Permit 111111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00451
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2014
Parcel: 1S135DD05106
Jurisdiction: Tigard
Site address: 11999 SW PACIFIC HWY
Project: Bank of America Subdivision: LOMITA TERRACE Lot: 9
Project Description: (4)branch circuits to disconnect and reconnect three RTU's
Contractor: PORTLAND ELECTRICAL CONST INC Owner: CCC PROPERTY MANAGEMENT LLC
1019 7TH STREET BY CHERI LETHIN
OREGON CITY, OR 97045 PO BOX 25083
PORTLAND, OR 97221
PHONE: 503-655-2281 PHONE:
FAX: 503-655-5033
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 08/14/2014 $78.44
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 08/14/2014 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 accordan - 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. ATTENTI• 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 .ugh OAR 952 • -0r 0. ou may obtain a copy of the rules or direct questions to OUNC by callin 32.1987 or 1.800.3323344.
Issued = �'//L��. Permittee Signa �p .A_A
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: sf*
r —
LICENSE NO. 34{6
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 Applicati W FOR OFFICE USE ONLY
City of Tigard "�V '�' Received
Date/By: 1 1 �'�C a,D -t�0�/s
Permit No.:
Mil
• 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960E 1 3 2014 Date/By: other Permit.
TIGARD
Inspection Line: 503.639.4175 AI�Jf Date Ready/By: tuns: H See Page 2 for
Internet: www.tigard-or.gov V 'p�{� Notified/Method: Supplemental Information
_....__.- _ Q1T � iliGA RD -
Tl PE O(,P PI ∎\ RFl llVi
❑ p e l check that e elou
New construction Addition/ �acemeri{� Please checl.all that apply(subunit 2 sets of plans wntznu checked beluv.I
❑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.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-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","1-2","1-3",
Job no.: Job site address: 11999 SW Pacific Hwy IOOHPormore. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223-6474 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Bank'of America ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. I 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 1
r
r Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.) •
Limited energy,multi-family 75.00 2
Disconnect and reconnect three rooftop units. residential(with above sq.ft.)
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 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 168.54 2
Owner signature: _ Date: Branch circuits—new,alteration,or extension,per panel
® APPLICANT ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name:Portland Electrical Construction,Inc. each branch circuit
B.Fee for branch circuits without
Contact name:Greg Boen service or feeder fee,first I
56.18 56.18 2
branch circuit
Address: 1019 7th Street Each add'I branch circuit 3 7.42 22.26 2
City/State/ZIP:Oregon City,OR 97045 Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)655-2281 Fax::(503)655-5033 dwelling,service and/or feeder
Reconnect only 67.84 2
[-mail: greg @portlandelectrical.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Same as above Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 66.25/hr
Phone:( ) Fax:( ` `1 ID1 \� Industrial plant(1 hr min) 78.18/hr
/ / `
Inspections�cially listed CA fir ofen)1s i
CCB Lic.: 51764 1�`3` i Electrical Lic.: 3-246C .110
Su • Lic.: 34615 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 78.44
07744,Print name: Michael P.Donohue Date: 8-12-14 Plan review(25%of permit fee):
_
State surcharge(12%of permit fee): 9.41
Authorized signature: �/ _ TOTAL PERMIT FEE: 87.85
Print name: Michael P.Donohue Date: 8-12-14 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Number of inspections allowed per permit.
tl Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(1 1/05/COM/WEB