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Permit (113) CITY OF TIGARD ELECTRICAL PERMIT 1114 1 COMMUNITY DEVELOPMENT Permit#: ELC2018-00709 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/01/2018 T I c ,�h.C7 g Parcel: 1S136AD04000 Jurisdiction: Tigard Site address: 11511 SW PACIFIC HWY Project: Vine Gogh Subdivision: VILLA RIDGE Lot: 7 Project Description: (1)branch circuit to reconnect(1)RTU. Contractor: WILLAMETTE HVAC LLC Owner: MCLELLAN ESTATE CO 3075 SW 234TH AVE.#206 707 OLD COUNTY RD HILLSBORO, OR 97123 BELMONT, CA 94002 PHONE: 503-259-3200 PHONE: FAX: 503-848-2597 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 10/25/2018 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 10/25/2018 $6.74 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 Cen= . Those rules are set forth in OAR 952-001-0010 through OAR -001-0090 You y obtain a copy f the rules or dir t questions to OUNC by calling 503.231.1:: or .800.332.23 . Issued By: �iC 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 A lica .. $4- FOR OFFICE USE ONLI City of Tigard Received Permit No.: r v Date/B : 'f 1t i!I ,.-. i. . 4}c 114 Ill 13125 SW Hall Blvd.,Tigard,OR 972pC T 1 I .l 0lb Plan Review II Phone: 503.718.2439 Fax: 503.598.1'460 Date/B : Other Permit: 7 ,. j x- ATI C A R L) Inspection Line: 503.639.4175 ., i y i--It. .,.: 1$( PA ° Date Ready/By: IRMI ® See age 2 for Internet: www.tigard-or.gov ,P1 I {��,., e -'• 4 (,,, Notified/Method: Supplemental Information '144' TYPE .RKs t PLAN REVIEW ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where current 0 z... R: ; ,,CATEGORY OF q I©NNTRUCTIy ' exceeds 10,000 amps atground, faulte available 150 volts or ❑Flo Floating buildings.as and ards. less to14,000 or exceeds ❑Commercial-use agricultural ❑ 1-and 2-family dwelling ®Commercial/industrial 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or JOB SITE INFORMATION AND L CATION ❑Emergency system. larger separately derived system. , =4,==,- ,,= _. , „ 0 Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address: 11511 SW Pacific Hwy 1001IP or more. occupancy. 0 Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP:Tigard OR 97223 0 Health-care facilities. 0 Supply voltage for more than 0 Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name:Vine Gogh 0 Service or feeder 600 amps or more. ,'t. ; FEE SCHEDULE Cross street/directions to job site: Descriptiont. Qty. I Fee. j Total New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4 Ea.add'l 500 sq.ft.or portion 33.92 1 Tax map/parcel no.: Limited energy,residential ys : 75.00 2 �:;31E�CRIPTIOAJOIE` WORK ��. �.�� (with above sq.ft.) >�., Limited energy,multi-family reconnect RTU75.00 2 residential(with above sq.ft.) Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 0 PROPERTY OWNER 9 TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or relocation Phone:( ) Fax:( ) 200 amps or less 59.36 l Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel Owner signature: Date: A.Fee for branch circuits with PLICA,NT = `. above service or feeder fee, 0 C©NTACIERS©N 7.42 2 each branch circuit Business name:same as below B.Fee for branch circuits without service or feeder fee,first 1 Contact name: branch circuit 56.18 S f 2 Each add'1 branch circuit 7.42 2 Address: Miscellaneous(service or feeder not included) Each manufactured or modular City/State/ZIP: dwelling,service and/or feeder 67.84 2 Phone:( ) Fax: :( ) Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E-mail: Sign or outline lighting 67.84 2 CONTRACTOR .',-,.z. Signal circuit(s)or limited-energy Business name:Willamette HVAC LLC panel,alteration,or extension. Page 2 2 Each additional inspection over allowable in any of the above Address:3075 SE Century Blvd Suite 206 Additional inspection(1 hr min) 66.25/hr City/State/ZIP:Hillsboro,OR 97123 Investigation(I hr min) 66.25/hr Industrial plant(1 hr min) 78.18/hr Phone:(503)259.3200 Fax:(503)848.2597 Inspections for which no fee is 90.00/hr specificall• y listed('/.hr min) CCB Lic.: 56951 Electrical Lic.: 34346CRE Suprv.Lic.: 4025LEB ELECTRICAL"PERMIT FEES " 7 Subtotal: y Suprv.Electrician signature,required: _ Plan review(25%of permit fee): t r u Print name: mike sicard Date: 9/11/18 State surcharge(12%of permit fee): P Q/� TOTAL PERMIT FEE. ' o) )1(I 4---c.fi 4- Authorized signature: ��1 This permit application expires if a permit is not tamed within.30 days after it has been accepted as complete. Print name: Michael Malstrom Date: 9/11/18 * Number of inspections allowed per permit. I:\Building\Permits\ELC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB Electrical Permit Application - City of Tigard ❑ Other Page 2 - Supplemental Information Total number of commercial systems: _ LIMITED ENERGY PERMIT FEES: ::.No licenses are required. Licenses are require for all other installations RESIDENTIAL VOldi ONLY Fee for all residential systems $75.00 combined Check Type of Work Involved: ❑ Audio and Stereo Systems" ❑ Burglar Alarm n Garage Door Opener* ❑ Heating,Ventilation and Air Conditioning System'' n Vacuum Systems" ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control"" n Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting ❑ Protective Signaling I:\Building\Permits\ELGPermitApp.doc 07/01/10 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11511 SW PACIFIC HWY, TIGARD, OR, 97223 Record Type: Record ID: Commercial - Electrical ELC2018-00709 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor