Permit CITY OF TIGARD ELECTRICAL PERMIT
s, COMMUNITY DEVELOPMENT Permit#: ELC2014-00553
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/29/2014
Parcel: 1S 126BC01506
Jurisdiction: TIGARD
Site address: 9020 SW WASHINGTON SQUARE RD 170
Project: Pioneer Design Group Subdivision: 2005-035 PARTITION PLAT Lot: 3
Project Description: (8)branch circuits for TI
Contractor: R C COSTELLO ELECTRICAL CONT INC Owner: WISCO REAL ESTATE EQUITY FUND I
PO BOX 336 1501 SW TAYLOR ST STE 100
AURORA,OR 97002 PORTLAND, OR 97205
PHONE: 503-982-7400 PHONE:
FAX: 503-982-7400
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo/Purchase 09/29/2014 $108.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/29/2014 $12.97
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $121.09
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 - •r•an•- .ith 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. TENTION: Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-,•1-0010 through OAR 952- 01 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1 32.2344.
I ued By: / _s 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' l —!��-- / C Date:
T/5
LICENSE NO. 3
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 ApplicaRCEWFD fOR OFFICE USE()NI 1
City of Tigard AP 2 9 Received c-/SIT 4 Permit No.: f�.0.10I -D 553
=• 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review q
Phone: 503.718.2439 Fax: 503.5 (��{U Date/B : Other Permit: 464:Vey ��D�o7
T I c;n R n Inspection Line: 503.639.4175 �� ���°' Date Ready/By inns: See Page 2 for
Internet: www.tigard-or.gov Mil W I�41OPt
171t�1'� Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
D l❑New construction []Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑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,—J,( 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","I-2","I-3",
Job no.: Job site address: ci 0[ r '.t IOOHP or more. occupancy.
II iCt'. +1'::) ✓1 ❑Six or more residential units ❑Recreational vehicle parks.
City/State/ZIP: �l ❑Health-care facilities. ❑Supply voltage for more than
� ❑Hazardous locations. 600 volts nominal.
uite bldg./apt.no.: Ii v Project name:�on er De51)11 ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description f 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
Ea.add'l 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
Breine I/ C i 1-w its 4of _.. • residential(with above sq.ft.)
Renewable Energy El 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 nr 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, • r panel
❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first ' 56.18 5(p.is 2
branch circuit v
Address: Each add'l branch circuit 9 7.42 5(.9 Li 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:( ) Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR /� Sign or outline lighting 67.84 2
Business name: C. COS-ie i w t fed ficsa I wn�rpL-Fihol Signal circuit(s)or limited-energy See
J panel,alteration,or extension. Page 2 2
Address:7Q Box 33 6 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: Aurora OR 019002. Investigation(1 hr mm) 66.25/hr
Phone:(503)509_6,1 52, Fax:(503)Q82- 9 yo/ Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.:2" X02 Electrical Lie.:3-3 yy C Suprv.Lie.:3q31/e specifically listed(''/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required.: - Subtotal: / 0 `q', f2-
'ROD /� S4 21 f J Date:���I p` Plan review(25%of permit fee):
Print name: (_ l.0 1 l `( State surcharge(12%of permit fee): I I .9 II
Authorized signature: TOTAL PERMIT FEE: 12 I 0 _
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.\BuildingTemlitskELC_PermitApp_ELR_ERE.doe Rev 05/21/2013 440.4615T(I1/05/COM/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
9020 SW WASHINGTON SQUARE RD 170,
TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00553
Jeff Grove
Violation Summary:
Inspector Contractor