Permit CITY OF TIGARD ELECTRICAL PERMIT 41
I I. COMMUNITY DEVELOPMENT Permit#: ELC2014-00217
Tigard OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 05/05/2014
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Trlzn 9
Parcel: 2S 113AC00101
Jurisdiction: TIGARD
Site address: 16655 SW 72ND AVE 300
Project: Advantage Waypoint Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 37
Project Description: (2)branch circuits for freezer
Contractor: ACCURATE ELECTRIC OF OREGON INC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 2155 ATTN: N PIVEN
OREGON CITY,OR 97045 15350 SE SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-631-3507 PHONE:
FAX: 503-631-3544
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 05/05/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/05/2014 $7.63
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 952-0090. Y•u may obtain a copy of the rules or direct questions to OUNC by calling 503.232. 987 or 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.
ItECEIV
Electrical Permit Application
City of Tigard MAY 5 201�COC/VE: S7s72aiy �. [=CCali%OD�i7
ate ive tt No.:
III
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 CITY OF TIGA y Other Permit:
i 1 ,I:I� Inspection Line: 503.639.4175 1gA eady/By: Sufis: H See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISt(T '''ethos: Supplemental Information
TYPE OF WORK - PLAN REVIEW
❑New construction Et Addition/alteration/replacement Please check all that apply(submit l 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 ❑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 ®CommerciaUindustrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
SOD SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of of new motor load of ❑"A","E","]-2","1-3",
r at.� I00HP or more. occupancy.
Job no.: ZO-((p(„ Job site address: 1 l0(y S Lo-D S U I 30c� ❑Recreational vehicle
(, � � 0 or more residential units. parks.
City/State/ZIP: T-t �,t.t4.) eSY_ CI Health-care facilities. ❑Supply voltage for more than
I ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: �V et w /— W /p O 1``f El Service or feeder 600 amps or more.
/ 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 El
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,mufti-family
Q,{4--TS For T"(�?►`tezer residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ 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:( ) 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, 742 7_72. 2
Business name: h-c mot. E tee I'1%-c, a 0l,,pc�% each branch circuit
B.Fee for branch circuits without
Contact name: le_efA Sur-et) service or feeder fee,first 56.18 branch circuit 56. 5‘. i 8 U 2
Address: n0 gaX ( 15-5-- Each add'I branch circuit 7.42 ' 2
City/State/ZIP: O (.5x. C1-)0 l..lS Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503) 6 31 _ 35-0---.? Fax::(5°3 ) (o3/- 3 S y dwelling,service and/or feeder 9 Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy See
Business name: 113c L v r x •�`1 -�, 04' O r p`X� panel,alteration,or extension. Page 2 2
Address: PU Each additional inspection over allowable in any of the above
City/State/ZIP: O rye C,-)O Additional inspection(1 hr min) 66.25/hr .
` J Investigation(1 hr min) 66.25/hr
Phone:( 5(25) t x:(503 ) I^3514 Li Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 191 31-15— Electrical Lic.: G(p 3 Suprv.Lic.: 50 y S specifically listed(b hr min) _
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: _ Subtotal: 3 6,D
Print name: K e_In 3 w r 0 Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): '7 r tr ,
Authorized signature: TOTAL PERMIT FEE: '7/.
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.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-461ST(I1/05/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 otr. 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
1=1 Heating, Ventilation and Air Conditioning OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
ClOther: additional inspection over allowable in any of the above:
Other: Each additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is
specifically listed(%:hr min) 90.00/hr
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
❑ 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:
*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 Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16655 SW 72ND AVE 300, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
May 7, 2014 at 12:17:42 PM
ELC2014-00217
Jeff Grove
Violation Summary:
Inspector Contractor
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
16655 SW 72ND AVE 300, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
May 7, 2014 at 12:17:42 PM
ELC2014-00217
Jeff Grove
Violation Summary:
Inspector Contractor
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
16655 SW 72ND AVE 300, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
May 7, 2014 at 12:17:42 PM
ELC2014-00217
Jeff Grove
Violation Summary:
Inspector Contractor
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
16655 SW 72ND AVE 300, TIGARD, OR, 97224
Commercial - Electrical
199 Electrical final
PASS - No C of O
May 7, 2014 at 12:17:42 PM
ELC2014-00217
Jeff Grove
Violation Summary:
Inspector Contractor