Permit (58) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016-00806
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/19/2016
T t r;;�It C• g Parcel: 2S101AB02000
Jurisdiction: Tigard
Site address: 7175 SW BEVELAND RD
Project: Berman/Summers Subdivision: BEVELAND Lot: 4
Project Description: (5)branch circuits to reconnect(5)furnace replacements
Contractor: PYRAMID HEATING&COOLING Owner: BERMAN,JOHN M&
9409 NE COLFAX SUMMERS, MICHAEL L
PORTLAND, OR 97220 7175 SW BEVELAND RD#210
TIGARD, OR 97223
PHONE: 503-786-9522 PHONE:
FAX: 503-786-3432
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 10/19/2016 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/19/2016 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 •r if work is - spe :ed for more the 180
days. ATT •N: Ore..n law re. ires you to follow the rules adopted by the Oregon Utility Notification •-nter. Th.:/rule/ are -et forth in OAR
952-001-.010 through OAR 9 -08 -0090. Y u ay obtain a copy of the rules or direct questions to OUNC by calling 503.2 '.1987'.r 1.:40 32.2/ .
Issue By: U /% 'LJ Permittee Signature:
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:
/ CO C •R INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' A N �/� . Date: /e)ifp///,
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 i%TE; FOR OFFICE: I;SI ON1.1
y
y A �� �} Date/B : </ �� Permit#: `�i 4-.60 �0 :7
City of Tigard Received /
13125 SW Hall Blvd.,Tigard,OR 97223 OCT 9 L 015 Plan Review
1 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Pennit#:
Inspection Line: 503.639.4175 ReadyDate/BY Juris: ® See Page 2 for
1 'GARD C % OF fl www.tigard-or.gov .> Notified/Method: Supplemental Information ormation
TYPE OF jjV DI6 DIVISION
PLAN REVIEW
❑New construction q Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition ❑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 ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family Master builder 0 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: 7/75— d¢vv e t OOHP or more. ❑"A "E °°l-2",°°l-s°
//via
Cit /State/ZIP: -t ❑Six or more residential units. occupancy.
y /2-=n0/ �il. 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 8,2/440''2 /$u W)yl/14,V ❑Hazardous locations. 0 Supply voltage for more than
S ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each 1 Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: 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
/) _ (with above sq.ftJ 75.00 2
/�>.L®vl I1 Q� Gi r�,t I�.er n c-4--0..--e.5 Limited ener
Ogy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: J
ear- 200 amps or less 100.70 2
vHG vii / 6'rl 144y1?�s, .
Address: 5::,j { �� 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 I
Phone:( ) 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
5 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
/ A.Fee for branch circuits with
Business name: py, � l��O t'k� (�®� 2 above service or feeder fee, 7.42 2
// / each branch circuit
Contact name: /1,,,, S2!/lc/1 B.Fee for branch circuits without
Address: sit (� ( (� service or feeder fee,first 1 56.18 c--6.,K. 2
v` Ave o 4, branch circuit
City/State/ZIP: A,..._/./6,,,,:p0 17220 Each add'l branch circuit y 7.42 ,;Zrj,(5 2
`' Miscellaneous(service or feeder not included)
Phone:(c63 ) _ Y5-z,-r__ Fax: :(cp.3) 7$ -..34/f7,- Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: XcrI( o ((vvi 9- tyre ivi id ea-/,--:7 , /"p�
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: gii/Au /0/ r4-4 15- Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:xr6 A// ]Q,/�Q� 0 See Page 2 2 panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
O.' /i r'l i 9y l-7 Z Z Additional inspection(1 hr min) 66.25/hr
Phone:( cz)3)215-6_,5—Zzi I Fax:( ) Investigation(1 hr min) 90.00/hr
Email: DS l l %- -{ - e o:+G Industrial plant(1 hr min) 78.18/hr
✓fif ��� ��t / - specifiInspeccally listed(Vons for , no hr min)
90.00/hr
CCB Lic.: S7 3.5-z Electrical Lic.:L/7/s 1/3 Su rv.Lic.:,2 S6 7k,-...6.
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: t/✓i ¢ Subtotal: �'Sr 84
Print name: 1.1,-Js,� s Da e: t !t 0 4 ❑Plan Review Required(25%of permit fee):
(12% /p.,90 __,
State surcharge of permit fee): �� / ;,
Authorized signature: / , '4 TOTAL PERMIT FEE:
e1 This permit application expires if a permit is not obtained within 180
Print name: /00v-e o ! / Date: /oh gr/( days after it has been accepted as complete.
``O * Number of inspections allowed per penult.
I:\Building\Permits,ELC_PermitApp_ELRERE.doc Rev 06/17/2015 440-4615T(I1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
4VDescription I Qty. I Each I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
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
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* >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 ]
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
WiTELECMICAL PE tMIr?FEES;
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
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ 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:ABuilding1Permits\ELC_PermitApp_ELR_ERE.doe Res 06/17/2015
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
7175 SW BEVELAND RD, 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:
ELC2016-00806
Inspector:
Jeff Grove
Contractor