Permit v CITY OF TIGARD ELECTRICAL PERMIT
' g_ - COMMUNITY DEVELOPMENT Permit#: ELC2013-00484
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2013
Parcel: 2S102BD00100
Jurisdiction: Tigard
Site address: 12520 SW GRANT AVE
Project: St Anthony Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 52 '
Project Description: (8)200 amp services,(1)1000+amp service,(106)branch circuits and(1)low voltage for fire alarm for new
community center assembly building.
Contractor: CAPITOL ELECTRIC CO INC Owner: ST ANTHONY CATHOLIC CHURCH TIGAR
11401 NE MARX STREET 9905 SW MCKENZIE ST
PORTLAND, OR 97220 TIGARD, OR 97223
•
PHONE: 503-255-9488 PHONE:
FAX: 503-257-7121
FEES
Quantity Description Date Amount
8 ea Services or Feeders-200 08/27/2013 $805.60
Specifics: amps or less
1 ea Services or Feeders-Over 08/27/2013 $552.26
Type of Use: COM 1000 amps or volts
Class of Work: NEW 106 crt Branch Circuits w/Purchase 08/27/2013 $786.52
Service or Feeder
Type of Const: 1 ea Signal circuit or Limited 08/27/2013 $75.00
Occupancy Grp: Energy Panel
1 ea Plan Review Electricial 08/27/2013 $554.85
1 ea 12%State Surcharge- 08/27/2013 $266.33
Electrical
Total $3,040.56
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in = •• .ante wi- -.proved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. A NTION: Oregon la requires you to follow the rules adopted by the Oregon Utility Noti1 - •-n Center. Those •rules are set forth in OAR
952-001 .010 thr.ugh OAR 952-0' 11.0. may obtain a co.y of the rules or direct questions to OUNC b 1 u,• '03.232.1987 or 1.800.32.2344. '
Issu:d By: / •" 41.-.Ar..... Permittee Signal ' !4';' 4 ' / sz—,______,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' AMY , ` ,. /(-�`--" Date: - 0 7 /3
. r
LICENSE NO. A$r!o5
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 FOR OFFICE USE ONLY „
CEI P ED Received p
City of Tigard �rJJ
Date/By:Rev w 1/?/-3 rmit no L0,20%3'r�0 9,y
• 13125 SW Hall Blvd.,Tigard,OR 9721-31E Plan Rev w /
y ( Other Permi
Phone: 503.639.4171 Fax: 503.598.1960 AUG 1 5 ZOI3 Date/! //� elf/�o20/3�ea0 6�
T I GA R D
Inspection Line: 503.639.4175 Date R :• /By: Juris: U See Page 2 for
Internet: www.tigard-or.gov 0-3 �!}C}IT-Y OF r IG,IAeR(D� Notified/Methods < Supplemental Information
TYPE OF WORK BUILDif IVISION PLAN REVIEW
U New construction U Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked below):
❑ Demolition ❑ Other: Service or feeder 400 amps or more ❑Building over three stories
CATEGORY OF CONSTRUCTION where the available fault current ❑Marinas and boatyards
U I-and 2-family dwelling U Commercial/industrial H Accessory building exceeds 10,000 amps at 150 volts or ❑Floating buildings
❑ Multi-family ❑ Master Builder ❑Other less to ground,or exceeds 14,000 ❑Commercial-use agricultural
JOB SITE INFORMATION AND LOCATION amps for all other installations. buildings
Job no.: 130090 Job site address: °onr,CW McKanzie Street ❑ Fire Pump ❑ Installation of 75 KVA or
�" ,, /� ❑Emergency system larger separately derived system.
City/State/ZIP: Tigard,OR. /.�S?o b•u)(y �rTV C/ ❑Addition of new motor load of ❑"A","E","1-2","1-3",
100HP or more. ❑ occupancy
Suite/bldg./apt.no.: Project name: St Anthony Community Center ❑Six or more residential units Ill Recreational vehicle parks.
❑ Health-care facilities ❑ Supply voltage for more than
Cross Street/Directions to job site: ❑ Hazardous locations 600 volts nominal.
❑ Service or feeder 600 amps or more
Subdivision: Lot no.: FEE SCHEDULE
Description I Qty. I Fee. I Total I
Tax map/parcel no.: New residential-single or multi-family dwelling unit.
DESCRIPTION OF WORK Includes attached garage.
1000 sq.II.or less 5 168.54 4
Ea.Add'I 500 sq.ft or portion S 33.92 1
U PROPERTY OWNER I U TENANT Limited energy residential
Name:
(with above sq.ft.) $ 75.00 2
Limited energy,multi-family
Address: residential(with above sq.ft.) $ 75.00 _ 2
Service or feeders installation,alteration,and/or relocation
City/State/ZIP: 200 amps or less 8 5 100.70 805.60 2
•
201 amps to 400 amps S 133.56 2
Phone: Fax:
401 amps to 600 amps $ 200.34 2
601 amps to 1000 amps 5 301.04 2
Owner installation: This installation is being made on property that I own which is not Over 1000 amps or volts 1 $ 552.26 552.26 2
intended for sale,lease,rent or exchange,according to ORS 447,449,670,and 701 Temporary services or feeders installation,alteration,and/or
Owner signature: Date: relocation
200 amps or less $ 59.36 1
U APPLICANT I U CONTACT PERSON 201 amps to 400 amps $ 125.08 2
Business Name:
401 amps to 599 amps $ 168.54 2
Branch circuits-new,alteration,or extension,per panel
Contact name: A. Fee for branch circuits with
service or feeder fee,each
Address: branch circuit 106 $ 7.42 786.52 2
B. Fee for branch circuits
City/State/ZIP: without service or feeder fee,
first branch circuit $ 56.18 2
Phone: Fax: Each additional branch circuit: $ 7.42 2
Miscellaneous(service or feeder not included)
E-mail: Each manufactured or modular
CONTRACTOR dwelling,service and or feeder .$ 67.84 2
Business Name: CAPITOL ELECTRIC CO.,INC.
Reconnect only $ 67.84 2
Pump or irrigation circle .$ 67.84 2
Contact name: Richard Martin Sign or outline lighting -$ 67.84 2
Signal circuit(s)or limited-energy See
Address: 11401 NE MARX ST. panel,alterations,or extension. _ I _ Page 2 $75 2
Each additional inspection over allowable in any of the above
City/State/ZIP: PORTLAND,OR 97220-1041 Additional inspection(I hr min) 66.25/hr
Investigation(I hr min) 66.25/hr
Phone: 503-255-9488 Fax: 503-257-7121 Industrial plant(I hr min) 7R.18/hr
Inspections for which no fee is 90.00/hr
CCB Lie.: 48748 'Electrical Lie.: 26-496C ISuprv.Lic.: 28.65—S specifically listed(1/2 hr min)
Suprv.Electrician signature,required: .Z%p/�GA ELECTRICAL PERMIT FEES
Subtotal: $ 2,219.38
Print Name: Richard Martin Date: 08/15/13 Plan review(25%of permit fee): $ 554.85
Authorized signature: State surcharge(12%of permit fee):, $ 266.33
TOTAL PERMIT FEE: $ 3,040.56
Print Name: Richard Martin This permit application expires if o permit is not obtained within 180
days after it has been accepted as complete.
•Number of inspections per permit allowed.
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1:\Building\Permits\EI.C-PermitApp.doc 10/01/09 440-46151'(1 I/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 -Supplemental Information
LIMITED ENERGY PERMIT FEES:
;RESIDENTIAL WORK ONLY: 1
Fee for all residential systesm combined $ 75.00
Check Type of work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial sytem $ 75.00
(SEE OAR 918-260-260)
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: 1
*No licenses are required. Licenses are required
for all other installations
CAPITOL C,''G F e--
ELECTRIC CO., INC. <<C A0/3- 60 I//Y RECEIVED
11401 NE MARX ST. a1,41-/77Ai 1 5 2013
'G/�6 AUG PORTLAND, OR 97220-1041 r �
(503) 255-9488 FAX 257-7121 /°t-17-"/ A- �`" A-') CITY OFTIGARD
BUILDING DIVISION
LETTER OF TRANSMITTAL
DATE: 8/15/2013 \I
11
TO: City of Tigard l
n
ADDRESS: 13125 SW Hall Blvd. " �J`� \12 Tigard, OR. 97223 ) l ��
ATTENTION: Permit S.ecialist 1 P- �/ , -'
PROJECT NAME: St Anthon Communi Center a i Wrie Fr,
ATTACHED: BID PROPOSAL '^° Khtki
SUBMITTALS J
CHANGE ORD l � ` �
SPECIFICATIONS 01 ./tr i ' ' tie
LETTER
x SHOP DRAWINGS l� �' C
COMPACT DISK &D 9- OP 4fttjj)
O THER a
NUMBER OF COPIES: DESCRIPTION: clr
2-sets Electrical Plans r
, (IY
1 Permit application
•
1 Fee check
FOR YOUR USE
FOR YOUR REVIEW
x FOR APPROVAL
REMARKS
SIGNED RICHARD MARTIN 971-506-3711 cell
MAILED
x DELIVERED RECEIVED BY:
FAXED DATE:
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
12520 SW GRANT AVE, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
2014-03-06 (null)
ELC2013-00484
PASS - No C of O
Violation Summary:
Inspector Contractor