Permit (214) '10 ---- CITY OF TIGARD ELECTRICAL PERMIT
' _' COMMUNITY DEVELOPMENT Permit#: ELC2018-00446
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/03/2018
TIC;,41<'.t� g Parcel: 2S101 DA01000
Jurisdiction: Tigard
Site address: 7100 SW FIR LOOP
Project: Kelvix Subdivision: 72ND BUSINESS CENTER Lot: 10
Project Description: Replacing(5)branch circuits for TI.
Contractor: STUMPTOWN ELECTRIC LLC Owner: BKS INVESTMENTS LLC
PO BOX 14121 8313 SW CIRRUS DR
PORTLAND, OR 97293 BEAVERTON,OR 97008
PHONE: 503-729-2476 PHONE:
FAX:
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 07/03/2018 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/03/2018 $10.30
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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: Orego -w requires you t6' follow e rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA'-001-0 . You •follow/
of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: s L -el .9`G 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 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 = FOR OFFICE i.s l:ON 1.1
City of Tigard I I n * Received %,' permit#: ..c'0,. ► I
` V i Date/B : /
13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
'' C Phone: 503.718.2439 Fax: 503.598.1960 Date : Related Permit#: A
Inspection Line: 503.639.4175 Ready Date/By: Jurist ee Page 2 for
1 I G A R 1) Internet: www.tigard-or.gov i-:'''-''. ' - '"--1 '' ''' -1 i Notified/Method: Supplemental Information
r� TYPE OF WORK PLAN REVIEW
•/—�
❑New construction l,�t Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
1
0 Service or feeder 400 amps or more 0 Building over three stories.
D Demolition D 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
ampngs.
❑Multi-family ❑Master builder ❑Other: Fire for all other installations. but
0Fire pump. Installation❑ of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
' c (-: „..IN---14?.... P ❑ 00HFoo of new motor load of system.
Job#: Job site address:fl
e10HP or more. ❑"A" "E" "1-2""1-3»
City/State/ZIP k, (cq.) � �i t2...2_. ❑H Six or more residential units. R occupancy.
�/� ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: \C:e. x 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: J q �z V FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
7---C)L- C.
f_ i ` iM�tS So )^�C-`t
\• • (with above sq.ft.) 75.00 2
l Limited energy,multi-family
75.00 2
0,���,�.--�_ t�� residential(with above sq.ft.)
r �'�� '��� ��' �� 1 ' � Renewable Energy 0 See Page 2
PROPERTY OWNER 0 TENANT` Services or feeders installation,alteration,and/or relocation
Name: k a=i_\ \ )( 200 amps or less 100.70 2
Address:
"-1 I Q) 0 -, t 1 L CO P 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:`'—‘ G..1 N �)Q. CO 7.23 601 amps to 1,000 amps 301.04 2
Phone:)--7 f lCh--, i C) Fax:( ) Over 1,000 amps or volts 552.26 2
o_ r� Temporary services or feeders installation,alteration,and/or
Email: C;�,(� 1r K-�L\ \ y (i relocation
Owner installation: is 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
AM
APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: ����M �� ` Z.\ above service or feeder fee,
7.42 2
Contact name: L_�'v f' ` eacheebranchn circuit
� V yu � lr' B.Fee for branch circuits without
service or feeder fee,first
Address: p Q 112- -:--�....�..: .<,� _ 56.18 2
:JO:r.�-�i.,, branch circuit
Ci /State/ZIP:' - Each add'l branch circuit I-- 7.42 2
ty � OZ.... Miscellaneous(service or feeder not included)
Phone: Fax: 67.84 2
�� - `'� ( ) !� Each manufactured or modular
Email: S-1--..)('I?" - } _ �` i f , dwelling,service and/or feeder
i '• i.. f M a Reconnect only67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: S� ( CLA J k -E---t-t---c-A-0_,\G, L Sign or outline lighting 67.84 2
Address: f-� ' i' -�7 ` Signalles circuit(s)or limited-energy 0 See Page 2 2
,_�/ (\ \LA\ C_-J panel,alteration,or extension.
City/State/ZIP: /� 7 R 1 G
Each additional inspection over allowable in any of the above
ty �/ (_-►� v \�2°1--S
Additional inspection(1 hr min) 66.25/hr
Phone: 7� 2-Lf-7
L f-7 Fax:( ) ,. Investigation(1 hr min) 90.00/hr
Email: C v ( /\ o'a)� \ ��/1 t\-\ l Industrial plant(1 hr min) 78.18/hr
S "`� ‘---
CCB
Inspections for which no fee is 90.00/hr
CCB Lic.: C1�iC C' Electrical Lic.:C5 `-1 Suprv.Lie.: SZ. r specifically listed('/z hr min)
V ���� 7 �C��IU ,�� ELECTRICAL PERMIT FEES
Suprv.El/ cfan'3fg�lature,required7---_________ ---- Z-ie ._`-�----- Subtotal:
i
Print name: cr) C' Dat L 0 Plan Review Required(25%of permit fee):
J ti State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtainedwithin 180
Print name: )(`‘.1h„ ' C, Datei y( ,..j 1, 0days after it has been accepted as complete.
( ( L -e C) * Number of inspections allowed per permit.
L�Buildiug�Permits�ELC_PecwitApp_ELR_ERE.doc Rev 06/17 2015 440-4615T(l l/05/COM/WEB
Electrical Permit Application-City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESMNTIAL WORK Ont i.;'2,..24
1;6 ail
Description Qty. I Each I Total *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
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:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/hr min)
EuertucACruedir EE§ 122;2,9222252
MM ,A42:2 WORK ONL . n, ,
E
Subtotal Enteron Page
Fee for each commercial system: $75.00 1):
* 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
❑ 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_PennitApp_ELR_ERE.doc Rev 06/17/2015