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Permit (114) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00012 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/11/2016 Parcel: 2S110AD90021 Jurisdiction: Tigard Site address: 14868 SW 109TH AVE Project: PINNACLE PROPERTY MANAGEMENT COMPANY Subdivision: CANTERBURY WOODS CONDO Lot: 21 Project Description: Reconnect only. Contractor: Owner: PINNACLE PROPERTY MANAGEMENT COMPAN 17692 NW GILBERT LN PORTLAND, OR 97229 PHONE: PHONE: FAX FEES Quantity Description Date Amount Specifics: 1 ea Reconnect Only 01/11/2016 $67.84 1 ea 12%State Surcharge- 01/11/2016 $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 180d ys 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. Tho a rules ar set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain epya he rules or direct questions to OUNC by calling 2.19870 r B044 Issued By: `_ 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 dale. This permit card shall be kept in a conspicuous place on lho job site until completion of the projoet. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application rCWCX'By d City of Tigard ennit#: `L� - I • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax 503.598. ` 1960 VO Date By, Related Permit#. Inspection Line: 503.639.4175 G�w Ready Dore By: tars: 0 See Page 2 for Internet: www.tigard-or.gov Notified Method: Supplemental Information TYPE OF ORK ict 1j PLAN REVIEW ❑New construction ❑Addition/alteratio aeeme w? Please check all that apply(submit I sets of plans x'ilems checked): ��N© ❑Service or feeder 400 amps or more E]Building over three stories. El Demolition El other: O V_ where the available fault current ❑Marinas and boatyards. CATEGORY OF CON exceeds 10.000 amps at 150 volts or ❑Floating buildings. ❑ I-and 2-family dwelling (Z Commercial/q1 s nal ❑Accessory building less to ground,or exceeds 14,000 ❑Comme cell-use agricultural amps for all other installations. buildings. Multi-family El Master builder E]Other: ❑fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATI� l- FOGNAND LOCATION ❑1 mergency system. larger separately denied #: Job stte address: IV(De, I " ❑Addition of new motor load of system. Job 1 w TJ '� I IIOHY or more ❑"A.. .,I'.. ..1.2.. ..l 1.. []Six onnorcre,idential units. occupancy. City/State/ZIP: T1 1�2 1!p O a"L 72 ❑Recreational vehicle arks. ❑Ileallh-care facilities. P Suite/bldg./apt.#: Project name: ❑Ba/mdous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps mature 600 sols nominal. Cross street/directions tojob site: FEE SCHEDULE Nice it.. 1 011. 1 EarM1 I Total n�'' n New residential single-or multi-family dwelling unit. Subdivision: � (�' x 60120 Lot#: Includes attached garage. 1.000 sq.It.or less 165.54 4 Tax map/parcel#: Iia.add1 500 sq.It.or Portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.A.) 75.0(1 _ C/ Limited energy,multi-family 75.00 residential(with atxwe. .0.) Renewable Encro ❑ See Pa c 2 M4ROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: *.Ii? vi� -iI�IWACix, 200 amps or less 100.70 _ Addres' � 0- i/�� W � 4 �� 01 amps to 400 amps 133.56 _ 401 amps l0 600 amps 200.34 City/State/ZIP: 'L-'7OaZ3 Z 601 amps to 1,000 amps 30L04 Phone: 75- - Q� Fax: ( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: �^ IILj 201 relocation Owner Installatlo : This installation is being made on perty that 1 own which is not 200 amps or less59.36 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 168.54 ANT IROZONTACT PERSON Branch circuits-new alteration,or extensionper panel A.Fee for branch circuits with Business name: 1p;i "Com /jj ,{ L alutveseniccorfeeder fee, each branch circuit T42 _ Contact name: 7nA-t-Lil 9kVlj2 _'M*fW B. Pee for branch circuits without service or feeder lee,first 56.18 9 Address: (� �- SD J/dJ L.fp� branch circuit - City/State/ZIP: L L l All1-Z 'f- Bach branch rcuit 7.4'_ _ _ Miscellaneous neous see rvice or feeder not included Phone: 17 5- — Fax: : (� ( ) Each manufadunxl or modular 67,84 2 _ dwelling,service and/or feeder Email: ��. IAA AA i Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 Business name: �,— Signor outline lighting 67.84 Signal curtails)or limited-energy See Page 2 "' Address: panel,alteration,or extension. g City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:( ) Fax: ( ) Investigation(I In mint Woo hr Email: Industrial plant(I In min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: scilicall listed 'G hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: Print name: Date: ❑Plan Review RcNuircd(25%ofpermit fee): State surcharge(12%of permit fee): Authorized signatu / TOTAL PERMIT FEE: q This permit application expires if a permit is not obtained within 180 Print name: Date: ' dans after it has been accepted as complete. ' Numberof'impeclmtu allowed per permit. R uuddine rermh.1:1 C Permi p 111 FRE&c Rec 06 17^_1115 440-4615Tt 11 05(OM WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees:g § y Renewable Energy Permit Fees: D mri tion t.. Each � Tornl Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 5.01 to 15 k,a 133.56 ❑ Audio and Stereo Systems* 15.01 to 25 kva zoa.34 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 2s,01 w 5o ,i 301.04 50.01 to 100 k, 552.26 2 ❑ Garage Door Opener* >100 k.a tree in accordance with OAR 918-309-0040) 552.6 ❑ Heating, Ventilation and Air Conditioning solar generation systems in excess of 25 kva: System* Inch additional kca nccr 25 7.42 3 ❑ Vacuum .Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: F-1 Other: Inch additional inspection is 66.25,hr I chargedat an hourh'0 hrmin) Inspections for schich no fee is 90.00 hr scificall=listed(SS hr mint 00MMMCIAL W0PWb Ti Y: +curl PER1Nn Fee for each commercials stem: $75.00 Subtotal(Enteron t, Page aggee I ): y • Nwnber of mspecnom allowed per pcnnn. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ 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.Building Panum 1=1 C PcnmiApp I IR ERE doer Rc%UG F 2015