Permit (47) CITY OF TIGARD ELECTRICAL PERMIT
11 .....„. * ' COMMUNITY DEVELOPMENT Permit#: ELC2019-00439
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2019
T t(;;1 p.f7 9 Parcel: 25101 DD00500
Jurisdiction: Tigard
Site address: 6755 SW SANDBURG ST
' Project: Reece Security Subdivision: SALEM FREEWAY SUBDIVISION Lot: 2
Project Description: Electrical for new second floor TI.
Contractor: ATLAS ELECTRICAL CONTRACTORS Owner: REECE HOLDINGS LLC
4403 SE ROETHE RD 25977 SW CANYON CREEK RD, STE E
MILWAUKIE, OR 96267 WILSONVILLE, OR 97070
PHONE: 503-803-7673
PHONE: 503-659-2212
FAX: 503-659-4944
FEES
Quantity Description Date Amount
3 ea Services or Feeders-200 07/09/2019 $302.10
Specifics: amps or less
1 ea Services or Feeders-Over 07/09/2019 $552.26
Type of Use: COM 1000 amps or volts
Class of Work: ALT 84 crt Branch Circuits w/Purchase 07/09/2019 $623.28
Service or Feeder
Type of Const: 1 ea Sign or Outline Lighting 07/09/2019 $67.84
Occupancy Grp: 1 ea Plan Review Electricial 07/09/2019 $386.37
1 ea 12%State Surcharge- 07/09/2019 $185.46
Electrical
13 ea Info Process/Archiving-Lg 07/09/2019 $26.00
$2.00(over 11x17)
Total $2,143.31
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 Cent. . Those rules are set forth in OAR
952-001-0010 through OAR 952- -0090. YmayAJ.tain a copy of -rules or direct questions to OUNC by calling 503.232.1/for 1.800.3 .23,. `
a_ �/ i LK.
Issued By: . ..—e I 9 �� 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 Application rzFOR OFFICE ISE ONLY
Received./."
CityUPI 4 O Tigard aI(1 Date/B : , # / ,A
131SW all Blvd.,Tigard,OR 97223 j L,.v , 1� y C.� '% �'� ` �^��_`
g Plan �� 12015 j
>! Phone: 503.718.2439 Fax: 503.598.1960 Date/By: f ' j
Inspection Line: 503.639.4175 Ready Date ty: ans: Es See Pagb1for
T I( y R I) Internet: www.tigard-or.gov IV. •i-d/Method' Supplemental Information
Ail
t,==1:: --7'7'.
Wrp :ren r � - „ "1.'.I 0 0 x'iA.® ; T ;: a:at= I Z -T3 Yy i MFlo
❑New construction 8 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
4ti _ "'A. -.-.°6:''''y' cow-A ictrom. 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 ❑Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family El Master builder El Other: 0 Fire pump. 0 Installation of 150 KVA or
altlot srr ',y t1 TIo mi LO TION I!r, i' ❑Emergency system. larger separately derived
f
Job#: ,9456;r30Job site address:(0?55 (.t.) � ❑Add
0HP o mores motor load of system.
IOHP or more. ❑"A" "E" "1-2" "1-3„
V ❑Six or more residential units. occupancy.
City/State/ZIP: Tit ara C) _ q-7a4.14
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: React, to r1.1, 0 Hazardous locations. ❑600Sulylts voltage
o r more than
`T
0 Service or feeder 600 amps or more.
Cross street/directions to job site: tkillftelbilllAll -, cH i3L
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
168.54 4
Tax map/parcel# Ea.l sdq,ft.or esa ads
500 sq.ft.or portion 33.92 1
„ P6omi1 P111 = s I'; 1 ''6 I1,!�d®. Q 'MLimited energy,residential III
6-1 ►C4 i /'l %) ul tV1 Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
❑1T:° f ° t°TY OW1 ER h �'H h❑�ITENA [`l;! 4. Services or feeders installation,alteration,and/or relocation
Name: Reece SerAAr;4-%,/ 200 amps or less 3 100.70 '509.,API 2
Address: x5511 5(,(,) Cprty014 C.Fee it. Rd. 5.6.
201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: U)i ticvn4 Ile,A <7670 601 amps to 1,000 amps 301.04 2
Phone:(503 ) 648,1- 61900 Fax:( ) Over 1,000 amps or volts 4 552.26 , . _ 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
,,, . ,°_. E ❑r 0 e T PERSONl` _Branch circuits—new,alteration,or extension,per panel
3e
�,� t - - A.Fee for branch circuits with
Business name: above service or feeder fee, pu
each branch circuit t 1 7.42 (pa,3. 2
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) I Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email
Reconnect only 67.84 2
iii 0 r
„ . Iu6);1110e,:'''....-6?-, . ' Pump or irrigation circle 67.84 2
Business name: j f_4 6s.i Sign or outline lighting I 67.84 67 eV 2
Address: itio3 C G�i v Signalnel,circuit(s)ern or extension.eionergy 0 See Page 2 2
s panel,alteration,or
ty Iryl`twill- tk i�+�w�/�J Each additional inspection over allowable in any of the above
City/State/ZIP: I'l 1I s "��d't0 / Additional inspection(1 hr min) 66.25/hr
Phone:(533)4,91-0.2-i9- I Fax:(0 )659—L/92/Li Investigation(1 hr min) 90.00/hr
Shaken c2- z 'se/eLt�r/cG/. tom Industrial plant(1 hr min) 78.18/hr
Email:
S Inspections for which no fee is 90.00/hr
CCB Lic.: 15 3a... Electrical Lic.: -6--®- Suprv.Lic.f 5- 5 specifically listed('/hr min)
1''' ( $ ELEC'T12icAI/'1
Suprv.Electrician signature,required: 157/5 y8
7
��,,� ,� ,�f`..;r Subtotal: ,
Print name:T A >-, ;�ate�?�gr �� ❑Plan Review Required(25%of permit fee): 3 2o.37
I Y y y ¢ State surcharge(12%of permit fee): (42)5.44
Authorized signature: t. ,_ ` TOTAL PERMIT FEE: ,
�� ' '' .t!, '�./1 This permit application expires if a permit is not obtained within 180
Print name:'7 D err A _' ' e: -i6/-6 days after it has been accepted as complete.
rr /'L�j C Jam•I t $ Number of inspections allowed per permit.
L•iBuitdng\Permits\ELC_PmnitApp_ELR ERE.doe Rev 06/17/2015 446-4615T(I I/OS/COM/WEB