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Permit (47)
CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT ; . Permit#: ELC2015-00617 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ` ' "` Date Issued: 08/05/2015 Parcel: 1S135BD01300 Wrnifin Jurisdiction: Tigard Site address: 10830 SW GREENBURG RD Project: Washington Square Motel Subdivision: MEADOW VIEW Lot: 8 Project Description: Alt 32 ckts.in 32 rooms as per new lay out(3rd&4th floors only).8/8/16 REPRINTED to add 30 additional branch circuits for 1st&2nd floors. 12/28/17: REPRINTED permit to add(15)branch circuits. Contractor: BRIGHT STAR ELECTRIC COMPANY Owner: SCHAEFER, ROBERT M&SALLY J& 3143 SW 22ND ST MILLER, GERALD V GRESHAM, OR 97080 BY SHILO INN-WASHINGTON SQUARE 11600 SW SHILO LN PORTLAND, OR 97225 PHONE: 971-998-8459 PHONE: FAX: 503-907-9809 FEES Quantity Description Date Amount 32 crt Branch Circuits wo/Purchase 08/05/2015 $286.20 Specifics: Service or Feeder 1 ea 12%State Surcharge- 08/05/2015 $34.34 Type of Use: COM Electrical Class of Work: ALT 1 ea Investigation Fee 04/04/2016 $90.00 Type of Const: 1 ea Investigation 12%State 04/04/2016 $10.80 Surcharge Occupancy Grp: 30 crt Branch Circuits w/Purchase 08/08/2016 $222.60 Service or Feeder 45 Misc Administration Fee 08/08/2016 $45.00 0 ea 12%State Surcharge- 08/08/2016 $26.72 Electrical 15 crt Branch Circuits w/Purchase 12/28/2017 $111.30 Service or Feeder 0 ea 12%State Surcharge- 12/28/2017 $13.35 Electrical Total $840.31 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 OAR 952-001-0090. 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: ,..r- Issued �� o--- Fermittee Signature: �‘-' y2511' E1 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: 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 .Al) Received 45, City of Tigard x o _ Date/By: I� l7 Permit#: e G) do 617 • 13125 SW Hall Blvd.,Tigard,OR 9722 -'� Plan Review /�.���.. = Phone: 503.718.2439 Fax: 503.598.19 4 Date/By: Related Permit#: 1!I4t" l] �r,1 d 7 Inspection Line: 503.639.4175 aN'?` Ready Date/By: Ju-rris^: gi See Page 2 for z T I G A R D tified Method: / y/,-, Supplemental Information Internet: www.tigard-or.gov v TYPE OF WORK 1 9,rye-�c-1 PLAN REVIEW 0 New construction (�Addition/alteration/re ` ien .,c �}, R41 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 CONSTRUi exceeds 10,000 amps at 150 volts or 0 Floating buildings. less to ground,or exceeds 14,000 0 Commercial-use agricultural 0 1-and 2-family dwellingCommercial/industrial 0 Accessory building 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 ❑Addition of new motor load of system. Job#: Job site address: /0 g b' Ls' 100HP or more. ❑"A","E">"l-z","l-3", 0 Six or more residential units. occupancy. City/State/ZIP: r�/ ,,,,e, c; 7 o Health-care facilities. 0 Recreational vehicle parks. Si ray 0 Hazardous locations. 0 Supply voltage for more than Suite/bldg./apt.#: Project name:,/ ❑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 * jolt ` New residential single-or multi-family dwelling unit. Subdivision: ..iftl,' • _ Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 gen& �L/41,47- 1�r// (with above sq.ft.) L/4L/41,47- 1 45P itti4ELimited energy,multi-family 75.00 2 ' e_ residential(with above sq.ft.) ;0/9W /CY Renewable Energy ❑ See Page 2 PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps ` 133.56 2 Address: 8SW SiZ �// �Q.�tv- 401 amps to 600 amps 200.34 2 t2 City/State/ZIP: //5r,70,4 ©' 47 7O 70 601 amps to 1,000 amps 301.04 2 Phon )7 ^�'�2.2„... 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 Branch circuits—new,alteration,or extension,per p tel ,g APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: /e`17/)-C.te, T'KPS,"C. )i-s" ._) above service or feeder fee, 7.42 2 each branch circuit Contact name: 1,---L-7„...". 4. rf�Lip/Z0( B.Fee for branch circuits without service or feeder fee,first 56.18 12 Address: / ` Ai- ,/ /Zfr. branch circuit l_ City/State/ZIP: 1, ra...07 A dje-- g-76_36 Each add'I branccircuit i 7.42 t 1 7- 2 Miscellaneous(service or feeder not included) Phone:(C57723 57 2.... V57 5 57 Fax: :( ) Each manufactured or modular 67.84 2 ��jLf dwelling,service and/or feeder Email: �p� ham r aia V .5%eco404- Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 8y'j Ai.. 8-7freik ele,..e,40.,6 Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address: „3 cS� A.�� panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: 64,11,901 op /t i7J, Additional inspection(1 hr min) 66.25/hr �` _ Phone:(91 /) 5,I$ $ F.x:( ) Investigation(1 hr min) 90.00/hr / Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: ( 05,./;,/(0 El ctrica Lic. O prv. ic.: �3 specifically listed(''/Z hr min) ELECTRICAL PERMIT FEES _ Suprv.Electrician signature,req red: I Subtotal: I 1 l,,JO Print name: 6 -of__ Date: 12,. Z.$ '70 Plan Review Required(25%of permit fee): _ State surcharge(12%of permit fee): , ,3 r 6 _ TOTAL PERMIT FEE: � - Authorized signature: idic This permit application expires if a permit is not o arned within 180 Print name: Date: 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: ., F'EE SCHEDULE Fee for all residential systems combined: $75.00 Description I Qty. I Each ( Total I * Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 H Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: H Burglar Alarm 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 ❑ Vacuum Systems* I >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(%2 hr min) Ol MEtiC 'WORK+( . " ,ELE T1 Ak 'ERMIT>FEFS Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems H Boiler Controls H Clock Systems Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems H Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 CITY OF TIGARD i ;. ELECTRICAL PERMIT 11111 COMMUNITY DEVELOPMENT j6 Permit#: ELC2015 00617 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2015 Parcel: 1 S 135BD01300 Jurisdiction: Tigard Site address: 10830 SW GREENBURG RD Project: Washington Square Motel Subdivision: MEADOW VIEW Lot: 8 Project Description: Alt 32 ckts.in 32 rooms as per new lay out(3rd&4th floors only).8/8/16 REPRINTED to add 30 additional branch circuits for 1st&2nd floors. Contractor: PARAMOUNT ELECTRIC CO Owner: SCHAEFER, ROBERT M&SALLY J& 39085 PIONEER BLVD STE#203 MILLER, GERALD V SANDY, OR 97055 BY SHILO INN-WASHINGTON SQUARE 11600 SW SHILO LN PORTLAND, OR 97225 PHONE: 503-703-2571 PHONE: FAX: FEES Quantity Description Date Amount Specifics: 32 crt Branch Circuits wo/Purchase 08/05/2015 $286.20 Service or Feeder 1 ea 12%State Surcharge- 08/05/2015 $34.34 Type of Use: COM Electrical Class of Work: ALT 1 ea Investigation Fee 04/04/2016 $90.00 Type of Const: 1 ea Investigation 12%State 04/04/2016 $10.80 Occupancy Grp: Surcharge 30 crt Branch Circuits w/Purchase 08/08/2016 $222.60 Service or Feeder 45 Misc Administration Fee 08/08/2016 $45.00 0 ea 12%State Surcharge- 08/08/2016 $26.72 Electrical Total $715.66 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 acc 'th 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. ATT ION: Oregon aw r ou to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0 10 through OAR 952- 1-0090( Y. ay obtain a copy of the rules or direct questions to OUNC by calling 3 .1987 or 1.800.332.2344. Issue By: d\-... / Permittee SignaturC p eiLif 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. 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 10830 SW GREENBURG RD, TIGARD, OR, 97223 Commercial - Electrical 120 Electrical rough-in FAIL ELC2015-00617 Herb Stabenow Contractor failed to meet -will recall the inspection Violation Summary: Inspector Contractor City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10830 SW GREENBURG RD, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2015-00617 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor