Permit Support Document 111 CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00237
TFGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� = Date Issued: 04/11/2018
Parcel: 2S 113AB00600
Jurisdiction: Tigard
Site address: 16160 SW UPPER BOONES FERRY RD
Project: phytelligence Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: TI. 8/1/2018:REPRINT permit to add(16)branch circuits for a total of(74).
Contractor: JOHANSEN ELECTRIC INC Owner: PACIFIC REALTY ASSOCIATES LP
16869 SW 65TH AVE, SUITE 311 ATTN: N PIVEN
LAKE OSWEGO, OR 97035 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-747-2503 PHONE:
FAX: 503-972-1861
FEES
Quantity Description Date Amount
58 crt Branch Circuits wo/Purchase 04/11/2018 $479.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/11/2018 $57.49
Type of Use: COM Electrical
Class of Work: ALT 16 crt Branch Circuits w/Purchase 07/27/2018 $118.72
Type of Const: Service or Feeder
0 ea 12%State Surcharge- 07/27/2018 $14.25
Occupancy Grp: Electrical
Total $669.58
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: Ore n 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 R 52- 1-0090. 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: ' Permittee Signature: eA/ /9--7° 4-,,,e 4 770"/
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 Applicata_ , E 1% El)
FOR OFFICE USE()NL)
City ofTigard Received, / 41 LCogQ/e-t!� 3 7
N . 4 5 � DatGBy:a ' �� Permit
13125 SW Hall Blvd.,Tigard,OR 97223 A 1�._ �, 1 a Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 yg Date By: Related Permit#:
I 1 c A R i� inspection Line: 503.639.4175 ,{ f"i� I Tit,t7 A CSD Ready Date/By:/ f 741. luras: El See Page 2 for
Internet. www.tigard-or.gov I t % ° a �]1C101`
y�q Notified/Method� /(�eclh`T Supplemental Information
' r .� ,i. -,r,-,:TYPE O" f Yr E 1 -
' m � � 'moi!� L�'lY/ -a�..��ti�L.41wI REVIEW
Please check all that apply(submit sets of plans w/items checked):
❑New construction gAddition/alteration/replacement
❑Demolition 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Other: where the available fault current 0 Marinas and boatyards.
T. CATEGORY' OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for ail other installations. buildings.
❑Multi-family 0 Master builder 0 Other:
0 Fire pump. 0 Installation of 150 KVA or
" :na` JOB SITE INFORMATION 'AND LOCATION ❑Emergency system. larger separately derived
Job#: 1 Job site address: /6/ S /���� 4 ❑100HP o of oew motor load of system.
//7/ I tx or or more. ❑occu anc"1-2","i-3",
City/State/ZIP: r•
❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt #: I Project name: Phy f€/t// T t.e ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEESCHEDUI,E
nesartanoa I Qrr. I Each I Total I *
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
Ea.add'l 500 sq.ft.or portion 33.92 1
ti. 4,,,.;.., - 4'= r1)EESC,RIPTION OF WORK /o Limited energy,residential
4 lIc 7 ' ex/s/7.1/en, ioe-nl�lI- L..+�-� 2t /3 231 (with above sq.ft.) 75.00 2
Limited'energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0,'PROPERTY OWNER - 0 TENANT:. Services or feeders 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:( ) 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 I
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
n
i ,PP C} "! " 1 ❑ CONTACT PERSON Branch circuits—new,alteration.or extension,per panel
A.Fee for branch circuits with
Business name: �t�C/Q.,1 S� p'/eta AG above serviceor feeder fee.
Contact name: eh g,'_` rin
each branch circuit 7.42 2
�� $(�/') B.sFeeifce bor circuits without
Address: 44&,/
/ service or feeder fee,first
w ill l branch circuit 56.18 2
City/State/ZIP: zAi,o /Ss, ei, Gr, -s e/r7Ggr Each addl branch circuit 14 7.42 2
(, Jq 1 Fax::( ) J Miscellaneous(service or feeder not included)
Phone: ) / ._,&) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: S t Sign or outline lighting 67.84 2
-Address: Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) 1 Fax ( ) investigation(1 hr min) 90.00/hr
Email' Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: / Eleetriea �/Q I Su rv.Lie.: /gip specifically listed(%:hr min) 90A0/hr
/ I I /( 4 `7 c_ f p "/D ELECTRICAL PERMIT.FEES_
Suprv.Electrician signature,requir 4(
Print name: Subtotal: //,,e, '�.1--
Li� J Date: 7/4_S7/�Bi ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): /V. ZS
Authorized signatur TOTAL PERMIT FEE: /3 , 437 7
This permit application expires if a permit is not obtained within 180
J1
Print name: J i, .) 16 Date: 1/2-s'4 days after it has been accepted as complete.
` * Numb
miter of inspections allowed per permit.
1:\Building\Pers\ELC_PermitApp_ELR_ E. �.doe RevO&17/2015 440•46151(11/05/COM,WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16160 SW UPPER BOONES FERRY RD, October 1 , 2018 at 9:25:16 AM
TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2018-00237
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor