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Permit CITY OF TIGARD ELECTRICAL PERMIT ' a . COMMUNITY DEVELOPMENT Permit#: ELC2016-00231 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/25/2016 TIGARD 9 Parcel: 2S102AD03000 Jurisdiction: Tigard Site address: 12850 SW ASH AVE Project: Burnham&Ash Apartments Subdivision: BURNHAM TRACT Lot: 5 Project Description: Building 1 -Electrical for new multifamily building. Contractor: BEAR ELECTRIC Owner: PREMIUM PROPERTY-TIGARD LLC PO BOX 389 1015 NW 11TH AVE., STE 243 DONALD, OR 97020 PORTLAND, OR 97209 PHONE: 503-678-1355 PHONE: 503-226-1972 FAX: 503-678-1108 FEES • Quantity Description Date Amount 1 ea Services or Feeders-200 05/25/2016 $100.70 Specifics: amps or less 3 ea Services or Feeders-201 to 05/25/2016 $400.68 Type of Use: MF 400 amps Class of Work: ALT 5 ea Services or Feeders-601 to 05/25/2016 $1,505.20 1000 amps Type of Const: VA 1 ea Services or Feeders-Over 05/25/2016 $552.26 Occupancy Grp: R-2 1000 amps or volts 86 crt Branch Circuits w/Purchase 05/25/2016 $638.12 Service or Feeder 1 ea Plan Review Electricial 05/25/2016 $799.24 1 ea 12%State Surcharge- 05/25/2016 $383.64 Electrical 14172 Electrical Permit 05/25/2016 $14,172.20 3543 Plan Review-Electrical 05/25/2016 $3,543.05 Total $23,795.75 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. 7; _ - are set forth in OAR 952-001-0010 through 952-001-0090. You ma obtain a •py o = ules or direct questions to OUNC by calling 503.232.19871.8'•332.234'. Issued By: I)411...--. ..... Permittee Signature: � A4 A 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: 1 I 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 cOliNN" l:0I2Or11( 1 I St ()NIA CityOf Tigard Received g tate ny 3 6 f t'ctittut No., r_ `., 01 _0::):23 41:,.• IN ■ 13125 SW hall Blvd Tigard,OR 972 YYY ^ 1 PI m Review ) / ■ Phone: 503.718.2439 Fax: 503.598.1960 t) k ,0 tate sty: /S/� `,4 Other Permit: 81,(10,201;--__0,0t5 T I e; a[i inspection Line: 503.639.4175 MP� P �to Readwt3v. �/ ,) }ms ® See Page 2 for Internet: wwss.tiaard-or.gov �` ��� ov. 4{eth(d:5//4 i r ' 4. Supplemental Information N ' • TYPE `WO .,,s,„ ,01/2" .a. � &4"(( W{ ..-PLA* �i r�: New construction ❑Addition/alteration/ree U`"lt �of Please check all that apply(submit 2 sets of plans N ttemv checked below) ,- , v TO Service as feeder 400 amps or more gg Building over three stones. 0 Demolition 0 Other: where the available fault currentMarinas V 0 an sac and boatyards. ' CATEGORY OF CONSTRDETION exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14.000 ❑Commercial-use agricultural o i-and 2-family dwelling 0 Commercial/industrial 0 Accessory building mops for all other installations buildings. Multi-family 0 Master builder 0 Other: 0 Fire lxtmp. 0 Installation of 75 KVA or a ❑Emergency system. larger separately derived system. SITE INFORIiIATION AND LO ❑Additionofnevvmotor load of ❑`A . 1." -I-2", 1-3", 1001iP or mon;. oceupancy Job no.: Job site address: / 8'56 /�1 ( ,/ J �G t V�i dzi Six or more residential units. ❑Recreational vehicle parks City/State/ZIP: /k , C a a3 ❑ilcalds-care facilities 0 Supply voltage for more than 0 li varduus locations 600 volts nominal. Suinelhldg/apt.no.:44 / I Project name: eU R��1 Aytp �f fip, � �Seg vice m feeder 600 amps or more. FEE SCHEDULE i :Cross street/directions to job site: t meriprfon Ory. Fre. i 'total New residential single-or multi-family dwelling unit. ���Q�II q- � ) iJ'P - Includes attached garage. Subdivision: Lot no.: Largest Unit Size I68 S 4 DESCRIPTtoJ1l-t?P WORiC Each Additional at Half 84.26 I / 202.46 ,3Da'4( Tax map/parcel no.: Flirt unit over 1,000 Sq.Ft. 1� , i - kys _ Nei - ,) M RLTx— ) - 14 M ILy Ott 1 L J�11-1 Each Additional over 1,000 Sq.Ft. at Half J3� 101.23 /3 9(�1,i10. k.•l Services or feeders installation,alteration,and/or relocation 200 amps or less / 10070 /ex,70 2 '�' 'i ' � O"W ' © TENANT 201 amps to 400 amps 3 133.56 1/602 401 amps to 600 amps 200 34 2 1 Name: out amps to 1.(1(10 amps �' 3()I 04 �f�� Address: Over I. 00 amps or volts / 552 26 - .d 2 C — Temporary services or feeders installation,alteration,and/or 2 t SS ', = 1 City/State/ZIP: relocation Phone:( ) Fax:( ) 2(81 amps or less 59 36 I 201 amps to 41X3 amps 125 08 2 Owner installation:This installation is being made on property that I own which is not ti intended for sale,lease.rent.or exchange,according to ORS 447.449,670,and 701. 401 amps to 599 amps 168 54 - Branch circuits-new,alteration,or extension,per panel Owner Signature: Date: A.Fee for branch circuits with jci APPLICANT 0 CONTACT PERSON above service or feeder fee, 7.42 each branch circuit et, �3_id_ 2 i It Business name: B41 Fee for branch circuits 1171110711 service or feeder fie.first 56.18 2 Contact name: branch circuit t:. ------1 Each add'f branch circuit 7 42 'S i Address: Miscellaneous(service or feeder not included) Each manufactured or modular City/State/ZIP: dwelling.service and/or feeder 67 84 2 i,j Phone:( ) Fav::( ) Reconnect only 67.84 2 Pump or inigation circle 67 84 2 E-mail: Sign or outline lighting 67 84 2 CONTRACTOR Signal circuit(s)or limited-energy Business name:name: •�� l panel.alteration,or extension. Page 2 2 ^ / '<!1� eCL_FiLi L / Each additional inspection over allowable in any of the above h Address: Pt, ez' ?G.e. Additional inspection(1 hr min) 66.25/hr • ' '\ L/ c?C> Investigation(1 hr min) 66.25/hr r City/State/ZIP:: �/)ti tLb O� /7d}z� Industrial plant(I hr min) 78.181 hr (sa3 ) Inspections for which no fee is +.: Phone:(313 ) (�5fs /,3SS Fax: r`e f-//4 specifically listed(:•z hr min) 90.00!hr CCB Lie.:0.6 gi 3 Electrical Lic.:a4i_ki7 C Suprv.Lic.:3-35----1 ELECTRICAL PERMIT Subtotal: Suprv.Electrician signature,required: e"."--- � / f. r_ i / Plan review(25%of permit fee):( y d 1 Print name: Etfitt 4 ,L i/ : State surcharge(12%of permit fee): c� Off%,36 - Authorized TOTAL.PI Rbdfr FEE: , 3 795. .5" Authorized signature: This permit applcationexpires Li; permit tc not obtato within 189 ['riot name: Date: days after it has beers accepted as complete. Number of inspections allowed per permit. 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