Permit Support Document (24) INCITY OF TIGARD ELECTRICAL PERMIT
'',`, COMMUNITY DEVELOPMENT Permit#: ELC2017 00151
T Oa RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ., ,,;'r Date Issued: 03/02/2017
Parcel: 2S102AB90007
'
Jurisdiction: Tigard
Site address: 9210 SW CENTER ST 7
Project: House Happy Subdivision: WILLOW BEND CONDO,THE Lot: 7
Project Description: Re-route kitchen circuits,replace ceiling heat with wall fan forced heaters. 3/15/17:REPRINTED permit to add(1)
branch circuit for microwave.
Contractor: OMNI ELECTRIC INC Owner: IMPAC FUNDING CORP TR
16670 SW WRIGHT ST BY EDMONDSON, SHARON
BEAVERTON, OR 97007 19500 JAMBOREE RD
IRVINE, CA 92612
PHONE: 503-747-0805 PHONE:
FAX: 503-649-2709
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo/Purchase 03/02/2017 $100.70
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/02/2017 $12.08
Type of Use: MF Electrical
Class of Work: ALT 1 crt Branch Circuits w/Purchase 03/15/2017 $7.42
Service or Feeder
Type of Const: 45 Misc Administration Fee 03/15/2017 $45.00
Occupancy Grp: 0 ea 12%State Surcharge- 03/15/2017 $0.89
Electrical
Total $166.09
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 952-001-0090uobtai o• of the les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: i�r��l
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 01I J( 1. I 'l ON I 1
City of TigardReceived
II
a 13125 SW Hall Blvd.,Ti t D eB ' - 17 'fir
gard OR 9722 Plan Review "
li Phone: 503.718.2439 Fax 50 tai i Related Permit#:
Date/B :
T I G A R D Inspection Line: 503.639.4175 .,. ), Ready Date/By: loris: H See Page 2 for
Internet: www.tigard-or.gov '1\��' Notified/Method: 6 Supplemental Information
TYPE OF WOI -
❑New construction AL„,[1,5e.k"
PLAN REVIEW
®Addition/alteration/trl( Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: l .;,i°-10,1.„1; ❑Service or feeder 400 amps or more 0 Budding over three stories.
`�'+ where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/ingsihal 0 Acce 'r i ding less to ground,or exceeds 14,000 0 Commercial-use agricultural
.
®Multi-family ❑Master builder _ u ° C installations. nildmgs.
,,,,:-.;:;..,...0, ❑Fire pummp- 0 Installation of 150 KVA or
JOB SITE INFORMATION AND ``.!r S7t't ❑Emergency system. larger separately derived
Job#: I Job site address:9210 SW Cent St ❑Addition of new motor load of system.
I00HP or more- ❑ A", E,"1-2."1-3 ,
City/State/ZIP:Tigard,OR ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: 7 I Project name:House Happy 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:
FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 ! 4
DESCRIPTION OF WORK Ea_ sq.ft.or portion 33.92 I
Limitedited energy,
gy,residential
Microwave circuit (will,above sq.ft.)
75.00 2
Limited energy,multi-family
CA.-etet 6i 6 VCA-tit- 10 e,--S°.r� , 2/ `l.�yresidential(with above sq.ft.)
75.00 2
0PROPERTY OWNER ` ENANT Renewable Energy 1 0 See Page 2 I 1
Name:
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
City/State/ZIP: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone:( ) I 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
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 ams to 400 am 1
P Ps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
0
APPLICAN ! 0 CONTACT PERSON Branch circuits—new,alteration,or extension, , r panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
Contact name:
each branch circuit 7.42 2
=R Fee—orhinnehMrrlrira-.:«t - - _
Address: service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP: Each add'1 branch circuit / 7.42 "7 if,,L 2
Phone: Miscellaneous(service or feeder not included)
( ) I Fax::( ) Each manufactured or modular
Email: dwelling service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84
Business name:Omni Electric Inc 2
Sign or outline lighting 69.84 2
Address:16670 SW Wright St Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above_
City/State/ZIP:Beaverton,OR 97007
Additional inspection(1 hr min) 66.25/hr
Phone:(503)747-0805 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email:omni_electric@hotmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 176615 I Electrical Lic.: c297 I Suprv.Lie.: 4270s specifically listed(Y:hr min) 90.00/hr
Suprv.Electrician signature,required: �� 4 /. ELECTRICAL PERMIT FEES
�/� Subtotal: 1,-t.(S ''r
Print name: John M.Kelso Date: 3/15/17 0 Plan Review Required(25%of permit fee):
State surcharge(I2%of permit fee): . , 51
Authorized signature: TOTAL PERMIT FEE: 5."--3 3)
Print name: I This permit application expires if a permit is not obtained within 180
Date: 3/15/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:1Brilding\PermitslELC_PeneitApp ELR ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9210 SW CENTER ST 7, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00151
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor