Permit (52) CITY OF TIGARD ELECTRICAL PERMIT
P :f' COMMUNITY DEVELOPMENT Permit#: ELC2016 00791
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/11/2016
Parcel: 2S 101 AB02703
Jurisdiction: Tigard
Site address: 7450 SW BEVELAND RD 100
Project: Ameriprise Finacial Services Subdivision: HERMOSO PARK Lot: 27
Project Description: (3)branch circuits for TI.
Contractor: R C COSTELLO ELECTRICAL CONT INC Owner: MCCAFFERY FAMILY TRUST
PO BOX 336 7450 SW BEVELAND RD, STE 100
AURORA, OR 97002 TIGARD, OR 97223
PHONE: 503-982-7400 PHONE:
FAX: 503-982-7400
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 10/11/2016 $71.02
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/11/2016 $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 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 ado•ted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You nay obtain a cop - -rules or dir=ct questions to OUNC by calling 503.2 or 0.332.2344.
Issued By: �_ Permittee Signature: —. C .-..)N.,
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 101i 01.Fl( F. l SF. OMl.v
City of Tigard ' ' Date/Bed 1 e® Permit#: / ”---
' -
13125 SW Hall Blvd.,Tigard,OR 97 i I plan Review
S Phone: 503.718.2439 Fax: 503.598., CC‘"sQ' Date/B : Related Permit#: ✓�
T 1 G AR", Inspection Line: 503.639.4175 Ready Date/By: t n See'age 2 for
Internet www.tigard-or.gov �. 2 Q� Notified/Method: Supplemental Information
4
❑New construction Ln Addition/alteratiotl/rppliwetrutint - t g` y Please check all that apply(submit 2 sets of plans w/items checked):
? s.,.3A.:'':-'),,A.., 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
tyar
' _, x,t t„` e °-a*i.,', .,:iiltniemmtalill exceeds 10,000 amps at 150 volts or 0 Floating buildings.
El1-and 2-family dwelling L Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑commercial-tire agricultural
amps for all other installations. buildings.
❑Multi family 0 Master builderOther
r 0 0 Fire pump• 0 Installation of 150 KVA or
1 f ti 11 ,
a •1 � p ,� ��� ❑Emergency system. larger separately derived
Job#: Job site address: 11-15 p fW 0 Addition of new motor load of system.
-geve U'e 1 U:1'I �t 100HP or more.
City/State/ZIP: Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: El Hazardous locations. 0 Supply voltage for more than
�1i t600 volts nominal.
0 Service or feeder 600 amps or more.
Cross street/directions to job site: I
;AMO" .Mi �x... . iy,t It
... .
Description .�f,=Qty .IEach Total 1'-
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
nINNIx.. "` .„n : u M,•, .
_ , . ' .„ _, r _ ,,, = Limited energy,residential 33.9 1
sq.ft.or2
(with above ft.) 75.00 2
brooch C i CGO'4S - / 1- y, Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
s t Renewable Energy 0 See Page 2
"' ".�, '''- �' °°' �•j *.< ,. .,.,.rif r 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
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
f , y y r 6> Branch circuits—new,alteration,or extension,per panel
.�,heti,.,.,"� a s. .z .,, r. +S ✓' +.� . .... ,,,A�-„ lF�' x>,
�� • A.Fee for branch circuits with
Business name: above service or feeder fee, 7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit I 56.18 GJ(e Vet t 2
City/State/ZIP: Each add'l branch circuit Z, 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
r Pump or irrigation circle 67.84 2
Business name:"pt C Cos-i-e ll° L/e c f r icc 1 /l ,„ ra`_i i ,,, Sign or outline lighting 67.84 2
Address: t7 Signal circuit(s)or limited-energy 0 See Page 2 2
/��- ox {3 panel,alteration,or extension.
City/State/ZIP: q 7002_ Each additional inspection over allowable in any of the above
(/N �
� Additional inspection(1 hr min) 66.25/hr
Phone:($03) 5 01/ e,--).5 s Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
rc co s-'e l I 0 e/P.0 !.t-J'f)1 C ci fY7 Inspections for which no fee is
CCB Lie.: g-)L-tG1'!1, Electrical Lic.: 3 -3L-/lit Suprv.Lie.: ,S4731/ J' s. ificall listed 'Ahrmin
90.00/hr
4 r r
Suprv.Electrician signature,required:, Subtotal .
Print name:"R ;e f_. C coc e//,, Date: /0/s1// i 0 Plan Review Required(25%of permit fee):
J / State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: $ ,
This permit application expires if a permit is not obta ned 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 4404615T(I1/05/COM/WEB
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
7450 SW BEVELAND RD 100, TIGARD, OR,
97223
Record Type:
Commercial - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
ELC2016-00791
Inspector:
Jeff Grove
Contractor