Permit (136) CITY OF TIGARD ELECTRICAL PERMIT
P Permit#: ELC2018-00650
``7 COMMUNITY DEVELOPMENT
Date Issued: 10/02/2018
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134AD06202
Jurisdiction: Tigard
Site address: 10500 SW NIMBUS AVE T
Project: Westside School of Mission Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: A
Project Description: Electrical for new tenant:(10)branch circuits for lighting in offices and library.
Contractor: DILIGENT HANDS INC Owner: DIETRICH, NANCY BISHOP
12345 S TOLIVER RD ROBINSON, JERRY CHRISTOPHER TRUST
MOLALLA, OR 97038 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-349-0882 PHONE:
FAX:
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo/Purchase 10/02/2018 $122.96
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/02/2018 $14.76
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 52-001-0090. You ... •• • ••. - •irect questions to OUNC by callin• I •;7 or�1.8000.�4 ,
Issued By: �77.� C Permittee Signature �i%� _/�'
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 RECEIV.
1FOROFFICE I SE o11_l
City of Tigard ! it eBy:ed eO 2 / Permit#: i 't 1 �.-6
13125 SW Hall Blvd.,Tigard,OR 97223 a n Review ( r.� t �rJ
g Plan Review
III Phone: 503.718.2439
111
l� I 2 2018 Date/By: Related Permit#:
p
Email: TigardBuildingPermits@Tigard-or.gov 0 Ready Date/By: Juris: 0 See Page 2 for
l 1 G A R D Inspection Line: 503.639.4175 Internet: y�ay, v(�s Notified/Method: Supplemental Information
p AI Ut' GAa _ iJ„ PP
TYPE.OF'WO PLAN REVIEW
0 New construction �ddition/alterati E�Cir10IiP DIVISION Please 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.
0 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.
O 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.
O Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
� r ❑Addition of new motor load of system.
Job#: Job site address:
Ry-.)00 0O SLj I"1✓t1 ✓.. 100HP or more. ❑«A„ «E„ «1.2„ «1.3„
e ❑Six or more residential units. occupancy.
City/State/ZIP:
1 c 4y,-.0 1 (V___. ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: /,�� a.l� r._ i r]Hazardous locations. ❑Supply voltage for more than
!�`� { �" c)f/'►"}i4) J]Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: l)( Vl(9 I(S cry FEE SCHEDULE
/T Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
I
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK - Limited energy,residential 75.00 2
t is f I (with above sq.ft.)
PQ-Veit 0,1±—IQ-13 01 lid /�S�'1/3 l7 014,e, 01461 Limited energy,multi-family
l/ jn rY ml („) ,-4,,,,,
) , ,, residential(with above sq.ft.) 75.00 2
/ !� Renewable Energy 0 See Page 2
0 PRO RTY OWNER TENANT Services or feeders installation,alteration,and/or relocation
Name: (14%.,,c. l VP 5 t AO 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 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
APPLICANT ICONTACT PERSON Branch circuits—new,alteration,or extension,per panel
I �.I A.Fee for branch circuits with
Business name: '31 1 ik 7v,,
Nc✓'y1 S, i above service or feeder fee,
7.42 2
each branch circuit
Contact name: M411/, u3 LQ2 B.Fee for branch circuits without
service or feeder fee,first
Address: 1 2._. (./ .' s; 7 v )/v r-- branch circuit 56.18 56, t ISt:/ 2
City/State/ZIP: ((6,4 00Ca ` 9--701f cT Each add'l branch circuit 7.42 /Jv 78'S;r 2
i
Miscellaneous(service or feeder nit included) tsi O
Phone:(5'`3 ) '3 �.
(/ dEach manufactured or modular 67.84 2
/ ^ - dwelling,service and/or feeder
Email: del (1 Cr,e,1�-� iV�t 5 vvioy-k )c i4/jc1 /, �/ ,,rt Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 5 t'YYk0 , Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension. g
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
`'..,1 Inspections for which no fee is
CCB Lie.: specifically listed('/hr min) 90.00/hr
°lZ..c� I ElecMcal Lim �j )5 Su�rv.Lic.: ;�
ELECTRICAL PERMIT
Suprv.Electrician signature,requlr � -- FEES
-�: - � Subtotal: f 0Print name: / ,, !. { _ �i ate: /0 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): al 74,
��� ,/ TOTAL PERMIT FEE: 3 7A
Authorized signature: ,/ _ • ,
This permit application expires if a permit is not obtained within 180
Print name: Or fL Date: ( ?� days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE scaEnuLE
x.hv_..,rte: .........::...�.:_, 4 . :..—�.-..,......u...,.
Fee for all residential systems combined: $75.00 Description Qry. Each Total •
Renewable
3' 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)
n 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
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
s.ecifically listed('/a m
hr inn
CO
.SM,. ILIVORK ONLY: LECTRICAt PERMIT FEES;
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
* Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
n 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_PermitApp_ELR_ERE.doe Rev 10/26/2017
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
10500 SW NIMBUS AVE T, TIGARD, OR, 97223 September 10, 2019 at
11 :58:15 AM
Record Type: Record ID:
Commercial - Electrical ELC2018-00650
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
FaceTime with Jeff Grove
Violation Summary:
Inspector Contractor