Permit CITY OF TIGARD ELECTRICAL PERMIT
! • • COMMUNITY DEVELOPMENT Permit#: ELC2015-00561
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/22/2015
Parcel: 1S 1260000300
Jurisdiction: Tigard
Site address: 9644 SW WASHINGTON SQUARE RD G13
Project: Brighton Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: S
Project Description: TI-(6)branch circuits and(2)low voltage systems,audio/stereo&data.
Contractor: A&A ELECTRICAL CONTRACTORS INC Owner: PPR WASHINGTON SQUARE LLC
1588 SKY TERRACE PO BOX 847
SALEM, OR 97306 CARLSBAD, CA 92018
PHONE: 503-949-3193 PHONE:
FAX: 503-378-9085
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo/Purchase 07/22/2015 $93.28
Specifics: Service or Feeder
2 ea Signal circuit or Limited 07/22/2015 $150.00
Type of Use: COM Energy Panel
Class of Work: ALT 1 ea 12%State Surcharge- 07/22/2015 $29.19
Electrical
Type of Const:
Occupancy Grp:
Total $272.47
Required Items and Reports(Conditions)
This permit is issueSLsubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Co•-s and all other applicable law. All work will
be don accordance w approved plans. This permit will expire if work is not started within 180 days of issu: • or if ork is suspended for more the 180
days. ATTENTION: Oregon -w requires you to follow the rules adopted by the Oregon Utility Notification -nter. hose rules are set forth in OAR
952- 01-0010 through OAR 952-0,1-r• 1. Y• may obtain a copy of the rules or direct questions to OUNC by calling 503.2 98 \ .800•32.2344.
Iss I` �. % - �� Permittee Signature: il •
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' ��i,
. 1j`� Date: 7 42p
91/6
LICENSE NO.
1l
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 FOR OFFICE USE ONI.1
City of Tigard RECEIVED Received: 7 A is" a &L.-Pe/ ..-CO 57o/
i - Permit r
'I 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.19. J 2 2 2015 Date nn : Related Permit#: Q� s eid/ .r
Inspection Line: 503.639.4175 J v L Ready Date/By: Irir�, la See Page 2 for
TIGARD interlet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
TYPE 01.^' PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply(submit si sets of plans w/items checked):
01 Demolition ❑Other:
El Service or feeder 400 amps or more ❑Building over three stories.
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
❑ Multi-family ❑ Master builder ❑Other: amps for all other installations. Installation ati
0 pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: El Addition of new motor load of system.
100HP or more. ❑"A" "E" "1-2" "1-3'
City/State/ZIP: (�/ [� C'. 1 u ❑Six or more residential units. occupancy.
ty % �J 7 "w J �f)/1 ❑Health care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name' / ❑Hazardous locations. ❑Supply voltage for more than
��C • ❑Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: 6, ka_,n (6 /f e I I..f FEE SCHEDULE
v ` Description 1 QIs. I Each I -I o:J
New residential single-or multi-family dwelling unit.
Subdivision: l Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add]500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
/1 (with above sq.ft.) 75.00
Ait KJ f; X 1- C,, e S /nP vJ(,Y' / xç)r (:l�ac iire(IC4' Limited energy,multi-family 75.00 2
0/214- 0/c/C nsSty (66-- 4.,,,,,/ to*N-t4,,, -1`J 12C fir) residential(with abovesq.ft.)T�❑t Renewa ble Energy ❑ See Page 2
PROPERTY OWNER I El TENANT Services or feeders installation,alteration,and/or relocation
Name: 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 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 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 _
Owner signature: Date: 401 amps to 599 amps 1 68.54 _
❑ APPLICANT ❑ C'ONTACT PERSON Branch circuits—new,alteration,or extension,per panel
=, A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first / 56.18 S4•I q
branch circuit _
City/State/ZIP: Each add'I branch circuit 7.42 !'7./O
Miscellaneous(service or feeder not included) _
Phone:( ) I-ax: : ( 1 Each manufactured or modular
dwelling,service and/or feeder 67.84
Email: Reconnect only _ 67.84 _
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Al /`f,,.,t Cal �i __ - ,c L'`e,, Sign or outline lighting 67.84 2
��ll I ((�` f �f l 7-Y Signal circuit(s)or limited-energy �'C�Page 2 '
Address: l S S 2) E <<Y -A.4-/ace c E. panel,alteration,or extension. /°L g l'S )r .
City/State/Z1P: S / �� 73 d (o Each additional inspection over allowable in any of the above
�1 Additional inspection(1 hr min) 66.25/hr
Phone:(543) 9 cf 9 3/ 9 3 l Fax:((7)3) 3? e 9 Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: /A41.9 �0 'I f t /4////y Inspections for which no fee is -
CCB Lic.:J j 39I( (Electrical Lie.: yk- R Suprv.Lic.: 3 t� f S specifically listed('L hr min) - _ �•�/hr
ELECTRICAL PERMIT FEES /
Suprv. Electrician signature,required: Subtotal: , 4 C J?,jl$
Print name: L c ' . C Date: • ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): .P7
Authorized signature: TOTAL PERMIT FEE: FA7A.i7
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.
1::.Building\Perini ts\ELC_PermitApp_ELR_ERE.doc Rev 06,17'2015 440-4615T(I1/05/COM'WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RES1DENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential s stems combined: $75.00 Description I Qty. Each Total
y Renewable electrical energy systems:
Check Ty t . Work Involved: 5 kva or less 100.70 2
-,� 5.01 to 15 kva 133.56 2
!'%'•to and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva: _
7 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
LI 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 I
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00'hr
specifically listed 1':hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system:ONLY:
$75.00 Subtotal 1 Enter on Page I I:
*
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
Check f Work Involved:
Audio and Stereo Systems
❑ Boiler Controls
❑ Clock S s
Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
I I 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
I:,,,uildingPermi ts'ELC_PermitApp_ELR_ERE.doc Rev 06/1 712 01 5