Permit q CITY OF TIGARD ELECTRICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit#: ELC2014-00454
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/18/2014
T t t"`�K.O 9 Parcel: 1S 133CC80163
Jurisdiction: Tigard
Site address: 14168 SW BARROWS RD 3
Project: Bank of New York Mellon Subdivision: SCHOLLS VILLAGE CONDO Lot: 16-3
Project Description: Electrical reconnect only
Contractor: Owner. BANK OF NEW YORK MELLON, C/O SELECT PO
BEN CAMPBELL
14168 SW BARROWS RD, 16-3
TIGARD,OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 08/18/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 08/18/2014 $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 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 acc dame 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. ATT ION: Orego law re•uires you to follow the rules adopted by the Oregon Utility Notifi = enter. Those rules are set forth in OAR
952-001- 10 through OAR 95 -009k. u may obtain a copy of the rules or direct questions to OUNC-by-ca e ' .232.1987 or 1.800.332.2344.
F(��-'�� is i/'
Iss d By: / Permittee Si ature: • i, i
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 Applicat EC IV D lot< (II FILE USL:ONL1
City of Tigard Received ,�m� 7� ZGC,;k3( —y5"
Permit No.:
13125 SW Hall Blvd.,Tigard,OR 9722AU G 1 8 2014
plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/BL_ Other Permit:
I t G A R D Inspection Line: 503.639.4175 4 r1�ppn Date Read/Bv: iotir 8 See Page 2 for
Internet: www.tigard-or.gov CITE I Ii1f1U Notified/Method: Supplemental Information•,t'` s"i TYPE"Oir` PLAN REVIEW•
Please check all that apply(submit 2 eels of plans w%items checked below)
❑New construction ❑Addition/alteration/replacement
CI
❑Service or feeder 400 amps or more ❑Building over three stories.
®Other: where the available fault current ❑.Marinas and boatyards.
. '1, , 4 0. ? <'. ' "'�, 4, `. exceeds 10,000 amps at 150 volts or ❑Floatin g buildings.
less to round,or exceeds 14,000 ❑Commercial-use agricultural
® I-and 2-family dwelling El Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder C]Other: ❑Fire pump ❑Installation of 150 KVA or
$ al�ol> TII�r>f:►Nlr. ❑Emergency system. larger separately derived system.
' ! 0 Addition of new motor load of ❑"A""E^ "1-2","1-3",
Job no.: Job site address:14168 SW Barrows Rd unit 16-3 1001Wormore, occupancy.
C:��j �7 t ,S ❑Six or more residential mots. ❑Recreational vehicle parks,
City/State/ZIP:Tigard,OR. t t 0� 3 ❑Health-care facilities. ❑Supply voltage for more than -
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: 16-3 Project name:Scholls village condos ❑Service or feeder 600 amps or more.
Cross street/directions to job site:Building 16 A'.(! " 1� r, r(. '.j'w; --.
_ Description Q� Pea Total •.�.
gate code Key symbol 082398,contractors box ft door 3902 New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision:Scholls Village condo Lot no.: 16-3 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.:82089238 Ea.add'l 500 sq.ft.or portion 33.92 I
Limited energy,residential
'" fEBGxRfI'TION OF'WORK (with above sq.ft.) 75.00 2
electrical re connect inspection — Limited energy,multi-family
residential(with above sq.ft.)� 75 00 I 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
1111474f 1E1( ^, :. ;_: 0 um* 200 amps or less 100.70 ; 2
Name:Bank of New York Mellon,do Select Portfolio sery 201 amps to 400 amps l 133.56 2
J' / 401 amps to 600 amps 200.34 2
Address ti I r en�!Gt l Jf 601 amps to 1,000 amps 301.04 2
City/State/ZIP: lC '�� Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Phone:( ) Fa,.i ( ) relocation
Owner installation:This installation is being made on property that 1 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
401 amps to,599 amps
168.54 2 Owner signature:
Date. Branch circuits-new,alteration.or extension, rer panel
-"'.'1 A.Fee forbranch circuits with 1
above service or feeder fee,
Business:name:Ben&Carolyn Campbell w/Premiere Property Group each branch circuit 7.42 2
n
Contact name:Carolyn Campbell -/r� / ,y L J B.Fee for branch circuits without
If7t�H 7t/[,r � s ,�/// --,?�,/„ service or feeder fee,first
� � ."- ""° branch circuit
56.18 2
Address: 16505 SE 1st St suite A,pmb#95 ���
r, i Each add'1 branch circuit 7.42 I 2
City/State'Z1P:Vancouver,WA.98684 /N ? l
__Miscellaneous(service or feeder not included) i
x' 1 A1/'r' Pach manufactured or modular f
Phone (360)281-7653 dwelling,service and/or feeder 67.84 2
Fax: (503-)296-5556 I i - —. +
E-mail:Carolyn @benandcarolyn.com Reconnect only I 67.84 67.84 2
r L" i Rri7flR Pump or irrigation circle 67.84
2
k
Sign or outline lighting 67.84 2
Business name: 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
Additional inspection(1 hr min) 66.25/hr City/State/71P:
Investigation(I hr min) 66.25:hr
Phone:( ) A Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
C CB Lie.: Electrical Lic.: Suprv.Lie.: specifically listed(/-hr min) 90.00/hr
:.
Suprv.Electrician signature.required: It:P4{Subr4.. y
Subtotal: 67,84 I
Print name t D) l / Date: Plan review(256/0 of permit fee):
Di, J State surcharge(12%of permit fee): 8.14
i
Authorized signature: . ,/(_,�f� � �/ .OTAL PERMIT FEE: 7198
J
Print name: �`r / �(J ��/ 1 i'his permit application expires if a permit is not obtained within 180
Date: 7 days after it has been accepted as complete.
11auit iing�.Pcm,irsfl,f PermitApp_ .R 5REdim Rev f15/i t.20 1i :his
of inspections allowed per peril.
- - 1 5T(11/051COMIWEn
Electrical Permit Application r FOR OFFICE USE ONLY
ill City of Tigard �E. ■ `v . II Received Permit No.:
' 13125 SW Hall Blvd.,Tigard,OR 97223 �J Date/B
g 8 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 AUG 1 0 2014 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: turis: ® See Paget for
Internet: www.tigard-or.gov CITY OF URO Notified/Method: Supplemental Information
TYPE OF ��(y+ �t PLAN REVIEW
W �� that k h
Please check a tat a I
pp y(submit 2 sets of plans w/items checked below):
❑New construction ❑Addition/alteration/replacement
❑ Demolition El Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
''''''.0-: ,,t0 Sr �� �" 8 s ty n e 9 #.4 ,, ae " I. exceeds 10,000 amps at 150 volts or ❑Floatin g buildings.
.' ' '"- ''( '``( ""'�"'"'' ' '` ``''' ° An ''" ""` '''.' u''ri.'��6 ` ' '-'i
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
0 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
0 Emergency system. larger separately derived system.
4 ❑Addition of new motor load of
Job no.: Job site address: 14168 SW Barrows Rd unit 16-3 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR. 7,z;3 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: 16-3 Project name:Scholls village condos ❑Service or feeder 600.. is or more.
FEE SCHEDULE
Cross street/directions to job site:Building 16 Description I Qty. I Fee. I Total l *i
New residen I single-or multi-family dwelling unit.
gate code Key symbol 082398,contractors box ft door 3902 Includes , ached garage.
Subdivision:Scholls Village condo Lot no.: 16-3 1,000 s..ft or less 168.54 4
Ea. •.d'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: R2089238 it energy,residential
75.00 2
DESCRIPTION OF WORK ith above sq.ft.)
invited energy,multi-family 75.00 2
electrical re connect inspection — / residential(with above sq.ft.)
it Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER J ❑ TENANT amps or less 100.70 2
U \,k 201 amps to 400 amps 133.56 2
Name: Bank of New York Mellon,c/o Select Portfolio sery u 401 amps to 600 amps 200.34 2
Address: �15t y4 AI ' (16a079, V' V 601 amps to 1,000 amps 301.04 2
1 Over 1,000 amps or volts 552.26 2
City/State/ZIP:
or ...41., . Temporary services or feeders installation,alteration,and/or
Phone:( ) __ F. , ( ) r relocation
\ 200 amps or less 59.36 I
Owner installation:This installation is being made on property t it I o which is not 201 amps to 400 amps 125.08 2
intended for sale, lease,rent,or exchange,according to ORS 44 449,6 ,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits–new,alteration,or extension,per panel
1:1 APPLICANT I e ONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: Ben&Carolyn Campbell w/Premier: 'roperty Group each branch circuit
B.Fee for branch circuits without
Contact name:Carolyn Campbell J service or feeder fee,first
tTftjrj(6is7 il,� fl,L�s+' � ,s' 56.18 2
j/ branch circuit
Address: 16505 SE 1st St suite A,pmb#95 ,, t , Each add'l branch circuit 7.42 2
City/State/ZIP: G' Miscellaneous(service or feeder not included)
ZIP:Vancouver,WA.98684 ea -141 ; 1, Each manufactured or modular
Phone:(360)281-7653 Fax: :(503-)296-5556
dwelling,service and/or feeder 67.84 2
Reconnect only I 67.84 67.84 2
E-mail:carolyn @benandcarolyn.com Pump or irrigation circle 67.84 2
CONT CTOR Sign or outline lighting 67.84 2
Business name: 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
Additional inspection(I hr min) 66.25/hr
City/State/ZIP: Investigation(1 hr min) 66.25/hr
• r
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: Electrical Lie.: Suprv. Lie.: specifical -listed(%:hr min)
,
,:, F 3C PERMIT:AEI:.
Suprv. Electrician signature,required: _ Subtotal: 67.84
Print name: j Date: Plan review(25%of permit fee):
34.
State surcharge(12%of permit fee): 8.14
Authorized signature: TOTAL PERMIT FEE: 75.98
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.
I\Building\Permits\ELC_PermitApp ELR_ERE.doe Rev 05/21/2013 440-4615T(I I/05/COM/WEB
L _
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
14168 SW BARROWS RD 3, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00454
Jeff Grove
Violation Summary:
Inspector Contractor