Permit (143) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00786
TfGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/10/2018
Parcel: 1 S134BC00403
Jurisdiction: Tigard
Site address: 12505 SW NORTH DAKOTA ST 901
Project: Meadow Creek Apartments Subdivision: None Lot: None
Project Description: Building 9: Install one 20A branch circuit in each of 16 units for water heater for units 901-916
Contractor: TICE ELECTRIC Owner: BEL PORTLAND HOLDINGS LLC
5405 N LAGOON AVE. BY EATON VANCE MANAGEMENT
PORTLAND, OR 97217 REIG DIRECTOR OF AASSET MANAGEME
2 INTERNATIONAL PL
BOSTON, MA 02110
PHONE: 503-872-8230 PHONE:
FAX: 971-230-3330
FEES
Quantity Description Date Amount
16 crt Branch Circuits wo/Purchase 12/10/2018 $167.48
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/10/2018 $20.10
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $187.58
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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. —�
Issued By: \ s`� � Permittee Signature: S ",c.,r
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 Tr , FOR OFFICE ISE ONLY
City of Tigard 1" Received �� � Permit#: �,�',- Th''C.'(�`C
ir1V' { 1 Date/By: �. 1CS \�
13125 SW Hall Blvd.,Tigard,OR 97223 ,;0 d °} plan Review J
Phone: 503.718.2439 Fax: 503.598.1960 ,r Date/By: Related Permit#:
Inspection Line: 503.639.4175 y I fit° (.31.-- 1 i k's 'r Ready Date/By: r, i 7ur s. ®See Page 2 for
I 1"1") Internet: www.tigard-or.gov 9 w`t d i n r, s(,,,,,,'`)otified/Method:I ,'4 M. t Supplemental Information
1 l
r ,a (` . ®
0 New construction ®Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked):
o Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
`-" - ,w.. "71C Oji co :._ exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building Tess to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
®Multi-family 0 Master builder 0 Other: ['Fire pump. 0 Installation of 150 KVA or
_._ �' E 11911— ,0-
� k w�<� R( � p ".-@'L'�1*I0kINt(11,;",?-4----.. a ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:12505 SW- l3;, s;[}rG 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard/Oregon/97223 tvtl ._�...-
,1�� I\ `Cr- ❑Six ci moreresidential units. 0 Recreational
parks.
O.>;, ❑Health-care facilities. Recreational vehicle
Suite/bldg./apt.#:9 I Project name: ater-Heat -en euits ❑Hazardous locations. 0 Supply voltage for more than
_ ❑Service or feeder 600 amps or more. 600 volts nominal
Cross street/directions to job site: \%- C--'t--'> --•t' A:liC~Cf`1A 7VP- =E: I_vel r
�s=s
Description I Qty. Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: 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
DES Ind i"E 0 L8R . ,_ :-.-1,-,--,, Limited energy,residential
Install one 20A branch circuit in each of 16 units for Water Heater
1Zt _ . (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
a I , residential(with above sq.ft.)
k'� 1 , '' � �� Renewable Energy I 0 See Page 2
111054 P -_� t ��ra Services or feeders installation,alteration,and/or relocation
Name: 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:( ) 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 I own which is not 200 amps or less 59.36 1 I
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
-41190411P1,4&14„0:-:
- 4 Branch circuits—new,alteration,or extension,per panel
� .-- OLA �_ _ �� �,� � -- �� A.Fee for branch circuits with
Business name:Tice Electric Company above service or feeder fee, 7.42 2
each branch circuit
Contact name:Sara Currie B.Fee for branch circuits without
Address:5405 N La con Ave service or feeder fee,first 1 56.18 56.18 2
I; branch circuit
City/State/ZIP:Portland/Oregon/97217 Each add'l branch circuit 15 7.42 111.30 2
Miscellaneous(service or feeder not included)
Phone:(503)872-8256 I Fax: :(503)231-3372 Each manufactured or modular 67.84 2
Email:sarac@ticeelectric.com dwelling,service and/or feeder
Reconnect only 67.84 2
7 I1 T,;;,11111113110
7 -x' f ' ! s 71` ;,x s, ,, Pump or irrigation circle 67.84 2
Business name:Tice Electric Company Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:5405 N Lagoon Ave panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP:Portland/Oregon/97217 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)872-8256 Fax:(503)231-3372 Investigation(1 hr min) 90.00/hr
Email:sarac@ticeelectric.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
�r-}it. CCB Lic.: 166 Electrical Lic.: 26-126C Suprv.Lic.: 3940S s ecific.
all listed /:hr mm)
_ rryk �_ v
i s, i '
Suprv.Electrician signature,required:
Subtotal: 167.48
Print name: Bob Richardson Date: 11/28/18 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 20.10
Authorized signature: TOTAL PERMIT FEE: 187.58 /
This permit application expires if a permit is not obtained within 180
Print name: Date: 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 440.4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
L- I'llwm
Fee for all residential systems combined: $75.00_ DRenewwesa1 °° QEach Total "
able electrical energy systemm s:
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
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:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is
s)ecifically iste Yz hr min 90.00/hr
'it
v .0.
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ 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\Pemtits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015