Permit CITY OF TIGARD ELECTRICAL PERMIT
III _ Permit#: ELC2013-00707
COMMUNITY DEVELOPMENT _
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 t Date Issued: 11/26/2013
T f t;A R.O 9 Parcel: 2S102AB04800
Jurisdiction: Tigard
Site address: 12460 SW MAIN ST
Project: Jeffery Alan Decor Subdivision: KINGSTON Lot: 2
Project Description: Electrical for TI:(1)panel and(1)sub panel,(40)branch circuits,and sign lighting for(2)signs. 4/21/14:Reprinted
permit to include(11 relocated 400 amp panel.
Contractor: SURGE ELECTRIC Owner: LUONG, PETER& HIEU
13617 NE 61STAVE 113 KINGSGATE R
VANCOUVER,WA 98686 LAKE OSWEGO, OR 97035
PHONE: 360-772-1321 PHONE:
FAX: 866-929-4771
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 11/26/2013 $201.40
Specifics: amps or less
40 crt Branch Circuits w/Purchase 11/26/2013 $296.80
Type of Use: COM Service or Feeder
Class of Work: ALT 2 ea Sign or Outline Lighting 11/26/2013 $135.68
1 ea 12%State Surcharge- 11/26/2013 $76.07
Type of Const: Electrical
Occupancy Grp: 1 ea Services or Feeders-201 to 04/21/2014 $133.56
400 amps
16 12%State Surcharge- 04/21/2014 $16.03
Electrical
Total $859.54
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 OAR 952-001-0090. You may obtain a co• of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332 234
�`��Issued By: •ermittee Signature: /-�r _.,_______7, .„\s'!0,
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 FOR OFFICE USE ONLY
r.
City of Tigard � CEI� Received
Date/B : AV Permit No.: ., 7
1111 .--• 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGARU Inspection Line: 503.639.4175 A 1 zp14 DateReadyBy: kris: 0 SeePage2for
Internet: www.tigard-or.gov APR f� Notified/Method: a Supplemental Information
TYPE OF WO TY *TIGARD PLAN REVIEW
❑New construction ❑Addition/alteration p�ga>eip1VISION Please check all that apply(submit 2 sets of plans w/items checked below):
11I1� ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑other: R` where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ❑Commercial/industrial ❑AS , • # ding amps for all other installations. buildings.
❑Multi-family ❑Master builder to,. I'! t�;+�4. ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: /�/�/ I OOHP or more. occupancy.
r� rL,.,t� ' I �-f`. ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: p ❑Health-care facilities. ❑Supply voltage for more than
_]]G] t CX ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: !/ I Project name: J. t d,.�.GV I ❑Service or feeder 600 amps or more.
�7 FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: 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
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
r residential(with above sq.ft.)
`�{���� `%' �� �'MP { Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
El PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps ( 133.56 /93 SZ 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:( ) 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
❑ APPLICANT I ❑ CONTACT PERSON A.Fee for branch circuits with
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
branch circuit 56.18 2
Address: Each add'I 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 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: - Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 _ 2
Address: �� _Each additional inspection over allowable in any of the above
t('t' Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: V�
1 �1 O ■ L/ Investigation(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr
ti Inspections for which no fee is
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: /33 z,
Print name:�Fi%'-e L V�q- Date: !�////y! Plan review(25%of permit fee):
7 State surcharge(12%of permit fee): _03
Authorized signature: TOTAL PERMIT FEE: )i_ i.5-1-
This permit application expires if a permit is not obtained within 180
Print name: p,,-;---,,e C�V,v Date: fL 2/�/1C days after it has been accepted as complete.
• Number of inspections allowed per permit.
I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-46151(11/05/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 Qty. I Fee I Total I •
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
❑ Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
❑ Heating,Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
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
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is
90.00/hr
specifically listed(/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
❑ Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
El 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
C\Building\Permi ts\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
1PermCITY OF TIGARD ELECTRICAL PERMIT
li 2_ COMMUNITY DEVELOPMENT
it#: ELC2013 00707
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/26/2013
Parcel: 2S 102AB04800
Jurisdiction: Tigard
Site address: 12460 SW MAIN ST
Project: Jeffery Alan Decor Subdivision: KINGSTON Lot: 2
Project Description: Electrical for TI: (1)panel and(1)sub panel,(40)branch circuits,and sign lighting for(2)signs.
Contractor: SURGE ELECTRIC Owner: LUONG, PETER& HIEU
13617 NE 61ST AVE 113 KINGSGATE R
VANCOUVER,WA 98686 LAKE OSWEGO, OR 97035
PHONE: 360-772-1321 PHONE:
FAX: 866-929-4771
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 11/26/2013 $201.40
Specifics: amps or less
40 crt Branch Circuits w/Purchase 11/26/2013 $296.80
Type of Use: COM Service or Feeder
Class of Work: ALT 2 ea Sign or Outline Lighting 11/26/2013 $135.68
Type of Const: 1 ea 12%State Surcharge- 11/26/2013 $76.07
Electrical
Occupancy Grp:
Total $709.95
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 OAR 952-001-0090. You a cop • the rules o •' =ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' Permittee Signature:
AlP tl
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 FOR OFFICE USE 0.NLY
City of Tigard �." ao Received ' ��. Permit No.: , I ••tt DateB J
v 13125 SW Hall Blvd.,Tigard,OR 97.32''4 - Plan Review
C • Phone: 503.718.2439 Fax: 503.598 l....., ' �Q13 Other Permit: /096219 J _ 50
1pU Date/By: 7ci
T I G A F l9 Inspection Line: 503.639.4175 v 1 Date Ready/By: orris: ® See Page 2 for
Internet: www.tigard-or.gov NO �\ N'i° Notified/Method: "�(p Supplemental Information
TYPE OF WORK ®'� C�!\1�ov.-`‘ PLAN.REVIEW
\s` Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction IQ Addition/alteration/ �q�} ant
�;�1°' ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
' CATEGORY,OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
-. less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑ 1-and 2-family dwelling ,Commercial/industrial ❑Accessory building 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 system.
❑Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: /2 4'e 0 �^F ,,,,-A-,.1-- 9 J Six or or more. R occupancy.Recreational❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: -75_, 13 7 2. L_ ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:j�t�F/t'/=�/z/�GLfi� /-fP/ ❑Service or feeder 600 amps or more.
// FEE SCHEDULE
Cross street/directions to job site: Ze Description I Qty. I Fee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
/.= Limited energy,multi-family
/'f'GCG C-a( residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration and/or relocation
(c'PROPERTY OWNER ❑ TENANT 200 amps or less 100.701�0 r2
201 amps to 400 amps 133.56 2
Name: F,�.' j ' `l./ 7.✓ - 401 amps to 600 amps 200.34 2
Address: 7 L 9s--- S W )0971.57l./717‘"j L/ . S'7' 601 amps to 1,000 amps 301.04 2
City/State/ZIP: r
Over 1,000 amps or volts 552.26 2
/ / �i��� �� • / 7 Z Z Temporary services or feeders installation,alteration,and/or
Phone:(SD3) y3/— 3/ ? P 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 .
• A.Fee for branch circuits with I �I
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, iy(JJ� 742 �l,/.� 2
Business name: each branch circuit —I (1�X10
B.Fee for branch circuits without
Contact name: service or feeder fee,first
branch circuit i 56.18 2•
Address: Each add'I 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 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRRjACCCTT�OR, , . . Sign or outline lighting 67.84 /3S,(yEr 2
Business name: € / `�t,, ,�"' e ///4.- Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: f' pG]1 Aim--//v(7 99 S JJ 7'/i7 Each additional inspection over allowable in any of the above
City/State/ZIP: v t%vv,!2' /� 9 e'' Investigation inspection(1 hr () hr min) 66.25/hr
,A /A�/ Inveigat (1 hr min) 66.25/hr
Phone:( p) 5 7 sf 9944 Fax:(fa)tV 9 / / 7/ Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: / ?, 2 ' Electrical Lic.:C 6 •,...-trv.Lic.:j7 0�"S specifically listed(%2 hr min)
ELECTRICAL PERMIT FEES Suprv.Electrician signature,requir-t.�� �� 3 Subtotal:
Print name: J` ia,f/97 ? Date:i/J//i� Plan review(25%of permit fee):
/ State surcharge(12%of permit fee): 1 76.07
Authorized signature: TOTAL PERMIT FEE: ( 70.55
Print name: Date: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-46t51(1I/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 Qty. I Fee I Total I
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
ElAlarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
El Heating, Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva—no additional charge 0.0 3
ElOther: 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:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
ElAudio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
❑ Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12460 SW MAIN ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2013-00707
Jeff Grove
Violation Summary:
Inspector Contractor