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Permit Support Document (27) I. IL ` CITY OF TIGARD ELECTRICAL PERMIT �r" ' Permit#: ELC2017-00149 `� COMMUNITY DEVELOPMENT Date Issued: 03/02/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 z Parcel: 3/02/2 B90005 Jurisdiction: Tigard Site address: 9210 SW CENTER ST 5 • f 7' Project: House Happy Subdivision: WILLOW BEND CONDO,THE Lot: 5 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: PHONE: 503-747-0805 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 0 2-001-0090. You may obtain a copy of th u es o irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: s` �"' i - Permittee Signature: ./A .4"/: 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 503.639.4176 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. lication 'V' riitt (Illi( , I .'I O",.1 Electrical Permit AppAC�� City of Tigard 1 �jived 7 1Jate/B . r>`i' -� • 13125 SW Hall Blvd.,Tigard,OR 97223 _, Phone: 503.718.2439 Fax: 503.598.1960 IFZEgllIllIllI■ Related Permit rt: Inspection Line: 503.639.4175 . t( eT Iiiy. H See Page 2 for T I GA R fJ ethod: Supplemental Information Internet www.ugard-or.gov '�,,�. ,„`I ��qq. °,t., TYPE OF WORK ' ' ‘i)v PLAN REVIEW ❑New construction ®Addition/alteration/replacementv Ø. Please check all that apply(submit 2 sets of plans wfitems checked): } °a 6 s 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 Other: ; o s ,:',S,'",-'' \ where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION �, t exceeds 10,000 amps at 150 volts or 0 Floating buildings. ,�'e,< less to ground,or exceeds 14,000 ❑Commercial-use agricultural 0 1-and 2-family dwelling 0 Commercial/industrial 0 Access build'' amps for all other installations. buildings.►1 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 0 Addition of new motor load of system. Job#: I Job site address:9210 SW Center St 10011P or more. ❑ A°',�E,°t-2',�1-s�, ❑Six or more residential units. occupancy. City/State/ZIP:Tigard,OR 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: S I Project name:House Happy 0 Hazardous locations. 0 Supply voltage for more than 0 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 I 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'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft) 75.00 2 Microwave circuit Limited energy,multi-family 75.00 2 C toe 0) C I jret t;j" ,, K f c ,I/y,-1 j" _residential(with above sq.ft.) � 1 Renewable Energy 0 See Page 2 ❑ PROPERTY OWNER 0'TE1 ANT 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 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 © CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7A2 2 each branch circuit Contact name: B.Fee for branch circuits without Address: branch circuit .. City/State/ZIP: Each add'l branch circuit i 7.42 7.4„2 2 Miscellaneous(service or feeder not included) Phone:( ) I 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:Omni Electric Inc Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address:16670 SW Wright St panel,alteration,or extension. City/State/ZIP:Beaverton,OR 97007 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(503)747-0805 I Fax:( ) Investigation(1 hr min) 90.00/hr Email:omni_electric@holmail.com Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 9000/hr CCB Lic.: 176615 I Electrical Lic.: c297 I Suprv.Lic.: 4270s specifically listed(r/z hr min) � ie,../.° ELECTRICAL'FERMI`):.' FEES Suprv.Electrician signature,required: Subtotal: t-1 r`14' Print name: John M.Kelso Date: 3/15/17 0 Plan Review Required(25%of permit fee): — State surcharge(12%of permit fee): , ,r Authorized signature: TOTAL PERMIT FEE: 153. 3/ This permit application expires if a permit is not obtained within 180 Print name: Date: 3/15/17 days after it has been accepted as complete. Number of inspections allowed per permit. r:\Building\Penaits\ELC PemutApp ELR ERE.doc Rev 06/17/2015 440-46t5T(11ro5/COMIWEB City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9210 SW CENTER ST 5, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2017-00149 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor