Permit (20) CITY OF TIGARD ELECTRICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: ELC2017-00288
-¢'1 C ARD 13125 SW Hat Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/24/2017
Parcel: 2S102AC00400
Jurisdiction: Tigard
Site address: 9230 SW BURNHAM ST
Project: Tigard Tap House Subdivision: None Lot: None
Project Description: (3)branch circuits for new addition.
Contractor: SWICH LLC Owner: DOLAN&CO LLC
PO BOX 10893 BY FLORENCE T DOLAN
PORTLAND, OR 97296 4523 NE DAVIS ST
PORTLAND, OR 97213
PHONE: 503-913-3192 PHONE:
FAX: 503-926-9200
FEES
Quantity Description Date Amount
Specifics: 3 crt Branch Circuits wo/Purchase 04/24/2017 $71.02
Service or Feeder
1 ea 12%State Surcharge- 04/24/2017 $8.52
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 952-001-009tain the rules or direct questions to OUNC by calling 503.232.1987 0 .8800033 1344.
Issued By%L . 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 Application I OR 0[41(I I SI ()NI 1
City of Tigard Received
lig I • 13125 SW Hall Blvd.,Tigard,OR 972 Date/B : ,y ��� t/, %fi
Plan Review
Phone: 503.718.2439 Fax: 503.598.1 Date/B : Related Permit#: A 41W CV 7
Inspection Line: 503.639.4175 Read Date/B
TICARD Y Y ® See Page 2for
Internet: www.tigard-or.gov 4 �t1� Notified/Method:
U At Supplemental Information
TYPE OF WORK 'N. Rnr, PLAN REVIEW
❑New construction Addition/alterationeill&if1Grtlw Please check all that apply(submit 2 sets of plans w/items checked):
❑ \I�N v �7 � 0
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition Other: where the available fault currentMarinas and boatyards.
CATEGORY OF CONS exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling is 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:
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
f� /�4' ❑Addition of new motor load of system.
Job#: Job site address:
/2.f V 1/✓rf3t.Y`i!1%'rn 9 100HP or more. ❑«A» «E» «1.2» «1 3„
City/State/ZIP: rc Ar 6.97e. F Z e�
0 Six or more residential units. occupancy.
-7/-j-
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: �- p,,T�— 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more.
/ /�/� Jc�`!r 5�� 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: Lot#: Includes attached garage.
Tax map/parcel#:
1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
/�
1 DESCRIPTION OF WORK// / Limited energy,residential
l/lPl� lU/C'/ , U/ /f/+ Ao/e//i 1 0' Ln (with above sq.ft.)
4 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
Cj PROPERTY OWNER ❑ TENANT' 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 I ❑ CONTACT PERSON Branch circuits-c new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee, 2 7.42 / *� 2
each branch circuitb ,t?
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first / 56.18 1[/ 2
branch circuit D
City/State/ZIP: Each add'l 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: `, L (/ Z. Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: /-:---7-e.,2 �,- L //7 :--5'�? y panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: /47) �l/ �� /� %?��� Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(S-O3) %r3 Z - Fax:
� ( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
of,[ _i<rr,(2- le c ,(. . '�-^-n
_ Inspections for which no fee is
CCB Lie.:/E--. .,.3--,9 5- Electrical Lie.: ,5.-- Suprv.Lie.: <-y E,-7 S specifically listed(%hr min) 90.00/hr
Suprv.Electrician signature,required: --- ELECTRICAL PERMIT FEES
G L - ,....,....,,,.„0..------"---
j Subtotal: '7/,0,2
Print name: 6—.6 ,,„___r g /i-).0„4.-- doirio""ra-te: f= —Z47.-/-70 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): F, ,
Authorized signature: TOTAL PERMIT FEE: "Y,51 f
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE sCHEDULE
Description I Qty Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
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
n Garage Door Opener* >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
EI 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
specifically listed('/: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:
El Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9230 SW BURNHAM ST, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00288
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor