Permit (37) CITY OF TIGARD ELECTRICAL PERMIT
Yrs . COMMUNITY DEVELOPMENT Permit#: ELC2017-00875
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/26/2018
Parcel: 2S 113AB00600
Jurisdiction: Tigard
Site address: 16195 SW 72ND AVE
Project: Option Care Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: Adding(15)service panels,and(180)branch circuits. All inspections performed under ELC2017-00895.
Contractor: COCHRAN INC Owner: PACIFIC REALTY ASSOCIATES LP
7550 SW TECH CENTER DR#220 ATTN: N PIVEN
TIGARD, OR 97223 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-234-6564 PHONE:
FAX: 503-238-2098
FEES
Quantity Description Date Amount
14 ea Services or Feeders-200 12/18/2017 $1,409.80
Specifics: amps or less
1 ea Services or Feeders-201 to 12/18/2017 $133.56
Type of Use: COM 400 amps
Class of Work: ALT 180 crt Branch Circuits w/Purchase 12/18/2017 $1,335.60
Service or Feeder
Type of Const: 1 ea 12%State Surcharge- 12/18/2017 $345.48
Occupancy Grp: Electrical
1 ea Plan Review Electricial 12/18/2017 $719.74
Total $3,944.18
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 952-4• X090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: /� �� Permittee Signature: e
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 ApplicatiotR FOR OFF1cE l SF. o\!_1
City of Tigard q Received / 7j �i /�) 7c
NOV Y 2 7 2017
Date/By: L / / it#:!i(/C�h[//�
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /
Phone: 503.718.2439 Fax: 503.598.19 //hi Related Permit#:y� t94/7�/nl�2,
z-� ,,L1 Date/By: � �y�( �C/
Inspection Line: 503.639.4175 ° Ready Date/By: oris: ( Bf See Page 2 for
Internet: www.tigard-or.gov �'���1 1°"1G �vl°' �4� /Ngotified/Method:` /� l Supplemental Information
TYPE OF WORK �%I i %L�/c jJ ` PLAN REVIEW
❑New construction ®Addition/alteration/replacement lease 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 ❑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 ®Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: El Fire pump. ®Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#:511167 I Job site address: 16195 SW 72"d Ave ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. occupancy.
0 Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:Option Care 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 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.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK ------- ---h Limited energy,residential
(with above sq.ft.) 75.00 2
Electrical tenant improvement,complete lighting rem del,4 new panels,n w UPS Limited energy,multi-family 75.00 2
new generator,(3)new ATSresidential(with above sq.ft.)
Renewable Energy 0 See Page 2
1:1 PROPERTY OWNER 0TENANT Services or feeders installation,alteration,and/or relocation
Name:Option Care 200 amps or less '7 14 100.70 1409.8 2
i
Address: 16195 SW 72"d Ave 201 amps to 400 amps 1 133.56 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:( ) I 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
Eil APPLICANT I 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Cochran Inc above service or feeder fee, 7.42 667.80 2
each branch circuitIf
Contact name:Jacob Welch B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:7550 SW Tech Center Dr#220 branch circuit
City/State/ZIP:Tigard,OR 97223 Each add'!branch circuit Ab 7.42 667.80 2
Miscellaneous(service or feeder not included)
Phone:(971)347-4433 Fax::( ) Each manufactured or modular 67.84 2
Email:jwelch@cochraninc.com dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Cochran Inc Sign or outline lighting 67.84 2
Address:7550 SW Tech Center Dr#220 Signalncircuit(s)trn or extension. 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Tigard,OR 97223 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(971)347-4433 Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(I hr min) 78.18/hr
Email:jwelch@cochraninc.com ,// eZej Inspections for which no fee is
CCB Lie.: 72942 Electrical Lic.:37 7/6e., Suprv.Lie.: 5457s specifically listed(/z hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: v �'e Subtotal: 2878.96
Print name: Ryan Richards - —Dare7-11-21-2017 El Plan Review Required(25%of permit fee): 719.74
State surcharge(12%of permit fee): 345.4$
Authorized signature: TOTAL PERMIT FEE: '9951T
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
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