Permit (20) CITY OF TIGARD ELECTRICAL PERMIT
Permit#: ELC2016-00295
111 I COMMUNITY DEVELOPMENT Date Issued: 04/11/2016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134BC00403
Jurisdiction: Tigard
Site address: 12505 SW NORTH DAKOTA ST
Project: Meadow Creek Apartments Subdivision: None Lot: None
Project Description: (1)branch circuit for swimming pool heater.
Contractor: P B ELECTRIC INC Owner: BEL PORTLAND HOLDINGS LLC
1108 SE DOGWOOD LN BY EATON VANCE MANAGEMENT
OAK GROVE, OR 97267 REIG DIRECTOR OF AASSET MANAGEME
2 INTERNATIONAL PL
BOSTON, MA 02110
PHONE:
PHONE: 503-936-5226(CELL)
FAX: 503-786-6005
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 04/11/2016 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/11/2016 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �`� 19-/)/°4 69-"r70/k/
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 603.639.4175 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 OFFI( L I L t)NI.v
EC E'V E D Received / j—. /� �j{�) p
Illi City of Tigard Dnie-By OA „1JC6I I Permit e'G[1t,.�/f�-e0,02 /
`" 13125 SW Hall Blvd.,Tigard,OR 97223APR 1 1 2016
Phone: 563 718.2439 Fax: 503.598.19 1 Plan Review
TIGARD Inspection Line: 503 639.4175 uta liy
Related Permit 4
CITY OF Related
Internet: vvwwtigard-or.00v
BUILDING DIVISION R
eat)ate'[3y liars .t See Page 2fur
N tiftvd.'Method. Supplemental Information
-c
TYPE OF WORE Business name. etc J ` ,yt C
.AddresS: IC.; , f �,
New construction "'Addit•ion/alterationtreplaccment I �`�' �C C> � /....,,r1
Demolition r�Othc r: )'� ( C!' Citv'Stata,l,lP: C
11
CATEGORY OF CONSTRUCTION Phone:I Fax:
I-and 2-familydwellingV.-Commercial/industrial Accessorybuildingph came.
s. . t
Multi-family Master builder Other:
CCR Lie.: RNLI `t"rn
Electrical Lie.:s.--q2 Si
JOB SITE INFORMATION AND LOCATION v
Suprv. Fit 'an stgnatu .required:
q CL//5
Job 4: Job site address: i 2,.0--tc : Av,ft/U 1 J ) `.
'(' f p t t L not name: eh l�t ee cl v— I�. 1)
City/State'/1P: 1 1 1�j cUY ) C.`'i.,. T7 Z�3 q "�
Suitetbld 'a n.#: J Project name: c r Authorized signal.. :
Cross street/directions to job site: ' Print name- eh �t� Int, -a/ U
PLAN REVIEW
Subdivision: ' I.ot 4:
Please check all that apply(submit 2.sets of plans wiitcros checked)-
]ax map;/parcel ri: Sen tee or feeder 400 amps or Building over three stories.
more Marinas and boatyards.
DESCRIPTION OF WORK where the available fault current Floating buildings.
xceeds 10,000 amps at I50 oohs Commercial Cue agricultural
ik?
r4' �y (11
� _ amps for ies,to all tothcr mstallahonst),or exceeds )0Installation of I SOKYA or
larger separately derived
2:2 „
/" J {( Jc Pity pump tun
L/ �/�� 4 �i1 f}1 1_r.-6.1.,t Emergencysystern
PROPERTY OWNER TENANT Addition of new motor load of occupancy.
_.... ._ .._. __.... _ .._.... .. _......_ ___. _.. _ __.._ ... ......_ - I00HP or more. Recreational vehicle parks
Natne: Six or more residential units Supply voltage for more than
I lealth-care facilities. 600 volts nominal.
Address: I-las3rdoas locations.
-. . _. _. ... .. _...... _ Set tree or feeder 600 amps or
Cil)'Staler/_I P: more.
Phone( ) Fax:f l FEE SCHEDULE
ocxripiion Qts. E:rri, Total "
Email:
New residential single-or multi-family dwelling unit.
Owner installation: this installation is being made on property that 1 ossn which is Includes attached gat'aRe_
not intended for sale.lease,rent.or exchange,according to ORS 447.449.670.and
701. 1,000 sq lior less 168.54 4
(honer signature: Date:
La.add-I 500 sq If or portion 33 92 1
',rout 1 aboveed ,residential 75.00
APPLICANT CONTACT PERSON l
Business name:1)C) � cLm)ited.ncrti},multi-faille
t X) residential(with above sq 75(X) 2
Contact name: D. ti.)
Address: I Renewable Energy See Page 2
City/State/ZIP: t tW e tt ''t"����� / Services or feeders installation,alteration,and/or relocation
Phone.(5-0.5�"( 1J f�ax: : ,...---0
V-' 7 0?,-&,,,;00,, 200 amps or fess. 100.70
`,� 201 amps to 400 nips 133 30 '
Email: t0 V e\e c , i v G ( C G� i.„„s , r 1�el
CONTRACTOR 401 amps to 600 amps 200.34 . 2
601 amps to 1,000 amps 301 04 ' 2
Over 1,000 amps or volts 552.20
'temporary services or feeders installation,alteration,and/or
relocation
200 amps or less 59_36
201 amps to 400 amps 125.08 2
401 amps to 599 amps 168 54 2
Branch circuits—new,alteration,or extension,per panel
A.Fee lir branch circuits with
above service or feeder the, �f
each branch circuit
742
It Fee for branch circuits
without service or feeder fee, / �)
first branch circuit 1 56 18 2
I/ach add'I branch circuit 7 42 2
Miscellaneous(service or feeder not included)
I ach manufactured or nodular
dwelling,service and/or feeder 67 84
Reconnect only 67.84 I
Pump or irrigation circle 67.84 2
Sian or outline lighting 67 84 2
Signal cireuits)or Iintited-
energy panel.alteration.or See Page 2 2
e?aensrort.
Lach additional inspection over allowable in any,of the
above
Additional inspection(I hr min) 66.251 hr
Investigation(1 hr mini 90,60;hr
Industrial plant(1 hr min) 78 18/hr
inspections for which no fee is •
specifically listed('/,hr min) 9000l hr
ELECTRICAL PERMIT FEES
Subtotal: 5-(p./
Plan Review Required(25`c of permit fee):
State surcharge(12%of permit fee): t 711
'1(11Al.
PERMIT FEd-
This permit application expires if a permit is of obtained within 181)days after it has been accepted as
complete.
Number of inspections.dluwed per permit.
ILOa Cs,o•z-)G(J)2i
. .
,
I )2, 0/ 57
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1108 SE DOGWOOD LANE
OAK GROVE, OREGON 97267
P . 5 3 . 9 6
FAX 303 186 . 60 C.,
CCB 8 5 8 9 6 FACSIMILE TRANSMITTAL, SHEET
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FAN NUMBER: ToTAL N.O. (.4 R.AR/JES INCLUDING V
COER:
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PHONE NUMBER: OUR PlIONE NUMBER:
(503)-786-6005 Office/ (503)936-5226 Philip
RE: -1, \ , i d• A _OUR FAX NUMBER:
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From: 04/08/2016 08:53 #041 P.001/002
FIVE STAR s(-,2 Atc,k
PLUMBERS
FACSIMILE TRANSMITTAL SHEET
TO: FROM:
Permitting Angela Strauss
COMPANY: DATE:
City of Tigard 04/08/16
FAX NUMBER- 'CCM:\L.NO.OF 1'AGI•;S INCLUDING(:OVER:
2
PHONE NUMBER. SENDER'S REEERENCI.NUMBER:
RI?: YOUR REFERENCE NUMBER:
Plumbing Permit
0 URGENT 0 FOR REVIEW 0 PLEASE: COMMENT 0 PLEASE REPLY 0 PLE SE RECYCLE
NOI lis;COMMENTS:
Please see attached plumbing permit applicatioin. We were hoping to schedule the inspection for
Monday but it seems your office is not open today. Can you please contact Sue Lass on Monday to
set up the inspection as I will be out of the office next week.
Thank you!
Contact Info:
Ph: 503-550-9882
Email: sue.m.lassc gmail.com
P.O. Box 28,Banks,OR 97106 * Phone: (503)324-0717, Fax(503) 324-0883 * CCB# 169703
LICENSED • BONDED • INSURED