Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2013 00236
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/29/2013
Parcel: 1 S136DD01300
Jurisdiction: Tigard
Site address: 6855 SW BAYLOR ST
Project: Tillamook Cheese Subdivision: WEST PORTLAND HEIGHTS Lot: 19
Project Description: (1) 200 amps or less to install one new 50A ckt for new UPS
Contractor: MILESTONE ELECTRIC Owner: GSP LLC
1281 NE 25TH AVE, STE. T MALCOM & SHARON ESLINGER LLC
HILLSBORO, OR 97124 BY DWIGHT SCHWAB
15450 SW BOONES FERRY RD STE 2
LAKE OSWEGO, OR 97035
PHONE: 503 - 645 -5323 PHONE:
FAX: 503 - 690 -4843
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 04/29/2013 $100.70
Specifics: amps or less
1 ea 12% State Surcharge - 04/29/2013 $12.08
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 - 00 q p90. Y oo a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature: O t t . l 4- PPzIci v kL
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 603.639.4175 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.
Apr.25. 2013 11:21AM Milestone Electric No.3715 P. 1
Electrical Permit Applic EIVED i.,),;(11 1 1( 1. l fit. 5-)`1,1
City of Tigard Received
DateB : : f/ 3 sf permit No.: t(.C.,d0/3._ 60,;31
• 13125 SW Hall Blvd., Tigard, OR 97223 APR 2 5 2013 Plan Review
• Phone: 503.718,2439 Fax: 503.598.1960 Date/By: Other permit:
1; :1 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: y: ;urn: la See Pa 2 for
Internet: wnvw.tigerd- or.gov i , k ' , , , Notified/Method: n tip Supplemental Information
❑ New construction 23 Addition/alteration/replacement
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
['Demolition ❑ Other: where the available fault current 0 Marinas and boatyards.
l'' (a 4, 0.41: rbl , ., t.I p, , r e ,, .1 exceeds 10,000 amps at 150 volts or ❑ Floating buildinp.
. r._... _.....:.: ....., less to ground, or exceeds 14,000
El 1- and 2- family dwelling ® Commercial/industrial ❑ Accessory building 0 com l.uu agricultural
g amps for all other installations. buildings.
❑ Multi - family Q Master builder ❑ Other ['Fire pump, ❑ Installation of 75 KVA or
x r ❑ Pmergency ayetem. larger separately derived system.
d t') kY f k + Ii 1 l t' Air d e f, t o' . l, ( A )ii / ` O Addition of new motor load or ❑ "A" "E" "1.2" "1 -3 ",
looHP or more. occupancy.
Job no.: 13168 Job site address: 6855 SW Baylor St.
❑ Six or more residential units. 0 Recreational vehicle perks.
City /State /Zip: Tigard, OR 97223 ❑ Health -care facilities. 0 Supply voltage for more than
O Hazardous locations. 600 volts nominal,
Suite /bldg. /apt. no.: I Project name: Tillamook Cheese O Service or feeder 600 amps or more.
‘1.1; t
Cross street/directions to job site: Qq• p,», Tool •
New residential tingle- or multi - family dwelling unit
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map /ptucel no.: Ea. add'l 500 sq. ft or portion 33.92 1
Limited energy, residential 75.00 2
- ,. ,.. r n ... 11 , l i l . '',1 c n 1 (with above sq. ft.)
Limited energy, multi family 75.00 2
Install one new 50A ekt for new UPS. residential (with above sq, ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
", t ,e a . 5-f " ; `a i 1 a ft t l i ): i t t . c r 200 amps or less 1 100.70 100.70 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City /State/Zl[P: Temporary services or feeders installation, alteration, and /or
Phone: ( ) I Fax: ( ) relocation
200 amps or less 59.36 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits new, alteration, or extension, per panel
).li + `^* f ' r °�` t r , ,,c , e: .` A. Fee for branch circuits with
r... , e � above service or feeder fee, 7.42 2
Business name: each branch circuit
- B. Fee for branch circuits without
Contact name: service or feeder fee. first 56.18 2
branch circuit
Address: Each addl branch circuit 7.42 _ _ 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Each manufactured or modular 67.84 2
Phone: ( ) Fax:: ( ) dwelling, service and/or feeder
Reconnect only 61.84 2
E -mail: Purnp or irrigation circle 67.84 2
ro' : e> Sigh or outline lighting 67.84 2
Business name: Milestone Electric Signal circuit(s) or limited energy
panel, alteration, or extension. _ 2 2
Address: 1281 NE 25 Ave. Suite T Each additional inspection over in any of the abov
City /State/ZIP: Hillsboro, OR 97124 Additional inspection (1 hr min) 66.25/ hr
Investigation (1 hr min) 66.25/ hr
Phone: (503) 645 Fax: (503) 690 - 4843 Industrial plant (1 lirmin) 78.18/ hr
Inspections for which no fee is 90 hr
�.
CCB Lie.: 153480 Electrical Lie.:: �34-618C Suprv. Lie.: 56635 specifically listed (14 hr min)
Suprv. Electrician signature, required: ` C. �„
Subtotal: 100.70
Print name: Chris Hay Date: 4/25/2013 Plan review (25% of permit fee):
State surcharge (12% of permit fee); 12.08
Authorized Signature: TOTAL PERMIT FEE: 112.78
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:1Budding\Pe itstPLC PermitApp 04o919.dao 440- 4615TO /Os /COM/WMB
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
6855 SW BAYLOR ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
05/03/2013 00:00
ELC2013-00236
PASS - No C of O
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
6855 SW BAYLOR ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
05/03/2013 00:00
ELC2013-00236
PASS - No C of O
Violation Summary:
Inspector Contractor