Permit (88) CITY OF TIGARD: . N. .,71 ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00144
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/06/2018
Parcel: 2S110AD08700
Site address: 10655 SW MURDOCK LN 2 Jurisdiction: Tigard
Project: Pacific Crest Apartments
Project Description: Adding(2)branch circuits for washer and dryer. Subdivision: None Lot: None
Contractor: TIMBERLINE ELECTRICAL CONTRACTORS Owner:
9414 SW BARBUR BLVD,#100 AUK-REDWOOD PC SPE LLC
PORTLAND, OR 97219 10695 SW MURDOCK ST
TIGARD, OR 97224
PHONE: 503-459-4089 PHONE:
FAX: 503-254-4227
FEES
Quantity Description Date Amount
Specifics: 2 crt Branch Circuits wo/Purchase 03/06/2018 $63.60
Service or Feeder
1 ea 12%State Surcharge- 03/06/2018 $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. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:
--- mittee Signature: ‹aor
c4_,11,, ,
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 603.639.4175 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,_Ej Eli� '�
. '' FOR OFFICE USE ONLY
- City of Tigard 7DReceived Ay i 1
'1 13125 SW Hall Blvd.,Tigard,OR 97223 { �; 2018
111
Plan Review �/ ✓
Phone: 503.718.2439 Fax: 503. 98 1960
Date/B : Related Permit#.
Inspection Line: 503.639.4175 a r J/ , _ L
TIGARD � �� ��li ,j` � r;��� ReadyDate/By: � See Page 2 for
Internet: www.tigard-or.gov " 1 ` r i t°"g
,.��tl1`6 �' Notified/Method:
Supplemental Information
TYPE OF �(. ,-1- j,� �'
PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply pp y(submit 2 sets of plans w/items checked):
❑ Demolition ❑Other:
0 Service or feeder 400 amps or more 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 0 Floating buildings.
❑ I-and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
[] Multi-family ❑ Master builder ❑Other: amps for all other installations. buildings.
0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job 4: Job site address: (D!or
0 Addition of new motor load of system.
J5 5ra) 3Yi itOp[K LA! roz. 100HPortnore.
City/State/ZIP: f(CC14RD1 OR - El"A","E" "I-2 1_�
q 7 Z Z� 0Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: FC).. Project name: (j Z �-
__ F D gyl S T A Z L 0 Hazardous locations. ❑Supply voltage for more than
Cross street/directions to job site: (69
I {'� - ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description 1 Qty. j Each 1 Total 1 *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add'I 500 sq.ft.or portion 33.92 1
Limited energy,residential
-��STA A-- Et EC_ C t12.C.UIT'S r- y2_ ( WA50(E� (with above sq.ft.)
75.00 2
( �F� Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
NI PROPERTY-OWNER I
El TENANT
Renewable Energy 0 See Page 2
/1 Services or feeders installation,alteration,and/or relocation
,4
Name: c)W Q•Q);)
PC- 5 p 6 i f C 200 amps or less 100.70 2
Address: (�(o is S J kvt v/4,90 C. K. 5 t E6..I 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 1-IczF412-D f ox 9'7 z 8 (
601 amps to 1,000 amps 301.04 2
Phone. ( ) I 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 1
intended for sale, lease,rent,or exchange,according to ORS 447;449,670.and 701. 201 amps to 400 amps 125.08
2
401 amps to 599 amps 168.54 2
Owner signature: Date:
APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
HP,
�� A.Fee for branch circuits with
Business name: T ✓ above service or feeder fee,
each branch circuit 7.42 i 2
Contact name: ��-1/41 '5(t...66,-/2_,C B.Fee for branch circuits without 11'1-
Address: Pd I&On Z3 t -7 branch it feeder fee,first �,,�]�j
branch circuit 56.18 e� 2
City/State/ZIP: -1-(61:4e.4) r Criz8 / Each add'l branch circuit 7.42 2
Phone: ! Miscellaneous(service or feeder not included) 1
( 5 ) 3(7 - 7.7 )3 Fax: :( ) Each manufactured or modular
Email: $ 62- C-0.4'\b dwelling,service and/or feeder 67.84 2
7 Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 71 1.1013 riet4 1..le EY.. <14L. ex ACIKtQC•tO12-5 Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
�� r$ panel,alteration,or extension. 0 See Page 2 2
Address:
City/State/ZIP: j1 �g W o 6,0` b� Q 34) Additional
additional inspection over allowable in any of the above
Additional inspection(I hr ruin) 66.25/hr
Phone:50) ) 4459-L fdg? Fax:(573 );Sif U2 :1 Investigation(I hr min) 90.00/hr
Email' LtJ.}} Industrial plant(I hr min) 78.18/hr
14t T i 4 l bt Y 1t theeJ r gcliYlc,,.CL''1 Inspections for which no fee is
_CCB I,ic.. ffo0O j Electrical', ic.:9.. _/;//G Suprv. Lic.: 7specifically listed(%hrmin) 90.00/11r
Miff" ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required:
Subtotal:
Print name: tt j.16 A I C:14,� r� Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: - �c_< !a TOTAL PERMIT FEE: 7/._23
This permit application expires if a permit is not obtained within 180
Print name: GE 1�'ipti_D 3(t_GECE Date:Z I ZS//e days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:Building'\.Pennits',ELC PennitApp_ELR_ERE doe Rev 06/17/2015 440-4615T(11/05/COM/WEB