Permit CITY OF TIGARD ELECTRICAL PERMIT
III - "
3 " COMMUNITY DEVELOPMENT Permit#: ELC2015-00875
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/27/2015
Parcel: 2S110AB00200
Jurisdiction: Tigard
Site address: 14411 SW PACIFIC HWY
Project: Oregon Beverage Recycling Center Subdivision: CANTERBURY PLACE,AMENDED Lot: PTS 1-4
Project Description: Electrical for TI:(38)branch circuits lighting and equipment from(3)existing panels.
Contractor: GRESHAM ELECTRIC Owner: BULL MOUNTAIN INVESTMENTS LLC
4664 SE ANTELOPE HILLS DR ATTN JERRY KOLVE
GRESHAM, OR 97080 14389 SW PACIFIC HWY
TIGARD, OR 97224
PHONE: 503-810-8140 PHONE:
FAX: 503-667-9374
FEES
Quantity Description Date Amount
38 crt Branch Circuits wo/Purchase 10/27/2015 $330.72
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/27/2015 $39.69
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $370.41
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce' er. Those rules are -et forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy the rules or. •ct questions to OUNC by calling 503.2 2.1•87 or 1.80.. 2.2344.
Issued By: Permittee Signature: ,/ ad.i
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application IOR OI FI( I 1 SE 0\1.1
City of Tigard Received•IN 13125 SW Hall Blvd., OR 9 %8S41S)841 Plan Review
/` "" _,•
li Phone: 503.718.2439 Fax: 503.5 Related Permit#: O 00,?..7
Inspection Line: 503.639.4175 "... Ready Date/By: ® See Page 2 for
T I c.;1 k I) Internet: www.tigard-or.gov 1 l° Notified/Method: Supplemental Information
TYPE OF WOR ' , (?i .1, PLAN REVIEW
❑New construction ®Addition/alteration/r e t
�'. Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS$ MSN exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ I-and 2-family dwelling ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ Multi-family ❑ Master builder ❑Other: El for other installations. buildings.
pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: 14411 SW Pacific Hwy ❑100H Addition of ore.motor load of system.
Y 1 OOHP or more. ❑"A" "E" `,t-2""1-3"
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Bottle Drop ❑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'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
Install new circuits for lighting and equipment from 3 existing panels (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER I El TENANT Services or feeders installation,alteration,and/or relocation
Name:Oregon Beverage Recycling Cooperative 200 amps or less 100.70 2
Address:3900 NW Yeon Ave 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Portland,OR 97210 601 amps to 1,000 amps 301.04 2
Phone:(503)222-2266 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,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 1 56 18 56.18 2
branch circuit
City/State/ZIP: Each add'I branch circuit 37 7.42 274.54 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Gresham Electric Inc. Sign or outline lighting 67.84 2
Address:4664 SE Antelope Hills Dr. Signal circuit(s)era or limited-energy ❑ See Page 2 2
P panel,alteration,or extension.
City/State/ZIP:Gresham,OR 97080 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)810-8140 Fax:(503)667-9374 Investigation(1 hr min) 90.00/hr
Email:greshamelectric @gmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 129653 Electrical Lic.: 26-1004C Suprv.Lie.: 4429S specifically listed(/z hr min)
Suprv.Electrician signature,required ELECTRICAL PERMIT FEES
����� Subtotal: 330.72
Print name: Michael Elrod D : 10.26-15 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 39.69
Authorized signature:
TOTAL PERMIT FEE: $370.41
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\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-46151(11/05/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
14411 SW PACIFIC HWY, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00875
Jeff Grove
Violation Summary:
Inspector Contractor