Permit (205) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00531
Date Issued: 07/17/2017
t f
GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S113B000600
Jurisdiction: Tigard
Site address: 16060 SW 85TH AVE
Project: Clean Water Services Subdivision: None Lot: None
Project Description: O&M Building:addition&remodel. (3)200 amp or less services/feeders,(2)201-400 amp services/feeders,(107)
branch circuits&low voltage for(2)systems:fire alarm&security.
Contractor: HEIL ELECTRIC CO Owner: BURLINGTON NORTHERN INC
8425 SE STARK ST PROPERTY TAX DEPT
PORTLAND, OR 97216 PO BOX 961089
FORT WORTH,TX 76161
PHONE:
PHONE: 503-255-4074
FAX: 503-255-4139
FEES
Quantity Description Date Amount
3 ea Services or Feeders-200 07/17/2017 $302.10
Specifics: amps or less
2 ea Services or Feeders-201 to 07/17/2017 $267.12
Type of Use: COM 400 amps
Class of Work: ALT 107 crt Branch Circuits w/Purchase 07/17/2017 $793.94
Service or Feeder
Type of Const: 2 ea Signal circuit or Limited 07/17/2017 $150.00
Occupancy Grp: Energy Panel
1 ea 12%State Surcharge- 07/17/2017 $181.58
Electrical
Total $1,694.74
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. ATTENTIO► Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 hrough OA" 952-•: -0••Q. You may obtain a copy of the rules or direct questions to OUNC by calling5003..232.198oorr 1.800.332.2344.,80
Issued iSignature: /� / " "`"—` ���\�
� � �=��`►`� - Permittee 9
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: .00
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 Applicatio lE EJVEp FOR OFFICE USE ONLY
Received n �) permit#: 1 Sol 1 cO 571
' City of Tigard g JUL1 Z O 7 Plan Review(®�A-J7 '
1114 13125 SW Hall Blvd.,Tigard,OR 972237 Related Permit#: 7 ?
Phone: 503.718.2439 Fax: 503.598.1960 Date/B :
Inspection Line: 503.639.4175 �^.�-r-�� TIGARD
Ready DateBy: Juris: ® See Page 2 for
I 1 C;: IC I) P �.it t T OF 1 IGARl Notified/Method: Supplemental Information
Internet: www ttgard or gov
�' g .. 4::1:ir-i. ,.+.i-;it , 3,x trotAA klan, r ' , 1 .. .7 Vs . , .i), Vii
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Please check all that apply(submit 2 sets of plans w/items checked)
❑New construction ddition/alteration/replacement ❑Other: ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current ❑Marinas and boatyards.
n., :Af .GRY C l 1*Tril N s' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
Accessorybuildingless to ground,or exceeds 14,000 0 Commercial-use agricultural
El 1-and 2-family dwelling �(�*mmercial/industnal 0 amps for all other installations. buildings.
❑Multi-family r Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
E o****00, AND M1y rt y �;, 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job no.:110 D Job address: I(Q (A ‘10 85 �� l0oHP or more. ❑"A" "E" "1-2""1-3"
occupancy.
City/State/ZIP: —1-16)(11.-4, 0E, q1� � ❑❑HSix Itomore facilities. units.
Health-care facilities. ❑Recreational vehicle parks.
Project name: 0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.no.: I J UL/haft-ITT.l�l 600 volts nominal.
��/�/��p" E3 Service or feeder 600 amps or more.
u 1 t t
Cross street/directions to job site: ' ` a°*i t s" �' ' '
Description Qty. I Each Total '1'-
New
New residential single-or multi-family dwelling unit.
Subdivision: I Lot no.: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'1500 sq.ft.or portion 33.92 1
_� Limited energy,residential 75.00 2
.�� � : ' �� (with above sq.ft.)
C ‘CQ I wo(r, t)Y r�'t 1ajle k. Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
t.x ., Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 �J)Z.''�
Name: 201 amps to 400 amps a 133.56 214,.12 2
Address: 401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) I Fax:( )
Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Owner installation:This installation is being made on residential or farm property owned by me or a member of relocation 1
my immediate family. This property is not intended for sale,exchange or rent.(ORS 479.540(1)and 479.560(1). 200-amps or less 59.36
Owner signature: Date: 201 amps to 400 amps 125.08 2
401 amps to 599 amps 168.54 2
CONT P Si„1#�l .'
- Pd ' Branch circuits—new,alteration,or extension,per panel
Business name: A.Fee for branch circuits with
— qti
above service or feeder fee, )pi 7.42 )q3• 2
Contact name: each branch circuit
B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 12
Phone:( ) I Fax:( ) Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
E-mail: dwelling,service and/or feeder
CONTRACTOR only 67.84 2
� _
Pump or irrigation circle 67.84 2
Business name:(\ C Sign or outline lighting 67.84 2
Address: a5 � `*W L s1 1 Signal circuit(s)or limited-energy °p 2
.^ p (ye- 112-1 panel,alteration,or extension.
See Page 2Ur' O)
City/State/ZIP: Q r L 7` , Each additional inspection over allowable in any of the above
Phone:(0)4,,,,i4.40-1(4, Fax:(i) —1--11V Additional inspection(1 hr min) 66.25/hr
�Yc� CCB lic.no.: 30, fit/r19 Investigation(1 hr min) 90.00/hr
E-mail:�1 S I`—���P.CJTT Industrial plant(1 hr min) 78.18/hr
Electrical lic.no.: a(0 koleC 11A20. City or metro lic.: c:; Inspections for which no fee is 90.00/hr
s tfically listed(%:hr min �,
Supervising electrician ` ;
, ,AA �.�J,� t C� ,.E(,EICAL PE1123ki FEES
signature,required: /L/(,T ` 110fire- �57t I I i ` Subtotal: I S O�j. ((p
Print name�� YY� \ ' I Date: --0-ori
❑plan Review Required(25%of permit fee):
Authorized / 1 -e
// State surcharge(12%of permit fee): /0/•`
signature: 4,�{�(.(�/t ��` [. e TOTAL PERMIT FEE: �0 q�.
Print name�� t t 4 ex-ye Date:1 v\\\ This permit application expires if a permit is not obtained within 180
`'/°v„ days after it has been accepted as complete.
* Number of inspections allowed per permit.
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
•
Fee for all residential systems combined: $75.00 Descriptin I r Each I row I
)' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El 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
El 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
charged at an hourly(1 hr min)
Inspections for which no fee is mm) , 90.00/hr
$ specifically listed(%I hr
) 3 p %dal 116}z.e
Subtotal Enteron Page 1):
Fee for each commercial system: $75 00
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
El C• lock Systems
El Data Telecommunication Installation
Fire Alarm Installation
❑ H• VAC
❑ Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
IN/Other: Sec 0
Total number of commercial systems: a
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015