Permit (76) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00768
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/16/2017
T I GAR T7 9 Parcel: 25101 BA00600
Jurisdiction: Tigard
Site address: 7700 SW DARTMOUTH ST 110
Project: Spec Space Subdivision: 1995-013 PARTITION PLAT Lot: 1
Project Description: (1)panel,(30)branch circuits,and(1)data telecommunications system for TI.
Contractor: TRADESMEN ELECTRIC INC Owner: WAL-MART REAL ESTATE BUSINESS TR
PO BOX 128 BY PROPERTY TAX DEPT STORE 5935-00
BATTLE GROUND,WA 98604 PO BOX 8050
ATTN MS 0555
BENTONVILLE,AR 72716
PHONE: 360-666-1199 PHONE:
FAX: 360-666-6124
FEES
Quantity Description Date Amount
1 ea Limited Energy 10/16/2017 $75.00
Specifics:
1 ea Services or Feeders-201 to 10/16/2017 $133.56
400 amps
Type of Use: COM 30 crt Branch Circuits w/Purchase 10/16/2017 $222.60
Class of Work: ALT Service or Feeder
Type of Const: 1 ea 12%State Surcharge- 10/16/2017 $51.74
Occupancy Grp: Electrical
Total $482.90
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 OA13.1352-001-p090. u may obtainn 1copy of e rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ,r`G�LC-Zi2' Permittee Signature:
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.
Electrical Permit Application rolz of i i :i: usi: 011.1
City of Tigard Received I _
Date/B : / 7 4 ��
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
= Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: 14(i 02 00/.
T I G A K D Inspection Line: 503.639.4175 Ready Date/By: Juris: H See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction 1,14 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
0 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 E 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: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:
700 S4J bnttivi„jt 5t ,gyp 100HPormore. ❑"A" "E" "1-2" "1-3"
City/State/ZIP: "7-;,: th°rel / ❑Six or more residential units. occupancy.
�? ?722 3
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: 1/0 Project name: 1-ID./s 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: FEE SCHEDULE
Description I Qty. I Each I Total
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
/ (with above sq.ft.) 75.00 2
7cC 7Y1 4 ( �C S!1/!,,.,/ / /✓ w Pa
c h 6 1/ w'71 ?C Limited energy,multi-family 75.00 2
t 'FT /‘A 1 1T4.e out$A-C C, 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 I 133.56 /33,i-b 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
PLICANT ONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee, 30
each branch circuit 7.42 222 t
S�l�t l�f �r�0`�h� L• 2
Contact name: 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 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder
Email: 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: / .u 4 'f,W L,„, G'G/C/1'2 Sign or outline lighting 67.84 2
t
Address: /, Signal circuit(s)or limited-energy �(See Page 2 '5"• 2
!/, �c'J x /z$ panel,alteration,or extension. 1i
City/State/ZIP: !�j �/ Each additional inspection over allowable in any of the above
ty 5, �f4 6.76),„,/ / '✓/f / Cts 0 7 Additional inspection(1 hr min) 66.25/hr
Phone:(-7441, ) L 6,6 _ ,/99 Fax:(3 40 ) ^ea 646-6/2y Investigation(1 hr min) 90.00/hr
Email: r,6 4 � �44y,tel�e-fi,c., C�'�l
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: / t 7o l Electrical Lie.: i Suprv.Lie.: 274 f7 S specifically listed('/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: >///2-6
-1.., Subtotal: /I i,I(41
Print name: d`,r4,y�6_,r Date: /?,../6,J ❑Plan Review Required(25%of permit fee):
+� /3 State surcharge(12%of permit fee): 5 i, 7
Authorized signature: �yz :_`/1----- . TOTAL PERMIT FEE: lark C L,
v This permit application expires if a permit is not obtained hin 180
Print name: ' / Date: / / days after it has been accepted as complete.
cern, It/
�y1.- / �` 77 * Number of inspections allowed per permit. p
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(I1/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY f FEE SCHEDULE
Description I Qty. I Each I Total I *
Fee for all residential systems combined: $75.00 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:
n 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
with OAR 918-309-0040) 552.26 2
n 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 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 P RMIT FEES
COMMERCIAL WORK°SLY:
` �'` 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
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
Ti Landscape Irrigation Control*
Ti Medical
❑ Nurse Calls
Ti Outdoor Landscape Lighting*
Ti Protective Signaling
❑ Other:
Total number of commercial systems: I
*No licenses are required. Licenses are required for all
other installations
1:\Budding\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7700 SW DARTMOUTH ST 110, TIGARD,
OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00768
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor