Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00713
T i C;ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/31/2014
Parcel: 2S 102AC00700
Jurisdiction: TIGARD
Site address: 12550 SW MAIN ST
Project: DOLAN&CO Subdivision: BURNHAM TRACT Lot: 1
Project Description: (1)service over 400 amps.
Contractor: FUZION ELECTRIC LLC Owner: DOLAN&CO LLC
1335 SW 197TH AVE BY FLORENCE T DOLAN
ALOHA, OR 97006 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-528-6033 PHONE'
FAX: 866-284-0482
FEES
Quantity Description Date Amount
1 ea Services or Feeders-601 to 12/31/2014 $301.04
Specifics: 1000 amps
1 ea Plan Review Electricial 12/31/2014 $75.26
Type of Use: COM 1 ea 12%State Surcharge- 12/31/2014 $36.12
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $412.42
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 of -r 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 '/wor is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. 1 Th.s rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a•• or direct questions to OUNC by callieg03. •2.1987 or yAA 801. 32.2344.
Issued By: ...An,- -- •=rmittee Signature: 11112.%.01
OWNER
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 Application 1 1111 11I II( 1 1 .1 t,\I
City of Tigard CyIVEP Received• �1 �r DateB : f., I�r��1 insimmemeni
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review s
i� ■ Related Permit k:
Phone: 503.718.2439 Fax: 503.598.19 Date/B : ( ,e '
Inspection Line: 503.639.4175 Ready Date/By: P,� � 1. 's: EI See Page 2 for
I I(,:�IS 1) Internet: www.ti ard O[. ov 2014 Notified/Meth�.. - Z
g g DEr 11 Supplemental Information
OF WORK ` AAjj i ,e0677-----
� .I/ PLAN REVIEW
❑New construction Addition/alteratioel rlt ii l " ease check all that apply(submit 2 sets of plans w/items checked):
*� ervice or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: G D 1 v nT IS1O1� here the available fault current ❑Marinas and boatyards.
CATEGO F CON .. exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling ommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑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
Job#: Job site address: (2.50 �j�J �p is, 54-- ❑Addition 0H of new motor load of system.
100HP or more. ❑"A" "E" "1-2""1-3„
City/State/ZIP: 7-6.).„,, ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168,54 4
Tax map/parcel#:
Ea.add'1 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
1 (with above sq.ft.) 75.00 2•
N P.w Service - r fjV�(%(-I< �� (fu f/1/rrT</�/ ,�`-�`1 Limited energy,multi-family
�_ rr�7 residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
PROPERTY OWNER �] TENANT
ER
Services or feeders installation,alteration,and/or relocation
Name: a�,v D� W 200 amps or less 100.70 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 3() .Olt 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 I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit _
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
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: �t�'L.t� `1 et.41 C. Sign or outline lighting 67.84 2
3 3 5 /9,, i �a Signal alteration,t(s)or limited-energy ❑ See Page 2 2
Address: (.) panel,altera or extension.
City/State/ZIP: `A (v al 7 cfEr& Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(SE 3) . e..11.-4 rJ 33 Fax:( ) Investigation(1 hr min) , 66.25/hr
��,p Industnal plant(1 hr min) 78.18/hr
Email: iwt to t.2 rut_e(ec-6-1 c _ Gd Lv-- .
Inspections for which no fee is 90.00/hr
gq�
CCB Lic.: I 13- Electrical Lic.: c,ST( Suprv.Lic.: 55,2.p Q 3 specifically listed(Y hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: -(t. Jc.)If i't ,- / Date: 12- II- I ❑Plan Review Required(25%of permit fee): _
State surcharge(12%of permit fee):
Authorized signature: %�r TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: � *140 5 Date: I Z'( ( - /41 days after it has been accepted as complete.
' Number of inspections allowed per permit.
1.)Building\Permit\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 440-46151(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
Fee for all residential systems combined: $75.00 Description ; I Q4 u
• I Each I Total I
S' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
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* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 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
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(V:hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page I):
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* A„ _116 ,,I
❑ 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
r.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014
RECEIVED
DEC 11 2014
CITY OFTIGAIW
Fuzion Electric 800 amp Meter/Breaker Upgrade BUILDING DIVISION
Brett Johnson 12550 SW Main St,Tigard,OR
503-528-6033
NEW(2)200 amp
breaker/meter NEW(2)200 amp
combo pack breaker/meter
FUTURE combo pack New gear
termination can
Existing
rPGE meter to be removed
oo 200 N 0
Parallel 500 KCMIL
Phase A.B.C,and N
O 200 1
•
24)Copper
PGE Transformer Size: 300 KVA
Impedance 2.98 a
Sec.Voltage(L tot.) 208 Wye Existing PGE CT can to be used as
Length: 70 feet a new customer termination can
Maximum Fault Cvrern 17,864 amps
. OFFICE COPY
CITY OP TIGARD 17 VI r W F• • ' ',a 11I,I 1".T, L
REVIEWED 110)i GODB CQDCE ;'t : 'cd: i 11
&( a-
...c ;2z, 1)1' ;: 1 i
„ _ Ad 4- .. 3
` sui te cc #:AiddmM 2- S5-o 5,. ( . S
Ult.Os By: L•d[C:
Bjs , 7111.111.17 Data 2 7 .
eill
I