Permit Support Document (35) --- CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT / Permit#: ELC2019-00502
13125 SW Hall Blvd.,Tigard OR 97223 71 24 Date Issued: 07/29/2019
TIGARD 9 503. 8. 39 ��JI Parcel: 1 S 134AA02100
V� Jurisdiction: Tigard
Site address: 10300 SW NIMBUS AVE P
Project: SAILBRI TI-JOB#1614 Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3
Project Description: OFFICE AND PRODUCTION AREA TENANT IMPROVEMENT. 9/10/19:REPRINT to add limited energy for data
telecommunication installation.
Contractor: MCCOY ELECTRIC CO INC Owner: DIETRICH, NANCY BISHOP
29191 NW WEST UNION RD ROBINSON, JERRY CHRISTOPHER TRUST
NORTH PLAINS, OR 97133 ROBINSON, LYNN ET AL
9701 SE MCLOUGHLIN BLVD
MILWAUKIE, OR 97222
PHONE: 503-234-7521 PHONE:
FAX: 503-234-9473
FEES
Quantity Description Date Amount
25 crt Branch Circuits wo/Purchase 07/29/2019 $234.26
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 07/29/2019 $28.11
Type of Use: COM Electrical
Class of Work: ALT 1 ea Restricted Energy Permit 09/19/2019 $75.00
Type of Const: 9 12%State Surcharge- 09/19/2019 $9.00
Electrical
Occupancy Grp:
Total $346.37
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 9 1-0090. u m btain a copy o he rules or direct questions to OUNC by calling 503.232.19 or 1.800.332.2344.
Issued By: _go � / Permittee Signature: 1711°// e7 /_7'
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 Applicata ? 1 , '`,, FoR of Fl( 1�.lar,oil,'
City of Tigard Date/By: `i /0 [9 17 enn %vfi oe(///----/Ak
IN . 13125 SW Hall Blvd.,Tigard,t7R.97223 plan Review
ss Phone: 503.718.2439 Fax: 503:598.4960 Date/By: Related Permit if:
Inspection Line: 503.639.4175 Ready Da-.., kris. 62See Page 2 for
r I G:1/4 R D Internet: µ,why tigard or.gov Notifi �i: Supplemental Information
4; '1,t;_----;---',,z,:,;IS;-e.zz.--. -.. 7- ..W: ..IriykV5:-::,.t-*v4Ket---)iie
❑New construction ®Addition/alteration/replacement ♦ 1 ` II Please check all that apply(submit 2 sets of plans w/items checked):
0 Demolition El Other: . 0 Service or feeder 400 amps or mom 0 Building over three stories.
i E,, , — ri where the available fault arcrent ❑Marinas and ards.
- =-* ° i4 t),d-iii i+Y 61' fe e --&----;;-9-";',;-_-.. .-4,7A-. exceeds 10,000 am s at 150 volts or
`�' ^ -�v,_.fr��.�'_�� �n �� ._4 - ' : p 1:1 Floating buildings.
❑ 1-and 2-family dwelling ®Commercial/industrial ❑Accessory bu ding less to grmutd,or exceeds 14,000 ❑Commercial-use agricultural
amps❑Multi-family Cl Master builder 0 Other: ❑Firepump,
other installations. tngs.
._, K, _ pump. Installation of 150 KYA
4 '`0Y b e I S0''.1 ` EmergencyElstem. largerseparately i.:,-,-::: "{Z..-4%-.3 .7i5:0)14._. � )'� �._ � �.ice:: �,£:.' sy � Y
❑Addition of new motor load of system.
Job/1.1614 I Job site address:10300 SW Nimbus Ave. 1ooHP or more. ❑"A^,^E^,^1-z^,'t-3^,
City/State/ZIP:Tigard OR 97223 ❑Six or more residential units, occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bidgJapt.ft:Building P I Project name:Sailbri in Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal•
Cross street/directions tojob site: ;a_
�.F- ,. tea :ei s r1i a ii �� ��� -
Description I Qtr. I Earl 'I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: I Lot 41: 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
Limited energy,residential 75.00 2
Data Telecommunication Installation (with above sq.ft.)
Limited energy,multi-family 75.00 2
This is an adder to Permit#ELC2019-00502 residential(with above sq.ft.)
- .�� 01:-'404
. „c ) �.a ��",�� :. Renewable Energy ❑ See Page 2
"" -, � � '`P'f`'b)'3 41- "' -`�s^' l SOY``ter 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:( ) J 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
• ,.s.: r:v H 9,61 , �A - uootcroz :- .:a,_ Branch circuits-new alteration,or extension,per panel
t
' A.Fee for branch circuits with
Business name: above service or feeder fee,
7A2 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 6784 2
dwelling,service and/or feeder
EmailReconnect only 67,84 2
u _- .s?4+�_:ER 6 a. . rs Pump or irrigation circle 67.84 2
Business name:Mc Electric ..E.In or outline _62.114„._ ......_4, j,
Address:29191 NW West Union Rd. Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,a extension.
Each additional inspection over allowable in any of the above
City/State/ZIP:North Plains OR 97133
Additional inspection(1 hr min) 66251 hr
Phone:(503)234-7521 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:ericg@mccoyeIectric,com Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:8277 Electrical Lic.:26-*i,. Suprv.LW.:5208S specificall listed 44 hr min) 90.00/hr
rte,
Suprv.Electrician signature,required: //L�I
r..� Subtotal:
J /
I
Print name: Z Date: i/l 0/�ftp ❑Plan Review Required(25%of permit fee):
"`"�' ` State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMiT FEE:
This permit application expires if a permit is not obtained within 180
Print name:Zack Armstrong. Date:9/10/19 days after it has been accepted as complete,
Number of inspections allowed per permit.
I:\auildintu'ernulstELC PermdApp_ELR_EREdoc Rev 06/17/2013 440.46157(I lro5/COM/WEB
r
Electrical Permit Application--City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
,00417y -4` RFS$ D
Description l Qty. 1 Each I Total 1
Fee for all residential systems combined: $75.00 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 2s 1wa 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 552.26 2
Heating,Ventilation and Air Conditioningsolar generation
Sion
09-0040)
❑ 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 an of the above:
❑ Other Each additional inspection is 66.25/hr 1
charged at en hourly(1 hr min)
Inspections for which no fee is 90.001 hr
f0:0 .04; � t�� his"".•,b
s Mean listedhr ) 1
R" Subtotal(Enteron Page 1):
Fee for each commercial system: $75.00 a Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ 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:10uilding1Ponnila1ELC_PemtilApp_ELR_ERE.doe Rev 06/17/2015