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Permit
CITY OF TIGARD ELECTRICAL PERMIT . ' COMMUNITY DEVELOPMENT Permit#: ELC2018-00249 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2018 { s Parcel: 1S1260000300 Jurisdiction: Tigard Site address: 9585 SW WASHINGTON SQUARE RD Project: Tesla Subdivision: None Lot: None Project Description: Charging station modifications. Contractor: WHITE LIGHTNING ELECTRIC CO. Owner: PPR WASHINGTON SQUARE LLC 2310 NE 82ND AVE PO BOX 847 PORTLAND, OR 97220 CARLSBAD, CA 92018 PHONE: 503-772-3009 PHONE: FAX: 503-772-4008 FEES Quantity Description Date Amount 1 ea Services or Feeders-Over 04/18/2018 $552.26 Specifics: 1000 amps or volts 5 ea Temp Services or Feeders- 04/18/2018 $625.40 Type of Use: COM 201 to 400 amps Class of Work: ALT 1 crt Branch Circuits w/Purchase 04/18/2018 $7.42 Service or Feeder Type of Const: 1 ea Plan Review Electricial 04/18/2018 $296.27 Occupancy Grp: 1 ea 12%State Surcharge- 04/18/2018 $142.21 Electrical Total $1,623.56 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 co. • e • - or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. O SSM Issued By: _ -Permittee Signature: Air P 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 k t''N'''':: '' ;; '',1 • FOR OFFICE USE ONLY ,1,,„ i,' 1, ,t 4 If . - City of Tigard ., „, , .. i , , -0eived , i ' Date/By: 471//4, if 0 skt#: , ,,,,..„,,k,,, q 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review. /7 411'11°'-ated Permit#. III al Phone: 503.718.2439 \p p I a, /II 1 k Date/By: l_...„dliF - Email: TigardBuildingpermits@Tigard-or.gov '''''' ' t ti ' Ready Date/B : '41111/101r.is: TIGARD I rupSpeleemPeagneta2l Information Inspection Line: 503.639.4175 Internet: www.figard-or.gov N clified/Method:Cy ii , Supplemental ,TyPE pr4oRK if::. '--",,:,i?: ',...:,,,,,,,...,,,rik i Ilk 0,L...,.w.t.4rAisl REVIEW --,- , 0 New construction 0 Addition/alteration/ PliceMbni- : ' -; , Please eheck all that apply(submit 2 sets of plans w/items checked): rd Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: here the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTitUCTION C ' - -- exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 D Commercial-use agricultural amps for all other installations, buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE'INFORMATION'AND'LOCATION c. C' : c o - 0 Emergency system, larger separately derived ''''----- 0 Addition of new motor load of system. Job#: Job site address:-.76 ,--, ,...' -co F;s1-1 IN-fa, tag i 100HP or more. City/State/ZIP7 ,,...A., ©� 0 Six or more residential units. occupancy. : 6 <4 v9 7 z2-? 0Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: --rt 0 Hazardous locations. 0 Supply voltage for more than - V) 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SOIECIjULE Description 1 Qty. 1 Each 1 Total 1 * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: , , Ea.addl 500 sq.ft.or portion 33.92 1 ,DEselopfloA of WORK,,.,,,, ,,,,, ,,,,,. ,"0: * Limited energy,residential 75.00 2 frz.i. (with above sq.ft.) )--.. q_e.,s Limited energy,multi-family residential(with above sq.ft.) 75.00 2 0 See Page 2 ta,rt#9 PFRNP8 ,R-- 41''''' '4'.. * fa * '":CI Olt:S:64o , *d** ! I'd : SReernveiwc easbl ore feedersEner Energy 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:( ) Over 1,000 amps or volts 552.26 6524. 2 Email: Temporary services or feeders installation,alteration,and/or relocation ..tt,H. Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps S 125.08 (025 '` 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 113*APPLICANT- ' '''' '''. ''''' 10.., :4 •.t -r3 CONTACTotPERRO -t t ,, Branchcircuitsbhcircuitswith :new,alteration,or extension,per panel AFee for Business name: k,ot„,1--, 1 k 1..p+h t 1-...0 2.1 CIL(..411.4 C each branch circuit above service or feeder fee, 1 7.42 7(12. 2 Contact name: B.Fee for branch circuits without service or feeder fee,first Address: 2- 0 p.)E I.3.,c1 A v e, branch circuit 56.18 2 ,.., City/State/ZIP: —20,,kkok,in. A ci-7 2,7 (-:, Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(ç?) (4.-- c'?..... 32,s•tp Each manufactured or modular 67.84 2 Email: dwelling,service and/or feeder ,,. Reconnect only 67.84 2 _,-CONTRACTOR, z, ,,,., .:: :„„ 2, ,. 7, :' 7-, - -,. '' :„,,.. Pump or irrigation circle 67.84 2 Business name: CNI.n.--c...... (.7.--K; Cd0Z-2,‘4 Q._ Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr mm ) 66.25/hr Phone:( ) Investigation(1 hr mm ) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: t S ft *7 i Electrical Lie.: 37,s;7c, I Suprv.Lic.: 075 5 specifically listed(A hr min) ELECTRICAL PERMIT TEES Suprv.Electrician signature,require — Subtotal: I I „.....___., , Print name: i Cpp j 1,141:4 Date: 0 Plan Review Required(25%of permit fee): Ottp,27 - State surcharge(12%of permit fee): 1 4 2. 11-1 i 623, CO Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 I Print name: I I Date: days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fels: Renewable Energy Permit Fees: RESIDENTIAL WOEI(ONLY: .... < FE SCIEI)UE } } y iption I Qty. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 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: ❑ B• urglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 In G• arage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) n Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 >100 kva—no additional charge 0.0 3 ❑ Vacuum Systems* Each additional inspection over allowable in any of the above: Each additional inspection is 66.25/hr 1 ❑ Other: charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr mm) c. �. A PEIT'OS COMMERCIAtW611 ,xONL Y'; 4 .. Subtotal(Enter on Page 1): I 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 ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9585 SW WASHINGTON SQUARE RD, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2018-00249 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor