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Permit CITY OF TIGARD ELECTRICAL PERMIT = " COMMUNITY DEVELOPMENT Permit#: ELC2015-00956 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/08/2015 Parcel: 1S136CA01500 Jurisdiction: Tigard Site address: 7709 SW PFAFFLE ST B20 Project: HAWTHORNE URBAN DEVELOPMENT LLC Subdivision: FAIRVALE Lot: 6 Project Description: Reconnect only. Contractor: Owner: HAWTHORNE URBAN DEVELOPMENT LLC 7705 SW PFAFFLE ST PORTLAND, OR 97223 PHONE- FAX- FEES HONE PHONE: FAX FEES Quantity Description Date Amount 1 ea Reconnect Only 12/08/2015 $67.84 Specifics: 1 ea 12%State Surcharge- 12/08/2015 $8.14 Electrical Type of Use: MF Class of Work: OTR Type of Const: Occupancy Grp: Total S75.98 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 Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma rules or direct questions to OUNC by calling 503.232.1987 or 1.8000.33322.22344. Issued By: ✓`� -_- - - Permittee Signature: cCLQ 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. DEC-03-2015 16:43 From:HUI-Scanner 5036242770 To:5035981960 Page:1/2 Electrical Permit Application NANVIII t,u tli'1 tc l_ t St_()NIA T City of Tigard �� 1 ,� e�1! _ r Ire■ 13125 SW Hall Blvd. Tigard,OR 9 Plan Review Phone: 503.718.2439 Fax: 503.59 .1960 o1C3 oate/(i Inspection Lane: 03.639.4175 t, rC, 3 2 Ready nateBy: ® see Page 2 for I 1 ri 1 It 1, Irilernet: www,tlgHJd or.glry V�v Notified/Method: _ _ Supplemental Information 0 New construction ❑Addition/alteratlt t 1<� 0 n�1 N Please check all that apply(submit 2 sets of plans w/items checked): k �V" 1 D Service or feeder 400 amps or more ❑Building over three stories. 0 Demolition ®Other:ExiSitn_ 4 ,1 where the available fault current ❑Marinas and boatyards. a ;;R exceeds 10,000 amps et 150 volts or 0 Floating buildings- ❑ I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building fij' IeSt to ground,or exceeds 14,000 0 Commercial-ase agricultural amps for all other installations. buildiog3- El Multi-family 1©Master builder ❑Other: 0 Fire pump. ID Installation of 150 KVA orw s 3 a` ❑Emergency system. larger separately derived � q c„,t. s'° :- _ . ._. _. .. - .. .wre t .......e -- - oad f Job#: Job site address:7709 SW PFAFFLE STREET ❑Addition of new motor t o "A1em. CI or more. " ",'1r""1-2" "1-3'• City/State/ZIP:TIGARD,OR 97223 O Six or more residential units. occupancy. ❑Health-care facilities- ❑RccreatMaal vehicle parks- Suite/bldg./apt.#:20lt Project name:HAWTHORNE VILLA ID Hazardous locations. 0 Supply voltage for more than ` ❑Service or feeder 600 Ain.s or more. 600 volts nominal. Cross street/directions to job site: nereopeoa Q17. Each Total • New residential single-or multi-family dwelling will. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.R.or less 16834 4 •"5 x <_.�. .g,,, 1: Limited energy,residents!Ea ad portion 33 92 1 x;":� . „- ,. - �. gy tial 7500 2 Re-inspect electrical panel for new service (with above so.R_) i , Limited energy,multi-family 75.00 2 residential(with abt*e sq.ft.) t�;x;�' 4 .t »- �`'; k Renewable Enerp' [� See Page 2 mss$§sw:',... • -_ .--. .. .t .1,::: -4'....-;''''',f---4,:..rw...:::.,,i.. ii,i --_-�..x„z:�. x94?` Services or feeders installation;alteration,and/or relocation T Name:Henry Louie 200 amps or less j 100.70 2 Address:7705 SW Mille street 201 amps to 400 amps 133.56 _2 401 amps to 600 amps 'i 200.34 2 v City/State/ZIP:Tigard,OR 9`/223 601 amps to 1,000 amps 301.04 2 Phone:(503)6398158 Fax:(503)6242770 — Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.361 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 166.54 2 4+x;��•rrs x " r"""' n ""'* "°"N", � 'W"s' Branch circuits-new,alteration,Or extension, er panel _.„ - ., . .. :,'.."1,..-1,_-...J:.'-',', „` ,-,---4.---7:-: .•..E. ..-< .'""h: `,7:-'" - A.Fee for branch circuits with Business name:Hawthorne Villa above service or feeder fee, 7.42 2 each branch circuit Contact name:Alex Taylor B.Fee for branch circuits without Address:7705 SW PFAFFLE STREET service or feeder fee;first 56.18 2 branch circuit 1 City/State/ZIP:TIGARD,OR 97223 Each add'I branch circuit 7.42 2 Miscellaneous(serviee or feeder not included) Phone:(503)6398158 Fax::(503)6242770 Each manufactured or Modular .. 6784 2 dwelling,service and/or feeder Email Itawthorttevilla@easCede management.com Rcconow only I .• ..,-;,-;-,...2.?.., ,_. ---;/,', w . 67.84 Co'? +�r ,, 2 .;., c ::::•':--', v - z _ ''>x,xE. x�i ¢ 'r "sew ".. P .� a ,a ,. .,bsrc _E, .: x-.s; rump or irrigation circle 67.84 2 Business name: Sign or outline lighting; 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel.alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone;( ) Fax:( ) Investigation(1 ht min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90,00/hr Electrical Lic.: s• cficall listed vz hr mm Suprv.Electrician signature,required: Subtotal: � Print name: Date: 0 Plan Review Retiulred`25%of Permit fee)_ — State surcharge(12%of permit fee): f.!y Authorized signature: TOTAL PERMIT FEE: 7S -- - This permit application expires if a permit Is not obtained within 180 Print name: Alexander Taylor Date; 12-1-2015 days artsr it bas been accepted as complete. ' Number of inspections allowed per permit 1:MuUdioeWermas\ErCPeretzApp�U�EPERoc Rev 7f2015 440-46151111/03/COM/WEB1 DEC-03-2015 16:43 From:HUI-Scanner 5036242770 To:5035981960 Page:2'2 -Elect; cal Permit Application—City of Tigard Page 2—Supplemental information Limited Energy Permit Fees: Renewable Energy Permit Fees: i ..,. ;°. e"'..: ) Z,.r.Yel..;a.7 x F.. _._�r.i•_rYsNa .Ya�.,iL� .. ., w,i c.,P. 7�',.Y-"'i: Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 13 Check Type of Work Involved: 5 kva or less 100.70 5.01 to 15 kva III 133,56 _13 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 El Wind_eneration s stems in excess of 25 kva: 0 Burglar Alarm 25.01 to 50 kva IN 301.04 ■o© ❑ Garage Door Opener' 50.01 to 100 kva _© >100 kva AR in -309- 040 -E _® with OAR 916-309-0040 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: Systems Each additional kva over 25 IIII 7.42 �© ❑ Vacuum Systems* >100 kva-no additional charge 0.0 _© Each additional ins r ection over allowable in a of the above: ❑ Other: Each additional inspection is ■11:121_� char,ed at an hourl 1 hr nun Inspections for which no fee is ■ 90-00/hr .111111 s.ecificail listed hr min :, ...n,.,. t• -g Nw ya"_yyo,"y'ry�.- Subtotal(Enter ou Page 1 ; MOM Fee for each commercial system: $75.00 • (SEE OAR 918-309-0000) Number of inspections allowed per permit Check Type of Work Involved: ❑ Audio and Stereo'Systems ❑ Boiler Controls 0 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 i:\auitainetesn:b7..51er.CJerwElApp_tLR.ERE.eoc Rev 05/172015 DEC-02-2015 13:50 From:HVI-Scanner 5036242770 To:5035981960 Pa9e:1'3 1111111 Form 1112(tl107) i • Cascade Management,Inc Real Estate Management Services Attention: Brandon ELECTRICAL PERMIT APPLICATION From: Hawthorne Villa Re: Electrical inspection for tenant without electricity Cr Cascade Management,Inc.,does not discriminate on the basis of handicapped status in the 60 admission or access to,or treatment or employment in,its programs and activities. Page 1 of 1