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Permit
III CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2020-00114 Date Issued: 02/26/2020 r t G,\R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134AA02100 Jurisdiction: Tigard Site address: 10300 SW NIMBUS AVE PC Project: KG Investments Subdivision: IKOLL BUSINESS CENTER,TIGARD Lot: 3 Project Description: Adding and altering(15)branch circuits for TI. Contractor: DML ELECTRICAL SERVICES LLC Owner: DIETRICH, NANCY BISHOP PO BOX 687 ROBINSON, JERRY CHRISTOPHER TRUST GLADSTONE, OR 97027 ROBINSON, LYNN ET AL 9701 SE MCLOUGHLIN BLVD MILWAUKIE, OR 97222 PHONE: 971-276-4484 PHONE: FAX: FEES Quantity Description Date Amount 15 crt Branch Circuits wo/Purchase 02/26/2020 $160.06 Specifics: Service or Feeder 1 ea 12%State Surcharge- 02/26/2020 $19.21 Type of Use: COM Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $179.27 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 re.u' - you to follow the adopted by the Oregon Utility Notification Center Tho rules are set forth in OAR 952-001-0010 through OAR 952-Or r09• ou may.• . a cop e rut r direct questions to OUNC by calling;$03 L3�. 7 0,1 0 .3.27234'4: l vJ Issued By: 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 RECEIVE, FOR OFFICE USE O\1 1 City of Tigard R Deate/Bceived: �� - ,� Pe.. ' Ale' - i�� L • 13125 SW Hall Blvd.,Tigard,OR 97223 FEB 2 6 2020 Plan Review • Phone: 503.718.2439 Date/: : F 9� 7% �i /r Email: TigardBuildingPetmits@Tigard-or.g T�Yv,OF TIGARD-�t� Ready Date By: `agezfor TIGARD Inspection Line: 503.639.4175 Intt'ern-PM 1 LU u1�510N Notified/Method: VIM' Supplemental Information ,,{I TYPE OF WORK 1tt L�LU�IVU PLAN REVIEW O New construction U Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑Service or feeder 400 amps or more ❑Building over three stories. ❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGOR'}' OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. D I-and 2-family dwelling ,,ommercial/industrial ElAccessory building less to ground,or exceeds I4,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: ['Fire pump. ['Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: I Job site address: to"? 3 _SW /U M6} k i�.. 100HP or more. ❑"A" "E" "1-z" "l-s" /, 0 Six or more residential units. occupancy. City/State/ZIP: TSckfC14l� `�/ 7 Z 1� ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.# ( ,, I Project name: ,4'J ,J Is D ., , Ak 0 Hazardous locations. 0 Supply voltage for more than 4. U Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: G— � - ve5 L� FEE SCHEDULE 'T Description I Qty. I 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 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) �� ,�, 75.00 2 / rc t(evy YCN evL� Limited energy,multi-family rl 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ❑ PROPERTY OWNER I 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 amps 200.34 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 .8 APPLICANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: `.D1 "L. 1: c-eecr.l _ 5' ,-vi e `f r above service or feeder fee, 7 42 2 1 F `J'^ - each branch circuit Contact name: i Or l Ltv, 4 t 1 ` B.Fee for branch circuits without / • - -- "UU service or feeder fee,first 56.18 2 Address: .•Q , II-ys,t, k 7 branch circuit City/State/ZIP: t,fr..td >'C,0€.-- 6 R a/7U 2-7 Each add'I branch circuit 7.42 /y 2 2.7� � �f manufactured Miscellaneous ed or(serviceoru feeder not included) Phone:(CrA Each manufactured or modular 67.84 2 ` i ( dwelling,service and/or feeder Email: d t�l II t h vf t L CJ CH)'i . ` ' �/^ Reconnect only 67.84 2 {� CONTRACTOR �* Pump or irrigation circle 67.84 2 \Business name: L. (eb.ivi z.4,e\ Se/VtJ -Z-1.� - Sign or outline lighting 67.84 2 T'-'\ Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Ty Additional inspection(I hr min) 66.25/hr Phone:( ) Investigation(I hr min) 90.00/hr Industrial plant(I hr min) 78.18/hr Email: K/rdloi i /©((/L-7 Inspections for which no fee is yry/,J_.17 I e". 6 ,I C /1 l �+ specifically listed('/hr min) 90.00/hr CCB Lic.:Y[�[fia'1 Electrical Lie.: ( � i�uprv.Lic.: / J ELECTRICAL PERMIT FEES Suprv. Electrician signature,required; / "N•11 • Subtotal: Print name: , )r park__ V--�O vi-v�l Date: 2-2ce ^20 0 Plan Review Required(25%of permit fee): State surcharge(12%of pennit fee): Authorized signature: TOTAL PERMIT FEE: 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_PernatApp_ELR_ERE.doc Rev 10'26/2017 440-46157(I 1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description I Qa• I Each T°tatI * 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: ❑ 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(/-hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): 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 IA Building PermilApp_ELR_ERE.doe Rev RI/26/2017