Permit u CITY OF TIGARD ELECTRICAL PERMIT
1111 ' COMMUNITY DEVELOPMENT Permit#: ELC2014-00698
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/08/2014
Parcel: 2S102AA05500
Jurisdiction: Tigard
Site address: 12215 SW MAIN ST
Project: Choi Building Subdivision: KINGSTON Lot: 19
Project Description: Adding(4)services and(2)branch circuits.Splitting existing service into 4,for shell service&suites 100, 110&
120.
Contractor: TRINITY ELECTRIC Owner: CHOI, WOO Y&MAN JA
13422 SW 128TH PL 2323 NE 165TH DR
TIGARD,OR 97223 PORTLAND,OR 97230
PHONE: 503-235-6481 PHONE:
FAX: 503-579-3929
FEES
Quantity Description Date Amount
4 ea Services or Feeders-200 12/08/2014 $402.80
Specifics: amps or less
2 crt Branch Circuits w/Purchase 12/08/2014 $14.84
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 12/08/2014 $50.12
Electrical
Type of Const:
Occupancy Grp:
Total $467.76
Required Items and Reports(Conditions)
This pe • is issued s••'- t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be ••ne in accordance with a••roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
d- s. ATTENTION: Oregon law equ •u to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
••2-001-0010 through OAR 952-001-•••0. You may•stain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
ssued By: — _ _� 'l�i� —•�/ ' 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' .—. Date:
LICENSE NO. 4.Vo2g?
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 Applica EtE1 M Efl l OR t1FFI( 1.: l si ()\l.\
City of Tigard Dateed /�®� �o 1p C�
:� • 13125 SW Hall Blvd.,Tigard,OR � 2� 8 2014 Plan Review j
Phone: 503.718.2439 Fax: 503.598.1960 Date/
Related Permit#:
Inspection Line: 503.639.4175
CITY Of Ir AUD Ready Date/By: torts: ® See Page 2 for
I I t, \1:1 t Internet: www.tigard-or.gov 1�1.1 r VI V A 1�. Notified/Method: Supplemental Information
TYP1V�i DIVISION PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked):
❑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-and 2-family dwelling ,Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
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
❑Addition of new motor load of system.
Job#: Job site address: 122/S ski /44 y) S/rt„S 100HP or more. ❑"n","E","l-z","l-3",
❑Six or more residential units. occupancy.
City/State/ZIP:
Tidl y OR- ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Cf ❑Hazardous locations. ❑Supply voltage for more than
�!h 0�� 5-A TI Ply,' �7 Q. ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site. I V FEE SCHEDULE
L 0 1 MO, /mg / Description I Qty. I Each I Total I •
o�/� New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 _4
Ea.add'I 500 sq.ft.or portion 33.92 1
•DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
4 5-ervte-5 anal 2 bra Pe/ e;re_-(4.{f Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
-- -, Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER 1 ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less ,[L 100.70 0 2,SO 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I 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
Owner signature: Date: 401 amps to 599 amps 168.54 _ 2
❑ APPLICANT 1 ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel _
A.Fee for branch circuits with
Business name: above service or feeder fee, 2 7 42 /41 "I 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2J
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ,r Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: J 42 2 5-� /�An f y �j� panel,alteration,or extension. g
Ci /State/ZIP: r Each additional inspection over allowable in any of the above
City/State/ZIP: I /ia),d ok 9-�----3 Additional inspection(1 hr min) 66.25/hr
Phone:(97/ 2 . ' s I Fax:(ST3)-�/l5— .3 2 Investigation(1 hr min) 66.25/hr
L Industrial plant(1 hr min) 78.18/hr
Email: y�z ,J70 �aA,„ r co, �O�//! Inspections for which no fee is
CCB Liic.: 2 Electrical Lic.: Su rv.Lie.: specifically listed(%z hr min) `��/hr
��66 6S C p 4�d' ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 11/7 (py
Print name:1-/A/ _ç a 1iv /Z) „� Date:/�/�/� 0 Plan Review Required(25%of permit fee):
r� State surcharge(12%of permit fee): ,j A
Authorized signature: / !, TOTAL PERMIT FEE: �07. 7
f� This permit application expires if a permit is not obtained within 1
Print name: .l7' 5"LtN ��, Date: /�/ /� days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 04/21/2014 440461 T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description Qty. I Each I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >l00 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y ' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
C\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12215 SW MAIN ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2014-00698
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor