Permit (56) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00103
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 02/15/2018
rrt_;;�I.t� 9
Parcel: 2S110AD08701
Jurisdiction: Tigard
Site address: 10665 SW CANTERBURY LN 8
Project: Pacific Crest Apartments Subdivision: None Lot: None
Project Description: (2)branch circuits for washer and dryer.
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
2 crt Branch Circuits wo/Purchase 02/15/2018 $63.60
Specifics: 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.�1You ay obtain a copy of the rul s or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: „AZ s'1/41 Permittee Signature: C Afp/t
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 RECEIVE
eceivyd i- -• i 15 �^
;+late/B �j Permit 4: -) y�.Ff�"(�U}t�_3
't 13125 SW Hall Blvd.,Tigard,OR 97223 ncJ
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Related Permit#:
Date/By: i .11:_t.,t)1 CIr
TIGARD Inspection Line: 503.639.4175 Ready Date/By: Juris 0 See Page 2 for
0 Internet: www.tigard-or.gov FEB 1 2 2018 Notified/Method: 7 Supplemental Information )
TYPE OF WO OF TIGARD PLAN REVIEW
❑New construction �'Add1t10n/alterati lde]evnl(ent '�j �"( Please check all that apply(submit 2 sets of plans w/items checked):
❑ Demolition ❑ Other: BUILDING DIVISION ISION ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
111I-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
15 Multi-family ❑ Master builder ❑Other:
0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job 4: Job siteaddress:10(065 51A) C-Atn•rEX.131/44 L-4ptE 100HP or more.
0 Six or more residential units. occupancy.
City/State/ZIP: 'f IGA�p a ai'1' 9
t 0 Health-care facilities. 0 Recreational vehicle parks.
�y 0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./sept. 4: ��S Project name:A06 �/-1� �,�c�-Tq�� - 0 Service or feeder 600 amps or more. 600volts nominal.
Cross street/directions to job site: -t-viAV G. FEE SCHEDULE
Description I Qty. I Each I Total I '
New residential single-or multi-family dwelling unit.
I Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel 4: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
-r--A-)cd-r-411, `� (with above sq.ft.)
�. i LC `4- Z"Z) Foe_ w�,'-k e e.-d- Limited energy,multi-family 75.00 2
-70 gyeresidential(with above sq.ft.)
( PROPERTY OWNER Renewable Energy 0 See Page 2
❑ TENANT Services or feeders installation,alteration,and/or relocation
Iame: A0I_- -RGDrj7o0 L yrE "LL 200 amps or less 100.70 2 '
Address: 10 6O Cis SIn.) v C Doc,K . 'i ecs--4- 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Tt[ AIT- d 12 9 7ZZ`f' 601 amps to 1,000 amps 301.04 2
Phone: ( ) Fax:( ) Over 1,000 amps or volts 552.26 j 2
Temporary services or feeders installation,alteration,and/or
Lnsai l: 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
Branch circuits-new,alteration,or extension,per panel
®v APPLICANT ❑ CONTACT PERSON
A.Fee for branch circuits with
Business name: , VIC above service or feeder fee,
7.42 2
Contact name: 4-44Feeeacobr nch circuit
3tt...C���. B.Fee for branch circuits,vithotet
servAddress: -pv &:),4 "Z3 Lg`1 branche it feederitfee,first 56.18 (�'
2
branch circuit t
City/State/ZIP: '1-16/4e-10. o a� 91 Each add'l branch circuit ( 7.42 j `(Z 2
r Miscellaneous(service or feeder not included)
Phone: (. 0) ) 3lZ_-el (3 Fax: :( ) Each manufactured or modular 67.84 2
rdwelling,service and/or feeder
Email: 11‘95 a- cp„no,/ , m Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
131isiness sante: -TtPA13ji=1e,,1-IE 64 Ffria<AL ,o=KRCTO'2-5 Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: po 60 �y 1 18 panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: L� �S iJ 6-e„,0 �j� '�Q 311 Additional
additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
Phone:503 ) z_( ,Lteg9 Fax:(5-03 );c(j if 2-2:7 Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
e*# t i 4)be Y or.e t)Lv/Yir✓ .,(-4'01 Inspections for which no fee is 90.00/hr
i CCB Lic.: (3005:4 Electrical ic.: /�,w/tet rj c Suprv. Lic.: j�!/cl specifically listed(%hr min)
4— j �1/'' ELECTRICAL PERMIT FEES
Suprv. Elcctr ian signature,required: j • Subtotal: 1
j t, +t 3`t
Print name. ? i L4 i 4;61 t v Date: I-Z8--zo is 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): "?r 6a 3
Authorized signature: � TOTAL PERMIT FEE: `'�"'7) , 7-3
'` This permit application expires if a permit is not obtained within 180
Print name:`��, .e..,;,.., f(.46-e•-t Date: 1 -Zs --(s) days after it has been accepted as complete.
* Number of inspections allowed per permit.
I'Building1.I'crmits`.ELC_PennitApp_ELR_ERE doe Rev 0/17/2015 446-4615T(I I/05/COM/WEB