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Permit (187) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00050 » 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/25/2016 Parcel: 2S113AA00400 Jurisdiction: Tigard Site address: 16240 SW 72ND AVE B2 Project: Precision Packaging Subdivision: ROSEWOOD ACRE TRACTS Lot: C Project Description: (14)branch circuits for adding,disconnecting&moving equipment. Contractor: CL COOTS ELECTRIC Owner: PACIFIC REALTY ASSOCIATES 4909 DORRANCE ST NE ATTN: N PIVEN SALEM,OR 97305 15350 SE SEQUOIA PKWY#300 PORTLAND, OR 97224 PHONE: 503-910-8828 PHONE: 503-624-6300 FAX: 503-390-1029 FEES Quantity Description Date Amount 14 crt Branch Circuits wo/Purchase 01/25/2016 $152.64 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/25/2016 $18.32 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $170.96 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_gcQrdance 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. TENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notific n Center. Those rules are set forth in OAR 95 001-0010 through OAR'952- 1-0 0.�ou may obtain a copy of the rules or direct questions to OUNC by callin 03.232.1987 or 1 0.332. 344. 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: //5- LICENSE 5- 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 APPHC I , CI O Tigard Received Permit#: 13125 SW all Blvd.,Tigard,OR 3 + ): Date/By: : / �'S ALL L��s �� i Plan Review Phone: 503.718.2439 Fax: 503.5 K106 '' Date/By: Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov 1 °t a Notified/Method: Supplemental Information TY y PLAI"� REVIEW ❑NeW construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more [IBuilding over three stories. El Demolition Other: 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 dwellingCommercial/industrial E]Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or I llRWQW"TWN,AM JWCATIM, ❑Emergency system. larger separately derived Job#: Job Site address: ❑Addition of new motor load of system. ]OOHP or more. ❑"A","E","1-2","1-3", El Six or more residential units. occupancy. City/State/ZIP: 'Z � ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name. ❑Hazardous locations. [I Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE:SCHEDULE Descri tion Each I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.fi.or less 168.54 4 Tax map/parcel#: Ea.add'1500 sq.ft.or portion 33.92 1 IIIESLRIPTI0 OF WORK Limited energy,residential 75.00 2 /� (with above s .ft. p Limited energy,multi-family residential(with above sq.ft.) 75.00 2 5 u 6-, Renewable Energy ❑ See Page 2 PROPERTY l45i11E TEAIST` 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 20034 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 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 O APPLICANT { CONTACT I!! Branch circuits—new,alteration,or extension er panel A.Fee for branch circuits with Business name:C-t— above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: T service or feeder fee,first ' 56.18 c1 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 _ Miscellaneous service or feeder not included Phone:( 3 )C�1©-- Fax: :( ) Each manufactured or modular 67.84 2 Email: dwelling,service and/or feeder Reconnect only 67.84 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. E3 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 t Industrial plant(1 hr min) 78.18/hr Email: '11t� 10 t ►f0 Inspections for which no fee is CCB Lic.: tl Electrical Lic.: Suprv.Lic.: 1� Specifically listed %hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,require �— Subtotal: 5_2 Print name' Date:��_ ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): ' Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Y Date: 1—Z� days after it has been accepted as complete. (� * Number of inspections allowed per permit. S/'7,1) .T I:\Building\Permits,ELC PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I1i05/COM/WEB 1-V Electrical Permit Application-City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: Description Each Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 z 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: ❑ 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 ❑ 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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/�hr min) 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: ❑ 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 L\BuildingTermits,ELC_PermitApp_ELR_ERE.doc Rev 06,172015 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 16240 SW 72ND AVE B2, TIGARD, OR, 97224 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2016-00050 Jeff Grove Violation Summary: Inspector Contractor