Permit .�
CITY OF TIGARD ELECTRICAL PERMIT
a COMMUNITY DEVELOPMENT Permit#: ELC2018-00603
13125 SW Hall Blvd.,Ti Date Issued: 11/07/2018
Tlt;Alt.T? and OR 97223 503.718.2439 9
Parcel: 2S 101 AA02900
Jurisdiction: Tigard
Site address: 12123 SW 69TH AVE
Project: Compass Oncology Subdivision: WEST PORTLAND HEIGHTS Lot: B
Project Description: Electrical for new TI.
Contractor: CAPITOL ELECTRIC CO INC Owner: MCKESSON SPECIALITY HEALTH
11401 NE MARX STREET 10101 WOODLANDS FOREST DR
PORTLAND, OR 97220 THE WOODLANDS,TX 77380
PHONE: 503-255-9488 PHONE: 281-863-4723
FAX: 503-257-7121
FEES
Quantity Description Date Amount
1 ea Limited Energy 10/31/2018 $75.00
Specifics:
7 ea Services or Feeders-200 10/31/2018 $704.90
amps or less
Type of Use: COM 1 ea Services or Feeders-201 to 10/31/2018 $133.56
Class of Work: ALT 400 amps
Type of Const: 34 crt Branch Circuits w/Purchase 10/31/2018 $252.28
Service or Feeder
Occupancy Grp: 1 ea 12%State Surcharge- 10/31/2018 $139.89
Electrical
1 ea Plan Review Electricial 10/31/2018 $291.44
Total $1,597.07
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 t - 'es -••• -• by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 95 -$01-0090. You.• --..' _ ••,of the rules or dire. questions to OUNC by calling 503.232.1987 or 1.800.332.2 ..
40111C-
/ AOMP ' Sfl✓' `
Issued By: �/" >L �� Permittee t nature: �}--
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 USE ONLY
City of Tigard � `Received 4 /t // , •malt#: /p
16 ' Deceive l (J r ,:� �`C�Uf �t���j
't 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
IN
C Phone: 503.718.2439 Fax: 503.598.1960 1 Date/By: v Related> p /��l)��--0? (L
Inspection Line: 503.639.4175 SEP 1 _ Ready •
Date�y: Sufis: G/ I vId See Page 2 for
TIGARI , Intertiet: www.tigard-or.gov .tfied/Meth4e 4i�`,,./ P Supplemental Information
',.s.ii;f a° ., ':, xxi.'s�,m '0,iP xe ', + -gin: , .i•-=�".apt. .,`. . ,..,., ..r.'Sa� .,..#.. w ,•,�' ....,
❑New construction ®Addition/alterat�1 p
'lir' —.. 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-
❑,v,,,,„.0.1:,,, � :� ��. ' ,.�►`�
Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
e.-N„^ d exceeds 10,000 amps at 150 volts or 0 Floating buildings.
, ,)7Y OF'a c01!jS ; �
El1-and 2-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations- buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump, 0 Installation of 150 KVA or
r. , .. :140:Ory ❑Emergency system. larger separately derived
(>' , 1Ira s
��"✓`'t t7 ❑Addition of new motor load of system.
Job#: 181900 Job site address: 12123 SW 69th Ave. IOOHP or more. ❑"A"."E","1-2","t-3",
0 Six or more residential units, occupancy.
City/State/ZIP:Tigard,OR 97223 El Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#:Bldg A I Project name:Compass Oncology 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:Corner of SW 69th/SW Dartmouth ' aw D . `�t ` �-
Description Qty. "Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: I Lot II: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
; t' T C 176-1 ° r1k rcn Limited energy,residential
75.00 2
Interior demolition of existing building,then tenant improvement shall be (with above sq.ft.)
Limited energy,multi-family 75.00 2
interior construction for women's cancer treatment center.
residential(with above sq.ft.)
trP14.21thidi Renewable Energy I 0 Sec Page 2
R.,""i14:34.0,010-0.v . ,AServices or feeders installation,alteration,and/or relocation
Name:McKesson Specialty Health 200 amps or less 7 100.70 704.9 2
Address: 10101 Woodlands Forest Dr. 201 amps to 400 amps 1 133.56 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:The Woodlands,TX 77380 601 amps to 1,000 amps 301.04 2
Phone:(281)863-4723 Fax:(281)863-6363 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
_Branch circuits—new,alteration,or extension,per panel
4. ` ,$ ❑, o ii, T ., !4,,,, :, 4.,:zCC ')('A PERSON A.Fee for branch circuits:tit:
Business name:CORGAN Architects above service or feeder fee, 34 7 42 2,582.42
each branch circuit
Contact name:Dennis Escobar , B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:401 N.Houston St. branch circuit
City/State/ZIP:Dallas,TX 75202 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(346)201-6201 I Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:dennis.escobar®corgan.com Reconnect only 67.84 2
f'," ,.fir s ,„ :'..CONTRACTOR ':.',4'''N "”, Pump or irrigation circle 67.84 2
Business name:Capitol Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ® See Page 2 75.00 2
Address:11401 NE Marx St. panel,alteration,or extension.
City/State/ZIP:Portland,OR 97220 Each additional inspection over allowable in any of the above
ty Additional inspection(1 hr min) 66.25/hr
Phone:(503)255-9488 I Fax:(503)257-7121 Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email: Re- Inspections for which no fee is
90.00/hr
CCB Lie.: 47478 I Electrical Lic.: 16 496C Suprv.Lie.: 3132-S
speclficall (y2fisted� hr mm
Suprv.Electrician signature,required: y >x ) Subtotal: 3,495.42.
Print name: Darrell McNeel Date: 9/12/18 0 Plan Review Required(25%of permit fee): 873.90
State surcharge(12%of permit fee): 419.47
TOTAL PERMIT FEE: 4,788.(i�
Authorized signature: ),, i), _�}
Ldp; This permit application expires if a"permit is not obtained within 180
Print name: Darrell McNeel Date: 9/12/18 days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 440-4615Ttt 1/05/COM/WEB
I
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
a...�'^�,%a.n.'^ 4.Im,me...,�,.0 ' di � 'h1'.t ' °� 1 " �i4+�3� * �,`� tIOW..
Fee for all residential systems combined: $75.00 Description Qty. I Each Total "
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15,01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
C Burglar Alarm
25.01 to 50 kva 301.04 2
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ 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:
E Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is
specificall listed t4 hr min 90.00/hr
fie °A4 Aro.
Fee for each commercial system: $75.00 Subtotal(Enteron Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
A. Fire Alarm Installation
El HVAC
O Instrumentation
O ntercom and Paging Systems
❑ Landscape Irrigation Control*
El Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
LI Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
la nuiiding\Permits\ELC_PermilApp ELR_ERE.doc Rev 06/17/2015
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12123 SW 69TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00603
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor