Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00142
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/26/2014
T[C ,1R I:7 9 Parcel: 25101 CB00400
Jurisdiction: Tigard
Site address: 12700 SW HALL BLVD F
Project: Performance Insulation Subdivision: 2007-064 PARTITION PLAT Lot: B
Project Description: (1)service and(3)branch circuits for office and storage.
Contractor: CHEROKEE ELECTRIC CO Owner: TCTPI LLC
13019 SW BRADLEY LN 4260 GALEWOOD ST, STE A
TIGARD, OR 97224 LAKE OSWEGO,OR 97035
PHONE: 503-209-9039 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/26/2014 $100.70
Specifics: amps or less
3 at Branch Circuits w/Purchase 03/26/2014 $22.26
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 03/26/2014 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137.72
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 copy of the ru_ •r direct questions to OUNC by calling 503.23r 1.800.332.2344
Issued By: - - _` Permittee Signature:
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 I t)R 1)1 1 I< I I `1 t)\1 )
City of Tigard r� Received Permit No.: —
tY g ` j`�i�' Date/B : a - Vii! —0-1.s/
• 13125 SW Hall Blvd.,Tigard,OR 97 �rj N Plan Review _
Alone: 3u3.)18.24.sv ras. )w.D98. 1-4 Date/By: , :0/1�pe� y zr27
i 1. is 1 Inspection Line: 503.639.4175 Date Ready/By: Juris ® See Page 2 or
I Internet: www.tigard-or.gov Q111 Notified/Method: ��., Supplemental Information
TYPE OF \yAT V �p,R `�6 2 't I I DI 410 .... ..W
❑New construction 0 Addition/alteration/roaueetl[ l(i NSl N Please check all that apply(submit l sets of plans w/items checked below):
`' V I ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: ��S Q�VI where the available fault current ❑Marinas and boatyards.
B{11� exceeds 10,000 amps at 150 volt or ❑Floating buildings.
CATEGORY OF CONSTRUCTION U
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
❑Emergency system. larger separately derived system.
.::J15 Si I L &2',I tlitMA I iLl,\ d1,111 t) i,l)l,A i tU.' ❑Addition of new motor load of ❑ A 'ti 1.2 `I-3',
/ 2 76 0 J;� //ado Six or or more. occupancy.
Job no.: Job site address: / �!
❑Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: ....it ❑Healthcare facilities. 0 Supply voltage for more than
1 � � 0 i:,u.iilluua lu4dtlulr_.
Suite/bldg./apt.no.: Project name:7� L�1 -'w ❑Service or feeder 600 amps or more
�� �` FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less I 168.54 I 14
Ea.add'I 500 sq.ft.or portion 33.92 1 It 1
TdA umpipaics .,,.. Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
E < Limited energy,multi-family 7500 2
1.t!:r- e V' O F F,G E c �+- o n °ic residential(with above sq.ft.)
�`-"'Q neucwaure Energy i Li see rage 2
Services or feeders installation,alteration,and/or relocation
�❑
200 amps or less PROPERTY OWNER ❑ TENANT I 100.70 /Q.U' 2
201 amps to 400 amps 133.56 2
Name. 401 amps to 600 amps 200.34 1 2
Address: 7c ) 5 l 17 601 amps to 1,000 amps 301.04 2
f itv/Ctatp/7TP r GG// 6 r Over 1;000 amps or volts I 552.26 I 12
a ewpurary services ur Ieetiers inataiiatiuu,alteration,auwor
Phone:( ) Fax:( )
relocation
200 amps or less I 59.36 I 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps I 125 n8 , 2 ,
.,,.4.1u4u.w �au�,1i..uw,1,told�, .,,...ilwlg..r,a.cvl ours Li.,viw 447,449,G70,and 701. ( 401 amps to 599 amps I I 168.54 ( 12
Owltut signature: Date: Branch circuits-new,alteration,or extension,per panel
} ❑ AI' UCA1il'I' I ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,each .••••
/l ,
branch rlp,i�g I O2 t/1
I3u.�uiGS:i name: 1 + I i T11 I•
Contact name: I I service or feeder lee,list branch � 5r,18 I 2
I If 1 circuit I I I 1 1
Audi�.sa: j i Each add i branch circuit /.42 1 2
j II II
1
....-�-..nu-.;;,(.__... :_ a=::uc..;.;d)
City/State/ZIP:
Each manufachtred or modular I
P
rr ,service and/or feeder 67.84 12
hnnP•( 1 I F.iv dwelling
.•! 1 III
F_,»n:l• i I I Kecondectonly- I 01.64 I ' 2
1 L.LN ui flll�j4Ui111 4L4.4 r
67.Z.;,4
CONTRACTOR
CONTRACTOR ( Sign or outline lighting 67.84 I 2 1—— --- -- 1
--- r.{p I� j� p /� /p _n eta:-.:',; ,,,:_r�1,..-11::::,=a - - c.�_
riu...11:::{5:1it11:'.! Cfiet CM1t` ' /ec � /t_J ( 2 ..n
I I panel,alteration,or extension Page 2 1 2
Address: 0 S w, T m b re L N . I Ltca autumnal inspection over atiuwabie in any of the anuvr 1
I Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: J ..e.IM EO I , Ov- 1 1 1`La- III14 LiVebiii�aiivit(I iii min) ' t1L.25 111
Phone:( ) I Fax:( ' f I Industrial plant(1 hr min) 78.18/hr 1 1
l Inspections for which no fee is 90.00/hr
CCB Lic.:354 g I Electrical Lic.:3-r�7 L Suprv. Lie.: 0.b `6 s specifically listed/:hr min)
ELECTRICAL PERMIT FEES j
Suprv.Electrician signature,required: I Subtotal: I /2'q/_ I
/aS/l i Plan review(25%of permit fee):
Print name: S Date: 7,
0 Iv G!' sv ✓ � State surcharge(12%of permit fee): /y
Authorized signature: 1 TOTAL PERMIT FEE: p"7.,7.
This permit applicatinn expires if a permit is not obtained within AO
Print name: Date: days after it has been accepted as complete.
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12700 SW HALL BLVD F, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
April 30, 2014 at 12:59:55 PM
ELC2014-00142
Jeff Grove
Violation Summary:
Inspector Contractor