Permit Support Document (27) CITY OF TIGARD ELECTRICAL PERMIT
2. '- COMMUNITY DEVELOPMENT s Permit#: ELC2018-00540
� Date Issued: 08/14/2018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ,/ '� Parcel: 2S112BD90131
I/ FF��'���� Jurisdiction: Tigard
Site address: 14655 SW 76TH AVE 13
Project: KEN-Timbercrest Condos-18943 Subdivision: TIMBERCREST CONDO Lot: 13
Project Description: Safe off and temp power. 11/15/18:REPRINTED permit to include(8)branch circuits.
Contractor: CLACKAMAS ELECTRIC INC. Owner: SCHWARTZ, KIMBERLY A
PO BOX 51 14655 SW 76TH AVE#46
BEAVERCREEK, OR 97004 TIGARD, OR 97224
PHONE: 503-969-5684 PHONE:
FAX: 503-632-2421
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 08/14/2018 $100.70
Specifics: amps or less
12 crt Branch Circuits w/Purchase 11/15/2018 $89.04
Type of Use: MF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/15/2018 $22.77
Electrical
Type of Const:
Occupancy Grp:
Total $212.51
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. You ma of th-rules or - questions to OUNC by calling 503.232.1987 or 1.800.32.23,44.
Issued By: - c - 'e 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 Aonlicadon 1:012 01.1.-1( 1: 1 !if.:ONI.N
City ofTigard Received
Pennit#EZ-Cu204,'..tOt.)--SY0
II 13125 SW Hall Blvd.,Tigard,OR 9722e E.---,--',,,c,, iv F:r,, -,.,-•'. :.Y:
7,1
i a
' Phone: 503.718.2439 Fax: 503.598.l90 Plan 11111-1- "11'1- ' '1-"" Plan Review
Related Pemait#:
,i,:A,,n Inspection Line: 503.639.4175 Date/By:
''''''''''''. Internet: www.tigard-or.gov NOV i 4 2.018
Ready Date/By: kris: B See Page 2 for
.. , .--...k otified/Method: Supplemental Information
Cf-I Y 0 1-- i 1(ItiAn ____________
3U1LTANG OMSION
, ,
Business name: cActegainas .1
El e_CAL17c-_÷T-Jic,
--- - -
1 New construction Addition/alteration/replacement
1 Demolition Other: City/State/ZIPLZecLyezrc)re.el DectioDci
....
C-'-A%. , Y, Ni4.4,7-,i;c7i9,4 -41% Phone-
(51)3)(032' 24 2-0 1 Pax:(51)3(°32-2
I 1-and 2-family dwelling Commercial/industrial Accessory building 1 Email:Se-c v i Ce‘prjaalo A'
1 Multi-family Master builder Other:
• CCB Lic.: 1 to lq 23 Electrical Lic.: -Gape. Sum
17.7"7" c.:73dai,-',-.-:,,w11, _____:,-,,..,.. _,,,,p4, ,, , 1
','s,,,,,,:40i,V7,-,'„g6,10/011.':::.1,tiPt, 14ea.''-I: -:III 01141: 1,.:TOWAT.141r401; ,,...'",Z,VIIII,',„.4.4.-:, 1 44111.11.1.-",....-.
1'11-,-0-,1-,11111 -1111---,.''15:r,,:i,•11,11,1'S-''''''' ",2-;"1-'''''' 1,4,L2L2,-,,,':''''1",,',,,,,,,,',',- Suprv.Electrician signature,required:
Job#: i 8q 43 i Job site address: 1 L4 (0,555w-7(011j_4.1..e.ti3 i
Print name: S ca,L.1._Jo le\in s,.. • ....1Date
..... _
11 City/State/ZIP:'Po rf 1_,4 DK) g 1.2-2,4
Suite/bIdg./apt.#: /3 Project name: keeraoritz451_ Authorized signature:
Print
I Cross street/directions to job site: rname: Date
Si— --- _ . _ —I
' •'':;'i.,':.,'.',-ii.01.147M,„ ,'"D.:,',•:='•,‘,,',',':;,:.-kg,,',1,.. 44:0:,`,n,"-..:‘,.-'1,-...77 :Af-i
i .','-r-vto-,-NI,'"-.A,-",::4-Ii:*,,.ViN4egvitiWIlerlititpwatt13!"71
.,Subdi vision: Lot#:
I.-
, Please check all that apply(submit 2 sets of plans w/items checked):
1 Tax map/parcel#:
Service or feeder 400 amps or Building over three stories.
l
i -8Fliiiz:-- : ';'''a-tiN 1 :1.7.the available fault=rent FMloatmgarinas' and boatyards.
:,...,....... - , .- - - exceeds 10,000 amps at 150 volts Commercial-use agricultural
I or
'AN 6c....,_ (Tu.).u'e_Am,g,......+1)..4e4Aexabea-11..r-aki,5 .- . I4less to ground,or exceeds 14,000 installation of 150 KVA or
Iamps for all other installations. larger separately derived
F.V-4"1-',"1—.- -IX/-16'10.T175. - 4 tr . 6 i 411 ..,". ''.'4.1 Emergency system.
.,it;,54,--„i:,-pit4i ,,„:!,-6 .-:-.. ,,041-',7,----,,,-,14 ,-,,,!,:,.4E14,,,: ,-?,,,S041:'A67,:, , Addition of new motor load of occupancy.
::",',430-:--,, ; t :-,,--121p21, ,, , - -,,nm1.71.,,, ..:-..,:f4,374, 1
1C0HP or more. Recreational vehicle parks.
I Name: I Six or more residential units. Supply voltage for more than
I Health-care facilities. 600 volts nominal.Fldress: ' Hazardous locations.
Service or feeder 600 amps or
i
. 1 City/State/ZIP:
rPhone:( ) I Fax:( ) Dk7777,70iiiRledrA,,,,,,,,..",,;.„1 ,,,,,,„....,,..„,,,,,,...
AFliii'.7.;
I
rEmail: _ 1 u.dialva [ Qty. ' EaehiTh6t 1 *
L _
i New residential single-or multi-family dwelling unit.
Owner installation:This installation is being made on property that I own which is Includes attached garage.
not intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and --
1 1
701. 1,000 sq.ft.or less 168.54 4
I
i z
Owner signature: Date: I ' 1 a.add'i 500 sq.ft.or portion 33.92 1 I I 1
L,11J1111.4,1111:4!11,4101i1tWAJA111t11 :1'.1 :1.L-1C00110.(11grIRT"lft
ASM: 1' Limited ener/g6 residential 1 I L...i.
1
75.00 i I 2
1 (with above sq.ft.)
ami1 1 1
1 Business name:
ILimited energy,multi-family : 1
1 I
Contact name: 1 residential(with above sq. 75.00 1 2
j &)
I Address:
1 -
1 — —
r- Energy Renewable See Page 2
i City/State/ZIP:
— Services or feeders installation,alteration,and/or relocation
Phone:( ) I Fax::( )
--- i1 i rt
-- -- 200 amps or less 100.70 i
1 2
€
1-Email: I 2:
.„.„. I 201 amps to 400 amps : 133.56 1
.., ,,--00:-,': -_,,,.-AFR,_f.'„,„,,,,,,,,._-,, 57574, ,--- ,..,NAtT :',,,,, '-,....- 4 i , 1
74,r4i-,; --±;1--tig%-,-.. 14-,w,i7 ,,IiTe,4- f-,--',-,I4leaSZ---'-',.-'g-eltt'k-v, ,
1 200.341 I -21
1 1
1:\Building\PermitslELC_PermilApp_ELRERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
10 we, t_61(91 41) ociG-ativo PeAtivivt-4 t.-1--C 20i - 0()51-10
•
601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
relocation
200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
above service or feeder fee,
each branch circuit 7.42 2
13.Fee for branch circuits
without service or feeder fa,
first branch circuit 56.18 2
Each add'!branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Each manufactured or modular 67:$4
dwelling,service and/or feeder
Reconnect only
Pump or irrigation circle 2
Sign or outline lighting67.84 1 2
Signal circuit(s)or limited..
energy panel,alteration,or See Page 2 2
extension.
IEach additional inspection over allowable in any of the
above
}Additional inspection(1 hr min) 1 66.25/hr
Investigation(I br min) q 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
specifically listed('h hr min) 90.00/hr
01 P1
Subtotal: sq,
Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): - 2
TOTAL PERMIT FEE: to , CJ
Thls permit application expires if a permit is not obtained within 180 days after it has been accepted as
complete.
Number of inspections allowed per permit.
I:\Building\Pe'mits\ELC_PermitApp_ELR_ERE.doc Rev 06/17!2015
CITY OF TIGARD ELECTRICAL PERMIT
• 2. ' COMMUNITY DEVELOPMENT r, t, ` ' Permit#: ELC2018-00540
HallBlvd.,Tigard503.718.2439Date Issued: 08/14/2018
T',GAR. 13125SW OR 97223 1 Parcel: 2S112BD90131
Jurisdiction: Tigard
Site address: 14655 SW 76TH AVE 13
Project: KEN-Timbercrest Condos-18943 Subdivision: TIMBERCREST CONDO Lot: 13
Project Description: Safe off and temp power. 11/15/18:REPRINTED permit to include(8)branch circuits.
Contractor: CLACKAMAS ELECTRIC INC. Owner: SCHWARTZ, KIMBERLY A
PO BOX 51 14655 SW 76TH AVE#46
BEAVERCREEK, OR 97004 TIGARD, OR 97224
PHONE: 503-969-5684 PHONE:
FAX: 503-632-2421
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 08/14/2018 $100.70
Specifics: amps or less
12 crt Branch Circuits w/Purchase 11/15/2018 $89.04
Type of Use: MF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/15/2018 $22.77
Electrical
Type of Const:
Occupancy Grp:
Total $212.51
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 - -•opted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You i'- -. - - of the rules or 'irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: -- �: Permi e- •.ture: r`. 1,4-----e-- ).--•.:
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.
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14655 SW 76TH AVE 13, TIGARD, OR, 97224 February 4, 2019 at
10:06:12 AM
Record Type: Record ID:
Commercial - Electrical ELC2018-00540
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor