Permit (119) CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: ELC2018-00104
T f i.A It v.) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/15/2018
Parcel: 2S110AD08701
Jurisdiction: Tigard
Site address: 10685 SW CANTERBURY LN 1
Project: Pacific Crest Apartments Subdivision:
Project Description: (2)branch circuits for washer and dryer. None Lot: None
Contractor: TIMBERLINE ELECTRICAL CONTRACTORS Owner: AUK-REDWOOD PC SPE LLC
9414 SW BARBUR BLVD,#100 10695 SW MURDOCK ST
PORTLAND, OR 97219 TIGARD, OR 97224
PHONE: 503-459-4089 PHONE:
FAX: 503-254-4227
FEES
Quantity Description Date Amount
Specifics: 2 crt Branch Circuits wo/Purchase 02/15/2018 $63.60
Service or Feeder
1 ea 12%State Surcharge- 02/15/2018 $7.63
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Y. may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: i ,� -
Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE
Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC'
Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application
FOR OFFICE USE ONLY
City of Tigard Y' ved
�. ..,t..{:y: ,02/6/1Permit#: _T L'+ie,
Iiii '� 13125 SW Hall Blvd.,Tigard,OR 97223 � L( ���j joie.,
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Date/By: Related Permit#:
TIGARD Inspection Line: 503.639.4175 FEB 1 ?018 ReadyDate/By:
ss Internet: www.tigard-or.gov 2 t""S I See Page 2 for
Notified Method: •'''-fid Supplemental Information
�WJ
TYPE OF WORK CITY Y OF 1 l( ARI PLAN REVIEW
❑ New construction Addition/alteratio c rc
DIVISION f('� Please check all that apply(submit 2 sets of plans w/items checked):
1 E Demolition � D�7 As9 l$ 0Service or feeder 400 amps or more
❑ Other: p 0 Building over three stories.
CATEGORY OF CONSTRUCTION where the available fault current 0 Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ I-and 2-familydwelling 11Commercial/industrial E Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
i ifMulti-family amps for all other installations buildings.
❑ Master builder ❑ Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job# I Job site address: f(,(0 't5jv CyI r_ 0 Addition of new motor load of system.
1�15Gk CASE 100HPormore.
Cil / tate//,Il': TGtAtt r> r Q q 7 2Z4 , ❑Six or more residential units. occupancy.
Suite/bid /a)t.4: `-� Ve t.Ca�i e- �a7-' 0^' ❑Health-care facilities. 0 Recreational vehicle parks.
€ IA W / I Project name: ❑Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: toTH4 Aqe
FEE SCHEDULE
__ Description I Qty. l Each I Total l
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel 4: 1,000 sq.ftor less 168.54 4
-- - DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 I
Limited energy,residential
�l�$i V1 t Z. with above s ft.) 75.00 2
I[O ®� i/01454-1.6e- �1- ( 4
Limited energy,multi-family
D Q to a. residential(with above sq.ft.) 75 00 2
® PROPERTY OWNER ❑ TENANT Renewable Energy I=1 See Page 2
^ Services or feeders installation,alteration,and/or relocation
Name: Au_ 2.EDt/.oof) pc s€'6 L.L.L 200 amps or less 100.70 2 i
Address: l 0(o q S t/-1 I'b1V QDoGK S�e , 201 amps to 400 amps 133.56 2
t ®� 401 amps to 600 amps 200.34 2
L City/State/ZIP: 7-16.4g..0 c .i
601 amps to 1,000 amps 301.04 2
Phone. ( ) Fax: .
( ) Over 1,000 amps or volts 55226 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
Owner signature: Date: 401 amps to 599 amps 168.54 2 1
( IAPPLICANT CONTACT PERSON Branch circuits-new,alteration,or extension, er panel
A.Fee for branch circuits with
Business name: � C x J Tom_ above service or feeder fee,
each branch circuit 7.42 2
Contact name: �'Iq,4 311_4. &—ec B.Fee for branch circuits without
Address: o X 23 `-) service or feeder fee,first p
branch circuit 56.18 y U t 2
Cit)/State/ZIP: 'Tt6 Iq�,p rc>C Each add'I branch circuit
_. -- ��Z� { 7.42 7 Z
Phone: (e03 ) 3r1--7 I3 Miscellaneous(service or feeder not included)
Fax: :( ) Each manufactured or modular
Entail: dwelling,service and/or feeder 67.84 2
1` c�V1 Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: '-r-t Wli) it,.16i-f Sign or outline lighting�1 3`f=.1Cf{L CfiYCT�RcTOf�s g g 67.84 2
Address: Signal circuit(s)or limited-energy
r 8 panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: �} ��W�� q 10 Each additional inspection over allowable in any of the above
d �► �� Additional inspection(I hr Iain) 66.25/hr
Phone:503 ) cl-Yd Fax: .
� (j0j ) y 2-2 Investigation(I hr mm) 90.00/hr
Email: td♦• j / lIndustrial plant(I hr min) 78.18/hr
- f rY1 r,Y(l 01„...e1 cT Yft; ..6'44/9
Inspections for which no fee is
CCB I.ic.: (60014 Electrical', ic.: ./ ')C Suprv. Lic.: !f rT 7j specifically listed('h hr min) 90.00/hr
Suprv. Electrician signature,required: d /
r ELECTRICAL PERMIT FEES
Print name. j� i��d Iw s
Subtotal: 43,iE 0
I 'iGt i L��r1 Date: A- -A5 i 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 763
Authorized signature: TOTAL PERMIT FEE: "'�i y3 I
I Itr�tq� 3This permit application expires if a permit is not ob wined within 180
I Print name: Gk.L..6
L_______ ' Date: (f2,8/(8days after it has been accepted as complete.
' Number of inspections allowed per permit.
I',Building l'enniu'.ELC PermiiApp_ELR-ERE doe Rev 06/17/2015 440-4615T111/05/COM/WEB