Permit r , CITY OF TIGARD ELECTRICAL PERMIT
1„„ ; COMMUNITY DEVELOPMENT Permit #: ELC2011 -00261
Date Issued: 05/18/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S113A600500
Jurisdiction: TIGARD
Site address: 16083 SW UPPER BOONES FERRY RD 105
Project: Metro Multifamily Housing Association Subdivision: FANNO CREEK ACRE TRACTS Lot: PT 37, F
Project Description: TI. Low voltage for fire alarm.
Contractor: LEAR ELECTRIC CO INC Owner: G &S FC LLC
5140 SE CIRCLE AVE 16083 SW UPPER BOONES FERRY RD,
PORTLAND, OR 97236 STE
TIGARD, OR 97224
PHONE: 503 - 849 -4723 PHONE:
FAX: 503 -661 -6389
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 05/18/2011 $100.70
Specifics: amps or less
12 crt Branch Circuits w /Purchase 05/18/2011 $89.04
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea Signal circuit or Limited 05/18/2011 $75.00
Energy Panel
Type of Const: 1 ea 12% State Surcharge - 05/18/2011 $31.77
Occupancy Grp: Electrical
Total $296.51
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 OA' • 2- 001 -0090. You may o - • • , • . e rule • ect questions to OUNC by calling 503.232.1987 or 1.800 332.2344. t
Issued By: Permittee Signature: //if`r
fI
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.
05/17/2011 09: 42 5036616389 • LEAR ELECTRIC CO INC PAGE 02
RECEIVED
Electrical Permit Application 1.0R 01. .I. 1 ():\.1).'
rd,, ..- a 2 W Ha ga OR 97223 M 1 7 2011
7
p °Rec : e8Y :R ive ev d 'iew 5- 'h 177
II C s of 11!g Ti
. Phone: 503.718.2439 Fax: 503.5986py OF TIGARD Dateflay; Permit No.; FiL fi---Cy126 i
Other Permit:
• 1 i , r K i ) Inspection Line: 503.639.4175
BUILDING D
IVISION Date Ready/By: kris: 13 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: -.)-1-1). Supplemental Information
Eginectattlitingitlig.,0 ..t'l 4 'c'fillfalliA Slitiflif:‘..:t,:" 0:
0 New construction [23 Addition/alteration/replacement Please check all that apply (submit a sets of plans w/items checked below);
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other where the available fault current 0 Marinas and boatyards.
gitaigaiRgiigliti!,tii:4!:k):AgSktk&i.jEgagiinggfaiigg exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
CI 1-and 2-family dwelling e Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: El Fire pump. 0 Installation of 75 KVA or
larger separately derived system.
giiiiitifetttif,e' ';',it.::!;,:;$t,' "
, 'A'.:),ut.,Y„ EAErnddeirtgirn Emergen s n y e s w tem mOtor load of 0"A", "E", "1-r "1-3",
Job no.: 11-314 Job site address: 16083 SW Upper Boones Ferry Rd too0P or more. occupancy.
1:1Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Tigard, OR 97224 0 Health-care facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no. 16 £51' . Project name: MMHA TI 0 Service or feeder 600 amps or more.
,.
Cross street/directions to job site: A int. 1 - I - 1' - -fa,: ty Description Ore. t Fee. '1 Total - l '.'
New residential single- or multi-family dwelling unit.
HZ/I.A.S' 1 4.10CrGrA))/V Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1
Tax map/parcel no.:
Limited energy, residential
W. (with above sq. ft.) 75.00 2
, 4 'I ,,, gert:O.1 '■ ■VA , i., .' .:0',04 ' ,.. !, ,,;- , ,,,,,,,,, , Limited energy, muiti
75.00 2
Tenant Improvement residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 100.70 100.70 2
NtRittint4WW4WW24 201 am to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
City/State/ZIP:
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
401 amps to 599 amps 168.54 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
Vtgg015001100§0POMAlgONONEVRINXI4K0000040*#00TCP4g above service or feeder fee
each branch circuit 12
7.42 89.04
2
Business name: B. Fee for branch circuits without
service or feeder fee, first
5618 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address:
Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP:
dwelling, service and/or feeder 67.84 2
Phone: ( ) I Fax: : ( ) Reconnect only
67.84 2
Pump or irrigation circle 67.84 2
E
Sign or outline lighting 67.84 2
11:1:i*IV,Or'hilPIRItfi . ' i '., .. A 2,,, re l e j g':'0V ; .qgia l M%';`!0: -, U - 40'4. Signal circuit(s) or limited energy I 75.00
panel, alteration, or extension. Page 2 2
Business name: Lear Electric Co., Inc.
. Each additional inspection over allowable in any of the above
Address: PO Box 573 Additional inspection (1 hr min) 1 66.25/hr
Investigation (1 hr min) 66.25/ hr
City/State/ZIP: Gresham, OR 97030
Industrial plant (1 hr min) 78A 8/ hr
Phone: (503) 665 Fax: (503) 661 Inspections for which no fee is
90.00/ hr
specifically listed 'A hr min
CCB Lie.: 52278 Electrical Lic.: 26 Suprv. Lic.: 3786S `f3PartaNF.‘ i' ,b . ' ' )4. 1
,
„. : 7
Z
Suprv. Electrician signs , Mred: , / 7 . Subtotal:
Plan review (25% of permit fee): 264.74
_
Print name: David Mumford te: 5/17/11 State surcharge (12% of permit fee): 31.77
TOTAL PERMIT FEE: 296.51
Authoriz ignature: ,,,, / .7"
10~ ,..... _ Thk permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: David Mumford Date: 5/17/11 • Number of inspections allowed per permit.
BBoilding\Permits 1 ELC-PermitApp doe 07/01/10 440-46 15T(I 1.10.5/COM/WEB
05/17/2011 09:42 5036616389 LEAR ELECTRIC CO INC PAGE 03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
t � �`�^ �!9 'rl'� � � S. ,�dGh � ;n�a..�. ,;? ?, `Q.'�, ���;1Y�p'n�,�2'!,�,�Nr r- ,,;�,�•';�,_` ;; �� " � ' `'"��a %�`'
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
n Other:
a 4�� � i �i. b1 •i� :� k �' i ' ''� �M � '� gia,��"t� �%^-"i ` &Y".�,a'� : "�`Y?�, 7' < �,'£'4 °y'u ^.y`. >;:�� ` ,,
tr'..A1400K ^f.,,r ,.isi `�'i�r; �:a if: ,y�:�:,o
Fee for each commercial $75.00
system
(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
: 1 auild ;ng\Permiro\ELC- PermitApp.doc 07/01/10