Permit (159) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00821
D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/19/2018
T f G}� ' g Parcel: 1 S135DA03500
Jurisdiction: Tigard
Site address: 11481 SW HALL BLVD 102
Project: Spec Space Subdivision: METZGER ACRE TRACTS Lot: 19
Project Description: (8)branch circuits for TI.
Contractor: GARY'S ELECTRIC CO LLC Owner: BECKAL LLC
1401 SW WALLULA DR 7100 SW GABLE PKWY
GRESHAM, OR 97080 PORTLAND, OR 97225
PHONE: 503-465-8145 PHONE:
FAX: 503-465-8517
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo/Purchase 12/19/2018 $108.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/19/2018 $12.97
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $121.09
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 foil ules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. • ua obtain gpy of the les or direct questions to OUNC by calling 50 232.1987 r 1.:0,. 344.
1 /1. /�'
Issued By: L�—,III -_ rmittee Signature: ��'
!411P.'
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.
:ECEIV.
Electrical Permit Application FOR OFFICE 1 1. ()NI.\
City of Tigard Re:!iew'
1 /�/ permit#: f�Lz �1f�"D
IN
13125 SW Hall Blvd.,Tigard,OR 97223 0 .C 19 201
„ Dad
Phone: 503.718.2439
■ RelatedPermit#: 67 „wt., _
Q iBy
Email: TigardBuildingPennits@Tigard-or.gov C I' ,!OF TIG It Date/By: Jute H See Page 2 for
1 WARD Inspection Line: 503.639.4175 Internet'BwwyggOtorsouw.11 44y2. ethod:
UIL ING 1)1. ii
TYPE OF WORK PLAN REVIEW
❑New construction Addition/alteration/replacement 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.
❑Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CA ORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 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.
0 Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
/ / ( s ,�� t I ` ` ❑Addition of new motor load of system.
Job#: Job site address: 1. I(,�
e �� � � 100HP or more. ❑"A" "E" "1-2" "1-3„
City/State/ZIP: . / Q(^ occupancy.
0 Six or more residential units. P y
0 Health-care facilities. CI Recreational vehicle parks.
Suite/bldg./apt.#: t C) Project name: ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'►500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
el t c I l G e t/'G i ty \A,,� ((5 •t (with above sq ft.) 75.00 2
!t 3 Limited energy,multi-family 75.00 • 2
D t I� residential(with above sq.ft.)
Renewable Energy 0 See Page 2
CI PROPERTY OWNER 0 TENANT 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 amps200.34 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
0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: gr
D;l�i S t' fed i i cc L Z-� above service or feeder fee, 7 42 2
�1 � each branch circuit
Contact name: iI . . , i1 B.Fee for branch circuits without
service or feeder fee,first 1 56.18 5-6,is2
Address: branch circuit
City/State/ZIP: Each add'I branch circuit 7 7.42 40'e fpr. 2
Miscellaneous(service or feeder not included)
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 3c 4.1 t !e C,Tr,C L j C-L�. Sign or outline lighting 67.84 2
Address: `4 0( i S v- "y /it)
J l} J{ Signal circuit(s)or limited-energy 0 See Page 2 2
� panel,alteration,or extension.
City/State/ZIP: G vAcz 01, DEach additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) d tkS , t ti5_ Investigation(1 hr min) 90.00/hr
Email: ii Poi( ICi 3cd' col iv/ Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.:, b ?i):i°4 lectrical Lic.: C, (&/U Suprv.Lic.:II 231-S specifically listed(''A hr min)
,,' //�, G ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required` /�// 5"'v`r 1' Subtotal: i!5'�, i
Print name: (cti Nt p f'tC, "r'1'c f1 V Date: CCI f 2C)3' 0 Plan Review Required(25%of permit fee): _
State surcharge(12%of permit fee): !Z t /_
TOTAL PERMIT FEEL ) 21
Authorized signature:
.: 0.)1
This permit application expires if a permit is not tamed within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Remtits\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 OLY: FEE SCHEDULE
I *
Fee for all residential systems combined: $75.00 Desc Renewable 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:
n 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 90.00/hr
specifically listed('/3 hr min)
ELECTRICAL PERMIT
FEES
COM1VlE�C =' ��ONLY: �,. �
Fee for each commercial system: $75.00 Subtotal(Enter on Page 0:
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11481 SW HALL BLVD 102, TIGARD, OR, 97223 February 13, 2019 at
8:56:32 AM
Record Type: Record ID:
Commercial - Electrical ELC2018-00821
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor