The URL can be used to link to this page

Permit (29) CITY OF TIGARD ELECTRICAL PERMIT 111 q COMMUNITY DEVELOPMENT Permit#: ELC2016-00595 and OR 97223 503.718.2439 13125 SW Hall Blvd.,Ti Date Issued: 07/26/2016 T[( .h.R.Tj 9 Parcel: 1 S 135CB00100 Jurisdiction: Tigard Site address: 10130 SW NORTH DAKOTA ST Project: Koi Fusion Subdivision: None Lot: None Project Description: (3)branch circuits for TI. Contractor: CARRICK INC Owner: NATIONAL SAFETY COMPANY 4875 NW KAHNEETA DR 17010 SW WEIR RD PORTLAND, OR 97229 BEAVERTON, OR 97007 PHONE: 503-334-6005 PHONE: FAX: 503-645-8273 FEES Quantity Description Date Amount 3 crt Branch Circuits wo/Purchase 07/26/2016 $71.02 Specifics: Service or Feeder 1 ea 12%State Surcharge- 07/26/2016 $8.52 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 do in accordance wi 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 day ATTENTION: Oregon -w re..res you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 001-0010 through OAR 952-0a 1 490. Y.0 a/obtain a copy of th- ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. I sued By: / �' Permittee Signature: �`�✓vim 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: Aar/ 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 roR()FT i( ,. isl,0N1,1 City of Tigard - �� c,,,, Received -7 ill 13125 SW Hall Blvd.,Tigard 3 s � _< Date/B : /iiyinI � Permit#: �a 0�� J q C` _ Plan Review �' J Phone: 503.718.2439 Fax 5 3 9"60 q Date/B : Related Permit#: C''161t; .Y} . Inspection Line: 503.639.4175 ` q 6 `Za 1C3 Ready Date/By: ® See Page 2 for T I(;ARI) Internet: wµw tigard-or.gov �\J L D Notified/Method: sor,. Supplemental Information TYPE OF, I,1� `"°`0 M.1�,f1cA�Btl PLAN REVIEW 0 New construction111 Addition/a]fe b@hiellt Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 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 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: [<o i Job site address: ❑Addition of new motor load of system. ( 0 l 3 o 5 i v 1,, ,n Tri D41 Rl1Tta 100HP or more. ❑«A„ «E„ «l 2„ <`l-3", City/State/ZIP: r i Gii-►e_D o ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: t< 6,1 cu s 1 0 N 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea..add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential �n C) (with above sq.ft.) 75.00 2 - D a CA IQC-L,L(T`5 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 0 PROPERTY OWNER TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: 4.<01 ,Fus i O 1V 200 amps or less 100.70 2 Address: p io 5 _ 201 amps to 400 amps 133.56 2 1.0 1.7©2T-f-1 D- t<o 1 iq 401 amps to 600 amps 200.34 2 City/State/ZIP: Ti GicivaD d 601 amps to 1,000 amps 301.04 2 Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 a APPLICANT0 CONTACT PERSON C1Branch circuits-c new,alteration,or extension,per panel A.Fee for branch circuits with Business name: Cl_ft a 1 npl C 1�� above service or feeder fee, each branch circuit 7.42 2 Contact name: Les Lt IeF..Ct,K, B.Fee for branch circuits without Address: _ service or feeder fee,first e j i 4 l 5 f C, t F Nt� f�) P� branch circuit r 56.18 ' (r 6 2 City/State/ZIP: 06se T �D O o- p 7a. Each add'l branch circuit 2- 7.42 /0-71i 2 Phone:( Miscellaneous(service or feeder not included) 03) 3 34•(,o o 5 Fax: :( ) Each manufactured or modular Email: i.e I QQP {r i C �'Yl a dwelling,service and/or feeder 67.84 2 C co re) Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: i/Yl P GL 5 cL. b 60 Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. 0 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: ( ) ;1 r Investigation 1 hr min l g ( ) 90.00/hr Email: A V7 ,��1i Industrial plant(1 hr min) 78.18/hr �� 'j�1 l Inspections for which no fee is 90.00/hr CCB Lic.: (2,0 (6o c' }� Electrical Lic.: LI.(f 3L Suprv.Lic.: )a q. ,S' specifically listed(A hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: �/ 0,,,I,Subtotal: Print name: h U u (i ;,,: ► Date: -7 ..z 6,.,,, 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): r. 5-)- Authorized signature: ( TOTAL PERMIT FEE:I 74 This permit application expires if a permit is not obtained Ivithin1180 Print name: LES[_j; Cjiq>e ,0.-K Date: - 46../6, days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 ❑ Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in any of the above: riEach additional inspection is 66.25/hr 1 Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(V2 hr min) ELECTRICAL PERMIT 1FEE$ COMMERCIAL WORK ONLY: 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 n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PemtitApp_ELR_ERE.doe Rev 06/17/2015