Permit (184) CITY OF TIGARD ELECTRICAL PERMIT
14, .
' 2.-' COMMUNITY DEVELOPMENT Permit#: ELC2018-00587
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/05/2018
-F[GAR Parcel: 2S113AD01800
Jurisdiction: Tigard
Site address: 16770 SW 72ND AVE B14
Project: Cedars Foods Subdivision: ROSEWOOD ACRE TRACTS Lot: PTS 5-11
Project Description: (4)branch circuits for walk-in cooler.
Contractor: WYTEK CONTROLS, INC. Owner: PACIFIC REALTY ASSOCIATES
PO BOX 2510 ATTN: N PIVEN
TUALATIN, OR 97062 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-691-9002 PHONE:
FAX: 503-691-0313
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 09/05/2018 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/05/2018 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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. Yo - •stain a co. o - •-s or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344.
Issued By: %�:.,�_, _- _ — 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 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 FOR OFFICE ( SE()NEN
City of Tigard Received
g DateB : , "��i7 Permit#: -_ _ g '
111111 v 13125 SW Hall Blvd.,Tigard,OR 972238 E 1 VE 0 Plan Review -....../l..,..,21
-rte
g Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 SEF Ready Date/By: H See Page 2 for
T 1 C A R D Internet: www.tigard-or.gov 2018 Notified/Method: ELMESupplemental Information
TYPE OF WOlatITY OF TIGAR[) PLAN REVIEW
®New construction 0 Addition/alter eM1y�S+ {� Please check all that apply(submit 2 sets of plans w/items checked):
V 1°7.O N 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 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 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-family ❑Master builderamps gall other installations. buildings.
0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 16770 SW 72ad Ave B14 0 Addition of new motor load of system.
100HP or more. ❑"A" "E" "1-2" `9-3"
City/State/ZIP:Portland,Oregon 97224 ❑Six or more residential units, occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:B14 Project name:Cedars Mediteranian 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:72m1 and Boones Ferry FEE SCHEDULE
Description I Qty. 1 Each 1 Total
New residential single-or multi-family dwelling unit.
Subdivision:Rosewood Acre Tracts Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel 4: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Install 4 branch circuits for new walk in cooler
(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:Pacific Really Associates 200 amps or less 100.70 2
Address: 15350 SW Sequuia Pkwy#300 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Portland,Oregon 97224 601 amps to 1,000 amps 301.04 2
Phone:( ) 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 1 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
0
APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
service or feeder fee,first 1 56.18
Address: branch circuit 56.18 2
City/State/ZIP: Each add'l branch circuit 3 7.42 22.26 2
Phone: Miscellaneous(service or feeder not included)
( ) Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Wytek Controls Inc Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:PO Box 2510 panel,alteration,or extension. 0 See Page 2 2
CitylState/ZIP:Tualatin,Oregon 97062 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)691-9002 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:Wael@wytekcontrols.com Industrial plant(1 hr min) 78.18/hr
/O/1 !it Inspections for which no fee is 90,00/hr
CCB Lic.: 127381 Electrical Lie.: 34-571 C Suprv.Lie.: 4892S specifically listed(V2 hr min)
r ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 78.44
Print name: r\nt if c7 S 1 Date. 9-5-18 0 Plan Review Required(25%of permit fee):
V State surcharge(12%of permit fee): 9.41
Authorized signature: TOTAL PERMIT FEE: 87.85
This permit application expires if a permit is not obtained within t80
Print name: Date: 9-5-18 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC PermitApp_ELR_ERE.dor Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
16770 SW 72ND AVE B14, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2018-00587
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor