Permit CITY OF TIGARD ELECTRICAL PERMIT
:1 a COMMUNITY DEVELOPMENT Permit#: ELC2016-00297
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/12/2016
I c ,�u.[� g Parcel: 2S110DCO2200
Jurisdiction: Tigard
Site address: 15660 SW PACIFIC HWY A-5
Project: New Sound Subdivision: 1997-016 PARTITION PLAT Lot: 2
Project Description: (10)branch circuits for TI.
Contractor: NORTH RIVER ELECTRICAL CONSTRUCTION Owner: ROIC OREGON LLC
PO BOX 780 ATTN: SCHOEBEL, RICHARD
BORING, OR 97009 8905 TOWN CENTRE DR, STE 108
SAN DIEGO, CA 92122
PHONE: 503-658-1911 PHONE.
FAX: 503-658-8783
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo/Purchase 04/12/2016 $122.96
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/12/2016 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes nd all of r ppf -ble -w. 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 wor is us.ended •r more the 180
days. ATTENTION: Oregon law requires you to follow the rules_.adopted by the Oregon Utility Notification Ce er. T se ul>- are se forth in OAR
952-001-0010 through OAR 952-001-0090. You •- •• -'n a co of the rules or dr-• questions to OUNC by calling 503.232.19 7 or 1.8 .33 .23 4.
Issued By: Permi •.ture:
.49
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 . ' '`� FOR oi•i•l( 1, i si. 0.1.v
City of Tigard '\� Received /i iri 41'
�� Date/B : '( /LP ' �_/
;� 13125 SW Hall Blvd.,Tigard,OR 0� ���
Phone: 503.718.2439 Fax: 503.548.1960 ( 1 �•n'� B, Related Permit it I, , b` ' ` „-
Inspection Line: 503.639.4175 ., ,4; Sr Ready Date/By: See Page 2 for
I It I:1> Internet: www.tigard-or.gov 1j� �� Notified/Method: -, Supplemental Information
TYPE OF WORfCr � ► PLAN REVIEW
0 New construction Addition/alteration/ ment Please check all that apply(submit 2 sets of plans w/items checked):
J 0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
CATE Y OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground.or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job Site address: / / (.11.-/z,
0 Addition of new motor load of system.
J `
S � p2__/.!_s"-- jure� e_ �,,/z., 100HP or more. ❑..A.,..E.....1_z..,..l_;"",
City/State/ZIP: r -ti / 0 Six or more residential units. occupancy.
�7 [_ '
/ � �� / 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 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 sqftor portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
���
) (with above sq.ft.) 75.00 2
l 0 5r-7/AMA G re-4,tiS .— i.'' • Limited energy,multi-family
residential(with above sq.11.) 75.00 2
0 PROPERTY OWNER 0 TENANT Renewable Energy ❑ See Page 2
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 200.34 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
0 APPLICANT 0 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
service or feeder fee,first 56.18 /li Ai/ 2
Address: branch circuit /
Each add'I branch circuit 7.42 4- LJ 2
City/State/ZIP: .�
Miscellaneous(service or feeder not included)
Phone: ( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: f VGA k., „,-i Sign or outline lighting 67.84 2
n p /� � panel,alteration,or extension.Signal circuit(s)or limited-energy'
Address: (!� 0 See Page 2 2
i �x �
City/State/ZIP: ���� Each additional inspection over allowable in any of the above
G'-^'� ` Additional inspection(1 hr min) 66.25/hr
Phone:(___&-y3) _/'3'/2 Fax:(5 ) (..'g- -S764) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: /-4 /i „...„:„...,_4e___, ,;,ti Git `^ _,- • C p.--` Inspections for which no fee is
90.00/hr
CCB Lie.: J33e/�3Electrical Lie.: �— jt'G Suprv. Lic.:s��/ specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: ] 7,_..) 1Q/t !b Subtotal: L.:2 3 `i"
Print name: �"2_ Date: Ll' 7f, / 0 Plan Review Required(25%of permit fee):
J State surcharge(12%of permit fee): / -,
TOTAL PERMIT FEE: ^
Authorized signature: �r ��
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 El C PermitApp F.LR_ERE.doe Ree 06 17'_015 410-4615T(1105 COM WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
7;OSIDESIIA.W ONLY: : . tilE,SCHEPVL
Description I Qh. I Each I Total 1
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:
❑ 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
with OAR 918-309-0040) 552.26 2
❑ 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* >100kva—noadditional 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 nin)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 allowe Subtotal(Enter on Page 1)-
(SEE OAR 91 8-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
n Clock Systems
ri D• ata Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n M• edical
n Nurse Calls
n Outdoor Landscape Lighting*
n P• rotective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I Building Permits I t.C_PermitApp ELR_ERIdoc Rec 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
15660 SW PACIFIC HWY A-5, TIGARD, OR,
97224
Commercial - Electrical
199 Electrical final
FAIL
ELC2016-00297
Herb Stabenow
No power several areas-not ready
Violation Summary:
Inspector Contractor
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
15660 SW PACIFIC HWY A-5, TIGARD, OR,
97224
Commercial - Electrical
125 Wall cover
PASS
ELC2016-00297
Jeff Grove
Violation Summary:
Inspector Contractor