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Permit iiires CITY OF TIGARD ELECTRICAL PERMIT 1 'a- COMMUNITY DEVELOPMENT Permit#: ELC2015-00964 •,y Date Issued: 12/08/2015 TIGARL? 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S136CA90000 Jurisdiction: Tigard Site address: 10900 SW 76TH PL 53 Project: SAGE EQUITIES LLC Subdivision:GARD WOODS,A CONDO COMMUNI1 Lot: Project Description: Reconnect only. Contractor: Owner: SAGE EQUITIES LLC 2075 SW 1ST AVE SUITE 2E PORTLAND, OR 97201 PHONE: 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 $75.98 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 Ce - . Ti.se ru s are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may ob< a copy-8'hthe rules or direct questions to OUNC by calling 503.23 9' 0 800..3 3,4. Issued By: T� f � Permittee Signature: 7 0• 401111/ 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 ,A - FOR OFFICE USE ONLY ' , City of Tigard e Received , Date/B 1 _ �� r '� 13125 SW Hall Blvd.,Tigard,OR 9722 015 Plan Review Q Date/13 Related Permit N: Phone: 503.718.2439 Fax: 503.598.1960 DEC O Inspection Line: 503.639.4175 �/; Ready Date/By: ® See Page 2 for TIGARD_ ��++ FM= Internet: www.tigard-or.gov ��� O���V`1' �0�� tified/Method: Supplemental Information TYPE OF WO i�,���1V PLAN REVIEW ❑ New construction ❑Addition/a terati replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. I=1 Demolition Other: at rt�.e(r✓z CfL where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling D Commercial/industrial I=1Accessory building less to ground,or exceeds 14.000 ❑Commercial-use agricultural amps for all other installations. buildings. 1=1 Multi-family ❑Master builder Other: e Obi c,D 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived /` / / 0 Addition of new motor load of system. Job#: Job site address: / ( ©%0Q 4(N —7 d, pi 2i`3 100HPormore. ❑"A. .E-, ..I 2.. ..I 3.. `--- 0 Six or more residential units. occupancy. City/State/ZIP: / 14' D ' 97 2 2. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 5—L7 Project name: 7�5' $4 4(,/, 6 Ws 0 Hazardous locations. 0 Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qtr. 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 I DESCRIPTION OF WORK n Limited energy,residential 75.00 2 jj (with above sq.ft.) C�-ccpP:icof t� e_ S l S L�- 75.00 2 Y Limited energy,multi-family residential(with above sq.fl.) Renewable Energy 0 See Page 2 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: age u ti(e5 Z-LC---- 200 amps or less 100.70 2 Address: pL p 7,5- (. l S7L �'T�/'e- �i� 201 amps to 400 amps 133.56 2 � / , am401 amps to 1600 amps200.3412 City/State/ZIP: Pp— YT4 (a UK 9'7� 601 amps to 1,000 amps 301.04 2 Phone: 6j63) R2.7_ 0 4 a 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 0 APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: �a�,�p 45 above service or feeder fee, 7 42 2 Cj each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: 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 67.84 2 Email: dwelling,service and/or feeder Reconnect only I 67.84 6 7 D ir 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. 0 See Page 2 2 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 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv. Lie.: specifically listed('h hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: 67- $L7 Print name: Date: 0 Plan Review Required(25%of permit fee): �� ��� r State surcharge(12%of permit fee): 6',,i Li Authorized signat ���///((( TOTAL PERMIT FEE: , g / / ' / .,__. This permit application expires if a permit is not obtained within 180 Print name: GZ LAW Date:! // days after it has been accepted as complete. CC * Number of inspections allowed per permit. 1:\Building\Penmts\ELC_PermitApp_ELR_EREdoc Rev 06/17/2015 440-4615T(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 Description I Qty. I Each I Total I * Fee for all residential systems combined: $75.00 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: pi Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 n Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n 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('A hr min) • COMMERCIAL_WORK ONLY' • ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: _ $75.00 Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* I I Medical n Nurse Calls PI Outdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:ABuddingVPermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 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 10900 SW 76TH PL 53, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2015-00964 Jeff Grove Violation Summary: Inspector Contractor