;G- each branch circuit (rte
B.Fee for brands circuits without
Contact name: ) service or feeder fee,first ,
Address: ( � t �'t ` i J hDl �
• branch circuit 57.18 2
? + 1N Each add'I branch circuit 7.42
Miscellaneous(service or feeder not iecinded('
City/State/ZIP: ""� - 3 Each manufactured or modular
1 dwelling,service and/or feeder
67.84 2
Phone:(c�3 s)1 1 o Fax::( )
Reconnect only 67.84 2•
E-mail: Pump or irrigation circle V 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: FI (Eyvti g ho. Oil Signal circuit(s)or limited-energy - See
fff panel,alteration,or extension. Page 2 _'
Address: t o Sao ,R .1"‘A Ave- Each additional inspection over allowable le in any of above
r V
_ ! Q R 3 Additional onn�iat( hr min) 66.25!hr -
City/5tate/ZIP: v 11.44.,r-4 Z Z Investigation(I hr min 66.25/hr
Phone:( ) J)I 0'. 9 /0 Fax:( ) Industrial plant(1 hr min) - 78.18/hr -
Inspections for which no fee is gp.ppy hr
CC Lic: 1:2. ).-7 T I Electrical Lie.:34-46+C, sigwv.i.ic.:43 ref, `5 specifically listed(Yr hr min)
rl j.El %(t 7 r !�/r//p EL®('1IriCAL PERMIT FEES
Su Electrician signature,required: �y "'� Subtotal:
Print name: H ma m o 1 Date: V2-61,4 Plan review(25%of permit fee):
// State surcharge(12%12%ofpermit fee):
Authorized signature: 71..4.l1 TOTAL PERMIT FEE:
��1�' 1111l I "This permit applies lion expires if a permit is not obtained within 180
Print name: 4 1 Yl'1 Date: �y�/a� days after it has bees accepted as complete.
( 1 �/ / • Numlxe of inspections allowed per penult
ItiBuilding\PernitsSELC_PmeilApp-_E _P.ME.doc Rev 05/21/21)13 440-46151(11/O9COM/WEB
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
13500 SW PACIFIC HWY 30, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00417
Jeff Grove
Violation Summary:
Inspector Contractor