Permit q CITY OF TIGARD ELECTRICAL PERMIT
I"! COMMUNITY DEVELOPMENT Permit#: ELC2015-00353
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/13/2015
Parcel: 2S102AB01200
Jurisdiction: Tigard
Site address: 9305 SW COMMERCIAL ST 3
Project: Park Glen Apartments Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 64
Project Description: 100 amp panel change
Contractor: HARBOR NORTHWEST ELECTRIC LLC Owner: COLLING, CHARLES W
1404 NE 17TH AVE KB PROPERTY MANAGEMENT LLC
BATTLE GROUND, WA 98604 13835 SW HALL BLVD
TIGARD, OR 97223
PHONE: 503-358-8723 PHONE: 503-936-4529
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/13/2015 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 05/13/2015 $12.08
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 accordance 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. ATTENTI•• . •re••• law requires you to follow the rules adopted by the Oregon Utility Notification Cep - . hose rules -r- s= f. in OAR
952-001-0011 rou h OAR 95 00 .0•'. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.23 . 987/ : 0 2. •4.
//
Issued 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.
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 1.1; 1 l I I l i 11 ,1 i i.I ,,
City of Tigard ' igate
7111
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960 narclB : tither Pamir
I t l Inspection Line: 503.639.4175 Date Ready/By: Bas: ®see Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Iafsrmatten
TYPE OF WORK PLAN REVIEW
❑New construction 0 Additioo/alteratitm/replacement
Please check all that apply(subnut J sets of plans wlitema checked below):
Q 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 0 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.
0 Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 K V A or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A""F""1-2""1 3"
Job no.: Job site address:930 /� 1001-IP or more. occupancy.
$W `OffJA'1/rGIV/ ❑Six or more residential units. ❑Recreational vehicle parts.
City/State/ZW: ❑Health-cue facilities. ❑Supply voltage for more then
—___— ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: 3 Project name: HQI��l_f a-p-r-fj ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: De t•.. I Qey, I Ree. I Total (•
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less I I 168.54 I 14
Ea.add'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited ,residential 75.00 2
DESCRIPTION OF WORK _ (with above sq_fl-)
Limited energy,multi-family 75.00 2
/PO QrtiQ �,4d/ 6441Z, residential(with above sq.ft.) —
r '�fI"�' Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation_
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less i 100.70 hyi,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 installadoa,alteration,and/or
Phone:( ) I Fax;( ) relocation
200 amps or less 59.36 l
Owner installadon: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
❑ 1 ❑ CONTACT PERSON A Fee for branch circuits with
JO
above branch or c it fa, 7.42 2
I3lisirreaa py each branch circuit
B.Fee for branch circuits withow
Contact name: service or feeder fee,first 56.18 2
branch circuit
Address: Each add'I branch circuit 7.42
City/State/ZIP: Mlaeeilaneons(service or feeder not included)
/� Each manufactured or nodular 67.84 2
Phone:(9)-331 �-�l_C..,45,9 I 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
Business name: �l�-✓�s,,Y .`1 �1 I!G Signal circuit(s)or limited-energy Sec
•YY W a•� Yf L - �snel,altera0mn or extension. Page 2 2
Address: t; Each additional inspeedon over allowable in any of the above ,
l�Di'� /'14: /7- "'At
Additional inspection(1 hr mill) 66.25/hr
City/State/ZIP: ik.//e 1 revrd f 16.*. f- 94;0* Investigation(I hr min) 66.25/hr
Phone:(5p; ) 8 - Ct^70? I Fax:( \ l'!Ilk Industrial plant(1 hr tin) 78.18/hr
5 v[w `t l Inspections for which no fix is 70.00/hr
b(i11 to CCB Lie.: M7 i No Electrical Lc.: f 8 4 I Suprv.Lic.:345.S specifically listed(:S hr min) -
Stglrv.Electrician signature,required: t 1 ELECTRICAL PERhf>T FE
Subtotal: /00,7c
7C
Print name: 1 Date: Plan review(25%of permit fee): ..—•-
glrirl ern 5 01 - State surcharge(12%.of permit fee): / •Lr<3
Au horized Iel gnature: TOTAL PERMIT FEE: //a,,7 c
This permit application expires V a permit is oat&tailed within 18111
Print name: I Date: days after it alas been accepted as map/ete.
• Number of inspections allowed per permit.
I.d Building t Pmnsu'ELC_PesmaApp_ELR_ERF..doe Rev 05212013 440.6157(1 I/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
9305 SW COMMERCIAL ST 3, TIGARD, OR,
97223
Commercial - Electrical
115 Electrical service
PASS
ELC2015-00353
Jeff Grove
Violation Summary:
Inspector Contractor