Permit (38)I
CITY OF TIGARD ELECTRICAL PERMIT
114
' COMMUNITY DEVELOPMENT Permit#: ELC2017-00244
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/11/2017
F f �a °L g Parcel: 2S112DB00500
Jurisdiction: Tigard
Site address: 15065 SW 74TH AVE
Project: Interstate Roofing Subdivision: FANNO CREEK ACRE TRACTS Lot: 15
Project Description: Electrical for new 16,893 sq.ft.two-story building: (2)200 amp services,(1)400 amp service,(60)branch circuits
and(1)low voltage system for data.
Contractor: TRI STAR ELECTIC INC Owner: INTERSTATE DEVELOPMENT LLC
PO BOX 231175 15065 SW 74TH AVE
TIGARD, OR 97281 PORTLAND, OR 97224
PHONE: 503-860-3838 PHONE:
FAX: 503-590-2302
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 04/11/2017 $201.40
Specifics: amps or less
1 ea Services or Feeders-201 to 04/11/2017 $133.56
Type of Use: COM 400 amps
Class of Work: ALT 60 crt Branch Circuits w/Purchase 04/11/2017 $445.20
Service or Feeder
Type of Const: 1 ea Limited Energy 04/11/2017 $75.00
Occupancy Grp: 1 ea Plan Review Electricial 04/11/2017 $213.79
1 ea 12%State Surcharge- 04/11/2017 $102.62
Electrical
Total $1,171.57
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 R 952-001-0090. •u may obtain a.•• of the rule-or direct questions to OUNC by calling 50 32.1987 or 1.800.332.2344.
Issued By: �` G^ i 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:
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 Applicata n toiz(II I t R t: I sl:0yIA
City of Tigard 'RECEIVED ReceivedteY /7 Permit#: E.A.! siI7-ooA
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
i Phone: 503.718.2439 Fax:
503.598.'1 ?R 10 2017 Date/By: , Cf ///17 Related Permit#: IJ 6:90/6,--00 A76
Inspection Line: 503.639.4175 Ready Dat Juris: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov Notified/Method:L( 0//11 � Supplemental Information
CITY OF TIGARD (�� n
TYPE BUOYING NG DIVISION 'cam F11:iy6G Ln( /�-1 lei, PLAN REVIEW
®New construction 0 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.
❑Demolition 0 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 /1 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: ['Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: 17001 Job site address: 15065 SW 74TH AVENUE ❑Addo of new motor load of system.
or more. ❑"A","E","1-2","i-3",
City/State/ZIP:TIGARD,OR 97224 13Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:INTERSTATE ROOFING 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:BONITA 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 75.00 2
CONSTRUCTION OF NEW OFFICE (with above sq.ft.)
Limited energy,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: 200 amps or less 2 100.70 201.40 2
Address: 201 amps to 400 amps 1 133.56 133.56 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 0 CONTACT PERSON Branch circuits-new,alteration,or extension, .er panel
A.Fee for branch circuits with
Business name: above service or feeder fee, 60
7.42 445.20 2
each branch circuit
Contact name: 13.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:TRI-STAR ELECTRIC,INC. Sign or outline lighting 67.84 2
Address:PO BOX 231175 Signal circuit(s)or limited-energy 1:27
d gee Page 2 75.00 2
panel,alteration,or extension.
City/State/ZIP:TIGARD,OR 97281 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)860-3838 Fax:(503)590-2302 Investigation(1 hr min) 90.00/hr
Email:DEBBIEM@TRI-STARELECTRIC.COM Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 153559 Electrical Lic.: 34-620C Suprv.Lic.: 3832S specifically listed(V2 hr min)
� � o ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: <Gc k�eL �7 Subtotal: 855.16
Print name: RICHARD METZLER Date: 4/10/2017 ElPlan Review Required(25%of permit fee): 213.79
State surcharge(12%of permit fee): 102.62
Authorized signature: TOTAL PERMIT FEE: --1-1-7 ?
This permit application expires if a permit is not obtained '
Print name: Date: days after it has been accepted as corn e. -
* Number of inspections allowed per permit. /' 1-7157 ,)
I:\Building\Petmits\ELC_PermitApp ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB .t'
F ectrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
*
Fee for all residential systems combined: $75.00 DescriptionI Qty. I Each I Total I
3' 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
❑ Gara a Door O eller* 50.01 to 100 kva 552.26 2
g p >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ 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
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(`/Z hr min)
ELECTRICAL PERMIT FEES
COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 + Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
• Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
El Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems: 1
*No licenses are required. Licenses are required for all
other installations
I:\Building\Pertnits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015