Permit Support Document CITY OF TIGARD f � I ELECTRICAL PERMIT
$ COMMUNITY DEVELOPMENT Wane Permit#: ELC2014-00392
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/21/2014
Parcel: 25101 DD00800
Jurisdiction: Tigard
Site address: 14020 SW 72ND AVE
Project: United Rentals Subdivision: SALEM FREEWAY SUBDIVISION Lot: 4
Project Description: Add Charger Outlets. 8/11/14.adding_(3)feeders and(38)additional branch circuits.
Contractor: JARMER ELECTRIC INC Owner: I S PROPERTIES LP
5105 SW 45TH AVE#200 ATTN: UNITED RENTALS LEASE ADMIN
PORTLAND, OR 97221 BY FISCHER&COMPANY URI
13455 NOEL RD, STE 1900
DALLAS,TX 75240
PHONE: 503-246-5381 PHONE:
FAX: 503-244-8037
FEES
Quantity Description Date Amount
3 ea Services or Feeders-200 08/11/2014 $302.10
Specifics: amps or less
48 crt Branch Circuits w/Purchase 08/11/2014 $356.16
Type of Use: COM Service or Feeder
Class of Work: ADD 1 ea 12%State Surcharge- 08/11/2014 $78.99
Electrical
Type of Const:
Occupancy Grp:
Total $737.25
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. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throw -001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 50 32.1987 or 1.800.332.2344.
Issued By: , � ��� �� 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
ti
SIGNATURE OF SUPR.ELEC' l 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 Applic ''JED
Ci}�, of Tigard 1 1 Received '/ p
City gr7 1 1 �O� Date/By: �y Permit No.: � ( -�3!�1
13125 SW Hall Blvd.,Tigard,OR 9M3' Plan Review �C
IN II Phone: 503.718.2439 Fax: 503.59 ��R pa1e/gy, Other Permit
I'IGAUD Inspection Line: 503.639.4175 C1iati""{'��I Date Ready/By. lur,s Id See Page 2 for
Internet: \Sww.tigard-or.gov BOW' 11rr' Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
Please check all that apply(subunit 2 sets of plans w/items checked below)
❑New construction ❑Addition/alteration/replacement
❑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 ❑flouting buildings.
less to grond,or exceeds 14,000 ❑Commercial-use agricullnrol
El I-and 2-family dwelling ❑Commercial/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","I-3
Job no.: 1 Job site address: 14020 SW 72"d Ave 10011P or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97233 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg,/apt.no.: Project name: United Rentals ❑Service or feeder 600 amps or snore
FEE SCHEDULE
Cross street/directions to job site: neser,,don f 1 . Fee. 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
--F Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
75.00 2'
ELC2014-00392 ADD ON residential(with above sq.6)
Renewable Energy, ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER ] ❑ TENANT 200 amps or less 3 100.70 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 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
0.APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 38 7 42 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first
56.18 2
branch circuit
Address: Each add'I branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)_
Each manufactured or modular
67.84 2
Phone:( )
dwelling,service and/or feeder _
Fax::( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2 1
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Jarmer Electric Inc Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 1 2
Address:5105 SW 45th Ave #200 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: Portland,OR 97221 Investigation(I hr min) 6625/hr
Phone:(503)246-5381 Fax:(503)244-8037 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 6924 Electrical Lic.: 26-144C Suprv.Lie.: 4044S specifically listed(Vu hr min) 90 001 hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Stuart Jarmer Date: 8/1 1/14 Plan review(25%of permit fee): _
State surcharge(12%of permit fee):
Authorized signature: r -+-�� TOTAL PERMIT FEE: 599.53
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 per permit.
1.\BuildingiPermilflELC_PermilApp_ELR ERE don Rev 05/2112013 440.461STt I 1/05/COM/WEB