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Permit Support Document 111 CITY OF TIGARD t- '1, ELECTRICAL PERMIT - - COMMUNITY DEVELOPMENT �© �„ Permit#: ELC2017-00734 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/04/2017 Parcel: 25101 DB00104 Jurisdiction: Tigard Site address: 7300 SW HUNZIKER RD 102 Project: Erickson Carnegie Subdivision: None Lot: None Project Description: Add 3 branch circuits for Tenant Improvements. 10/4/2017: REPRINT to add(3)branch circuits Contractor: JIMCO ELECTRICAL CONTRACTING INC Owner: HILLTOP BUSINESS CENTER LLC 1100 AIRWAY ROAD 9430 NW KAISER RD LEBANON, OR 97355 PORTLAND, OR 97231 PHONE: 541-258-6111 PHONE: FAX: 541-258-6292 FEES Quantity Description Date Amount 5 crt Branch Circuits wo/Purchase 10/04/2017 $85.86 Specifics: Service or Feeder 1 ea 12%State Surcharge- 10/04/2017 $10.30 Type of Use: COM Electrical Class of Work: ADD Type of Const: Occupancy Grp: Total $96.16 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: Ore.• 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•5 00•v. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. // 7. Issued By: / Permittee Signature: O /�/ �4O V 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. ` +— `fit y --, Electrical Permit Application 1 O12 O1.1 1( I: 1 SI:(/\1.1 OCT City of Tigard 2 i Received Date/B : Pennit#: II13125 SW Hall Blvd.,Tigard,OR 9722 0 Phone: 503.718.2439 Fax: 503.598.1 ! `! r 'I'" ' 'a i PlDatan RI3 view Related Pennit#: Inspection Line: 503.639.4175 I s' (I, t. ' 1' !C2, s y., ady Date/By: )oris: ld See Page 2 for Internet: www.ligard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction /t Addition/alteration/replacement Please check all that apply(submit J sets of plans w/items checked): 0 Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at ISO volts or 0 Floating buildings. CI1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural 1:3 Multi-family ❑Master builder ❑Other: amps for all other installations. buildings. ❑Fre pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: RC-1703 Job site address: ❑Addition of new motor load of system. 7300 SW Hunziker Rd 100HP or more. ❑"A","E","1-2, 1-3, City/State/ZIP: Tigard, OR 97223 ❑Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 102 Project name:Erickson Carnegie ❑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 1 Total I " New residential single-or multi-family dwelling unit. Subdivision: Lot 4: 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 DESCRIPTION OF WORK Limited energy,residential Add 2 circuits to existing Permit#ELC2017-00734 (with above sq.ft.) 75.00 2 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 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 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 I 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 Branch circuits—new,alteration,or extension,per panel IgI APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with Business name: Jimco Electrical Contracting above service or feeder fee, each branch circuit 7.42 2 Contact name: Amanda Fields B.Fee for branch circuits without Address: service or feeder fee,first 1100 Airway Rd branch circuit 56.18 2 City/State/ZIP: Lebanon, OR 97355 Each add'l branch circuit 2 7.42 14.84 2 Miscellaneous(service or feeder not included) Phone:(541 ) 258-6111 Fax::(541 ) 258-6292 Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:jimco@jimcoelectrical.biz Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Jimco Electrical Contracting Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address:1100 Airway Rd panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:Lebanon, OR 97355 Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:( 541) 258-6111 Fax:(541 ) 258-6292 Investigation(1 hr min) 90.00/hr Email: jimco@jimcoelectrical.biz Industrial plant(I hr min) 78.18/hr Inspections for which no fee is CCB Lie.: 1466 Electrical Lic.: 22-10C Suprv.Lic.:5423S specifically listed(%:hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal. 14.84 Print name: Bryan Shaffer gi-.‘--c 10/04/2017 ❑Plan Review Required(25%ofpermit fee): State surcharge(12%of permit fee): 1.78 _ Authorized signature: TOTAL PERMIT FEE: 16.62 Print name: Date: This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. • Number of inspections allowed per permit. i\Budding\Permits',ELC_PernelApp_ELR_ERE.doe Rev 06117'2015 440•4615T111/05;COMAVED City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 7300 SW HUNZIKER RD 102, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2017-00734 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor