Permit (72) CITY OF TIGARD ELECTRICAL PERMIT
ae" ' COMMUNITY DEVELOPMENT Permit#: ELC2016-00867
GARGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/08/2016
Parcel: 2S112DD01600
Jurisdiction: Tigard
Site address: 15575 SW SEQUOIA PKWY 130
Project: BFit Subdivision: PACIFIC CORPORATE CENTER Lot: 4
Project Description: Electrical for TI: (3)200 amp feeders and(75)branch circuits.
Contractor: CURRENT ELECTRICAL CONST CO Owner: PACIFIC REALTY ASSOCIATES
PO BOX 19652 ATTN: N PIVEN
PORTLAND, OR 97280 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-245-5997 PHONE:
FAX: 503-245-2919
FEES
Quantity Description Date Amount
3 ea Services or Feeders-200 11/08/2016 $302.10
Specifics: amps or less
75 crt Branch Circuits w/Purchase 11/08/2016 $556.50
Type of Use: Service or Feeder
Class of Work: 1 ea 12%State Surcharge- 11/08/2016 $103.03
Electrical
Type of Const:
Occupancy Grp:
Total $961.63
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are setyferth in OAR
952-001-0010 through OAR 952-001-0090. Y.• may o• .copy• - - -s or direct questions to OUNC by calling 503.232.1587 87 or 1. .332 4
Issued By: , tri =_ �i�i. — Permittee Signature:.40 "47
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
li"Electrical Permit Application ,,,,,,.% IOR M I K_L. USI:("LI
City of Tigard Received /f M
-43A N
Date/B /[ ��
114 "I 13125 SW Hall Blvd.,Tigard,OR 1, ; Q
C Phone: 503.718.2439 Fax: 503.5'.4 .0 1� s,:r - Related Permit#: irS ((a... ‘,..4;
Inspection Line: 503.639.4175 ad. Jnr s:
l 1G A K D w\oV y Date/By: ® See Page 2 for
Internet: www tigard or gov \ ,� 7, otified/Method: Supplemental Information
'� �'.%'
❑New construction ®Addition/alteration/ -. -`t: Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: I where the available fault current Marinas and boatyards.
,-, t. ' >_.:1:01=Tric'O$ ,,:' -r *, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-familydwelling0Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ ®Commercial/industrialamps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
,
f 1 t t l ' t 1 :lt 0 Emergency system. larger separately derived
�
o Addition of new motor load of system.
Job#: Job site address: 15575 SW SEQUIOA PARKWAY 100HP or more. ❑"A","E","l-2","l-3",
City/State/ZIP:TIGARD,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:BFIT PCC 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: , E • 1?l i t
Description Qty. 1 Each I Total *
New residential single-or multi-family dwelling unit.
Subdivision: I 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
ice% . . , 'xI E :OW'
..0140C:124`:7;r:r. ,,,,. ,::;As Limited energy,residential
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy
0 See Page 2
t
0 ,, R "- U - -" iii 4 Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 3 100.70 302.10 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:( ) I 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 s 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
". -i Branch circuits-new alteration or extension
"� per;2e1�` � ' i t A,Fee for branch circuits with pSE e �Zj
Business name: above service or feeder fee, 75 7 42 4 39 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit 56.18 2
City/State/ZIP: Each add'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: R
, econnect only 67.84 2
`
p�� ;lei`s
- � ,. 1.CTOR "`'' l' Pump or irrigation circle 67.84 2
Business name:CURRENT ELECTRICAL CONSTRUCTION Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:PO BOX 19652 panel,alteration,or extension. ❑ See Page 2 2
City/State/ZIP:PORTLAND,OR 97280 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)245-5997 Fax:(503)245-2919 Investigation(1 hr min) 90.00/hr
Email:KIERAN@CURRENT-ELECTRICAL.COM Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lic.: 46994 Electrical Lic.: 26-471C Suprv.Lic.: 5232S specificallylisted(/hr min)
Suprv.Electrician signaJy :O W _ • ., �, ° /, uti'l�. , ;:"
- - - -- Subtotal: - 8#+46--,g"5c,-le
Print name: - ON4ACQB CCI I Date: 9/26/16 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): . 94-11 /l j „
Authorized signatur --orc23 22 TOTAL PERMIT FEE: 878.5.3 a,/
.--' tt// This permit application expires if a permit is not obtained within 180
Print name: 1 RAN O'BRIEN Date: 9/26/16 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building' 'its\ELC_PermitApp_ELRERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB