Permit CITY OF TIGARD ELECTRICAL PERMIT
111111 2 COMMUNITY DEVELOPMENT Permit#: ELC2013 00699
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/25/2013
Parcel: 2S113AB00300
Jurisdiction: Tigard
Site address: 16037 SW UPPER BOONES FERRY RD 300
Project: Oregon State Bar Subdivision: FANNO CREEK ACRE TRACTS Lot: 38
Project Description: (1)branch circuit for TI
Contractor: LEAR ELECTRIC CO INC Owner: OREGON STATE BAR,THE
PO BOX 573 16037 SW UPPER BOONES FERRY RD
GRESHAM,OR 97030 TIGARD,OR 97224
PHONE: 503-255-0733 PHONE:
FAX: 503-255-0676
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 11/25/2013 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/25/2013 $6.74
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 rdance with approved plans. This permit will expire if work is not started within 180 o is nce, or if work is suspended for more the 180
days. A ENTION: Oregon law equires you to follow the rules adopted by the Oregon Utilit otificatfd Center. Those rules are set forth in OAR
952-001 0010 through OAR 952- 1-0 ou may obtain a copy of the rules or direct questions to aUNC by calling 50 . 1987 or 1.800 • 2.2344.
.
Issue By: Y� Permittee Signa �L
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' ( e_�[=�T'��_ 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.
11/18/2013 12:45 5032550676 LEAR ELECTRIC PAGE 01/02
Electrical Permit Application RECEIVE ip F(JR OFFICE ESE ONI.I
Ci 25o of Tigard Received �Date/B 1 / Permit No,: ELe l e/-60�
/S
; 131 S W Hall Blvd.,Tigard,OR 97223 N O V 1 8 2 013 Plan Review
Phone: 503.718-2439 Fax: 503.598.1960 Date/By: Other Permit: iiti Qf /,5•-a:Vi0
TI Inspection Line: 503.639.4175 CITY OFT[GARQ DateReady/By:
w Juris: B See Page 2fur
Internet ww.tigard-or.gov Notified/Niethod: Supplemental Information
TYPE OF W� LDING DIVISION PLAN REVIEW
❑New construction [" ,Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked below):
El Service or focder 400 amps or more ❑Building over throe stories.
❑Demolition ❑Other where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 arnpe at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
[] 1-and 2-family dwelling q Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family El builder 0 Other-. ❑Fire pump. ❑Installation of 150 KVA or
_
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
r ,/� ❑Addition of new motor load of ❑"A""E "1-2^"1-3"
Job no.: 13-(p Job site address: (pig 3'? Sc to ►.�P(�P '✓L AS Six or Or occupancy.
❑six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 'rl a `-e�/►rl� ❑Health-care facilities. ❑Supply voltage for more than
�4r� Q Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: ) Project name:OSa 61-e . OO ❑Service or feeder 600 amps or more. .
FEE SCHEDULE
Cross street/directions to job site: rk.wim:oe _ I Qv. I Pee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Ea_add't 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: -
Limited energy,residential
DESCRIPTION OF WORK with above sq.8.) 75.00 2
Limited energy,multi-family 73.00 2
Y\ o residential(with above sq.R,) - -
Renewable Eno 3 ❑ See Pa_e 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER l , ❑ TENANT 200 amps or less 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/ZIP: Temporary services or feeders installation,alteration,and/or—
Phone:( ) j Fax:( ) relocation
J 200 amps or less 59.36 1 .
r 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
❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 7.42 2
Business name: each branch circuit
B.For for branch circuits without
Contact name: service or feeder fee,first 1 56.18
2
branch circuit
Address: Each add'/branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
'Phone:( ) rFax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR _ Sign or outline lighting 67.84 2
•Business name:Lear Electric Co.,Inc. Signal circuit(a)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:6002 NE 112th Ave Each additional inspection over allo wable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland,OR 97220 Investigation(1 hr min) 66.25/hr
Phone:(503)255-0733 I Fax:(503)255-0676 Industrial plant(I hr sun) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 52278 I Electrical Lic.: 26-411C I Suprv.Lic.: 3 6S specifically listed(h hr min)
,�.� ,�/ E.LECTRICAL PERMIT FEES
Suprv.Electrician'sip..t e,required �j��// � Subtotal: _ 1
Print name: P.vid Mumford D : 11.4-.--1 Plan review(25%of permit fee):
Stare surcharge(12%of permit fee): _ —)q
`Authorized s'2 :rarer;��J�/ ,r TOTAL PERMIT FEE: (pa-1$0
Print name: *avid Mumford Aate: ) �fl This permit application expires if a permit is not obtained within 180
l
days titter it has been accepted as complete.
• Number of inspections allowed per permit,
l:\Building\Permits\ELCJermitApe,,E .RE.doc Re-05/21,2013 440-4615T(11/05/COMIW®
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
16037 SW UPPER BOONES FERRY RD 300,
TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
2014-01-23 (null)
ELC2013-00699
PASS - No C of O
Violation Summary:
Inspector Contractor