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Permit (263) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT } °III -` ELECTRICAL ELC2016-00910 Date Issued: 11/30/2016 T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 S 31 /7 '3:1 parcel: 2S104DC05800 Jurisdiction: Tigard Site address: 13950 SW ALPINE CREST WAY Project: Bull Mountain Park Subdivision: None Lot: None Project Description: (1)branch circuit for lighting. 5/31/17:REPRINTED permit to include(1)service and(2)branch circuits. Contractor: INLAND ELECTRIC INC Owner: CITY OF TIGARD 360 SE BASELINE 13125 SW HALL BLVD HILLSBORO, OR 97123 TIGARD, OR 97223 PHONE: 503-681-4700 PHONE: 503-639-4171 FAX: 503-681-4738 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 05/31/2017 $100.70 Specifics: amps or less 3 crt Branch Circuits w/Purchase 11/30/2016 $22.26 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 05/31/2017 $14.76 Electrical Type of Const: Occupancy Grp: Total $137.72 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 •• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Vii% �2, ...e,_ Permittee Signatur.I► �,; _ (11111P -.11 -11110 rolling 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 � � FOR OFF II I t SI,()NI ) CityofTigard Received i DateBy: Permit 5: �,r7cL'14,..i. j 111 't 13125 SW Hall Blvd.,Tigard,OR 97 esnq Plan Review ! Phone: 503.718.2439 Fax: 503 595. 60 1 Related Permit ti- Inspection Line: 503,639.4175 � V�� IlkReady Date.'By: Sorts' ® See Page 2 for Internet: www.tigard-or.gov it,,, 'ficdJMethod: Supplemental Information TYPE OF WORIOf \L�V��{1f�� +� 1• PLAN REVIEW ❑New construction 0 Addition/altered �f4{?ya®1y Please check all that apply(submit 2 sets of plans w items checked): 0 Service or feeder 40(1 amps or more ❑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 iSO volts or 0 Floating buildings. 0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14.000 El 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 _ I) ❑Addition of new motor load of system. Job 4: Job site address: )7.)c? )) r-- , (� �� r-�tt,.l�•�1 k}C_v � IOOHPormore. ❑•A. ;,E.. .1-....1_�•. City/State/ZIP: T 0 Sin or more residential unitS. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.4: Project name: ) ID Hazardous locations. 0 Supply voltage for more than �' ' l t K..�t ` ❑Service or feeder 600 amps or MOM600 volts nominal. Cross street/directions to job site: D --1 _ FEE SCHEDULE Nat:dation I Qty. I Eacb I Total I + New residential single-or multi-family dwelling unit. Subdivision: Lot 4: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel 4: Ea.add'l 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 ( �1 with above s ft.) A.l( , .- . GAG-(---: _0 I(a-- CO r`�`i t multi-family energy,multi-family / }LV CLU (It t ` t residential(with above sq.ft.) 75.00 2 i � ° '� �fir , .i Renewable Energy ❑ See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less I 100.70 /WO 0 2 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 1 City/$tate/ZiP: 601 amps to 1,000 amps 301.04 2 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 0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 1 7.42 /4..1(1 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each addi branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67.84 Email: dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: ` t, `int` I,,4 Sign or outline lighting 67.84 Signal circuit(s)or limited-energy Address: (, 13c.ccAir,e. 5.4. panel,alteration,or extension. ❑ See Page 2 2 i City/State/Z1P: IA e \s ' 11 143 Each additional inspection over allowable in any of the above t� ]p Additional inspection(1 hr min) 66.25/hr Phone:(5,3) f9 Q v y$Lt)0t� Fax:(S., ) t, 'T .J tj t1 Investigation(1 hr min) 90,00/hr Email:'�tvw i�i s' Liv. t(„� i1 4,_t v.,_ Industrial plant(1 hr min) 78.181 hr `« inspections for which no fee is 90.00/hr ,, CCB Lie.:15i (, L Electrical Lic.:&44 3.j4 G Suprv. Lie.: 3i'Zk 5 specifically listed(',!hr min) ELECTRICAL PERMIT FEES j Suprv.Electrician signature,required: 1+v3L-.. _ i l Subtotal: // _S2_ Print name: 1 'dv t-4. jY- '`'77i, Date:Z 4",43 i!/ ) +� 0 Plan Review Required(25%of permit fee): / !!! State surcharge(12%of permit fee): £3,rc !1. Authorized signature: TOTAL PERMIT FEE: i�c1 J This permit application expires if a permit is not obtained within Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. T'B undine Furious.Ft C'_PermitApp_ELR ERE.doe Res 06'17'2015 44046151(1i 05 COM'WhO --7G/- ,- fir . CITY OF TIGARD ELECTRICAL PERMIT I COMMUNITY DEVELOPMENT Permit#: ELC2016-00910 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/30/2016 T t i. r R Cr g Parcel: 2S104DC05800 Jurisdiction: Tigard Site address: 13950 SW ALPINE CREST WAY Project: Bull Mountain Park Subdivision: None Lot: None Project Description: (1)branch circuit for lighting Contractor: INLAND ELECTRIC INC Owner: CITY OF TIGARD 360 SE BASELINE 13125 SW HALL BLVD HILLSBORO, OR 97123 TIGARD, OR 97223 PHONE: 503-681-4700 PHONE: 503-639-4171 FAX: 503-681-4738 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 11/30/2016 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 11/30/2016 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 a • •-• e 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. A TION: Ore'••n law requires you to follow the rules adopted by the Oregon Utility Notification Cen er. Those les are set forth in OAR 952-00 -0010 through OAR 9 2-0• •T%•0. •u may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 7 or 00. . 344. Iss ed By: 41. ' Permittee Signature: 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' r Date: N/A0/(40 LICENSE NO. 33d--g S 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. I T Electrical Permit Appli IP . FOR OFFl( I 1St.ONL.1 City of Tigard \\\C‘3,1`Rec it �o /(� LL /(o-O ' (b : Permit r' r 13125 SW ball Blvd.,Tigard,OR 97223 ) ) Plan Review �t + zs. Related Penni[S: Y�f/ —' 3/0, Phone: 503.718.2439 Fax po Ui 1 4 +,r m y„p � [late Ry Inspection Line: 503639.417?b,g u.„ t, I ,''- t z+�., t Ready Date/By: funs: 6�1 See Page 2 for TIGARO k Internet: un+w.ugard-or.go'�j._1 � a°' NotiiiedrMethod: Supplemental information TYPE OF WORK PLAN REVIEW ®New construction 0 Addition/alteration/replacement 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 stones. ❑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. 1-31-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. 0 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 ❑Addition of new motor load of system. Job 4: Job site address: 13950 SW Alpine Crest Way 10oHP or more ❑"A .,E,_ "1-'' "1-t" ❑Six or more residential units. occupancy. City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities 0 Recreational vehicle parks. Suite/bldg./apt.4:N/A Project name:Bull Mountain Park 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:West onto SW Walnut St from Hwy 99W. FEE SCHEDULE South onto 132nd.Rt or SW onto MorningStar Dr.West onto SW Woodshire to end Description I Qtr. I Each I Total I ' New residential single-or multi-family dwelling unit. Subdivision:N/A Lot#:N/A Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#:2S104DC05800 Ea.add'1 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK t Limited energy.residential 75.00 2 Ci\ n ^ J (with above, flti J �'1ti- lir�l �t "`�'� (� Limited energy,multi-family 75.00 2 v v residential(with above sq.ft.) { Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:City of Tigard 200 amps or less 100.70 2 Address: 13125 SW Hall Blvd 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZiP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 •"., Phone:(503)718-2466 Fax:( ) Over 1,000 amps or volts 55226 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 Owner signature: Date: 401 amps to 599 amps 168 54 2 0 APPLICANT Branch circuits--new,alteration,or extension,per panel ❑ CONTACT PERSON A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first _ I 5618 2 Address: branch circuit City/State/ZIP: Each addi 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: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: \6v,_& tO<,k-+.`C it..... i,-\'-�,, , Sign or outline lighting 67.84 2 Signal circuits)or limited-energy ❑ See Page 2 Address: :c E,) ' . \ba. \%Nr. panel,alteration.or extension. 2 City/State/ZIP: '✓ ,,,,% ..." " t` Each additional inspection over allowable in any of the above ��j�}J rj+.� Additional inspection(1 hr mini 66.25/hr f Phone:(SFV)) Fax:('K*ya)6 ,t 1.4.)§. Investigation(1 hr min) 90.00/hr 1 industrial plant(1 hr min) 78.18;hr Email:�yS , T. ,zA Nt v;. tJ4-d .Y l.+1 \' Inspections for which no fee is i �S lc 3 �' � p { specifically listed('hr min) 90.00/hr CCB Lic.: { Electrical Lic.: , J/J" Suprv.Lic.: :3at1 ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: ,. `iw"•x Subtotal: . i Print name:t i i.k.„g ; Date:t 1//14, 0 Plan Review Required(25%of permit fee): i State surcharge(12%of permit fee): Le ,i' Authorized signature: TOTAL.PERMIT FEE: 61.51 I 1 This permit application expires if a permit is not obtained within ISO. Print name: Date: ) days after it has been accepted as complete. * Number of inspections allowed per permit t\Buildinrpetmits,ELC_PennitApn ELR_£REdoe Rev 06/17/2015 440-4615Tf 1 1105/COM.WER Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: 1:1Ar.'. ,<ML r Description Qty. 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 z 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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr d CA hr �._ � � r.,. specifically hsteELEC ) C OMM_ERCIAL.v. ®RK ONL � 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: ja- *No licenses are required. Licenses are required for all other installations l:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015