Permit CITY OF TIGARD ELECTRICAL PERMIT
1111 _ COMMUNITY DEVELOPMENT ELECTRICAL
ELC2014-00350
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/25/2014
T t C.;A K
Fr) Parcel: 2S 101 CB00500
Jurisdiction: Tigard
Site address: 12670 SW HALL BLVD, BLDG#2
Project: Apex Subdivision: 2007-064 PARTITION PLAT Lot: B
Project Description: (4)branch circuits to connect router and 3 vacuum pumps.
Contractor: ACCURATE ELECTRIC OF OREGON INC Owner: MCLELLAN ESTATE CO
PO BOX 2155 BY CHRISTOPHER M CAVE ESQ
OREGON CITY, OR 97045 1570 THE ALAMEDA, STE 100
SAN JOSE,CA 95126
PHONE: 503-631-3507 PHONE:
FAX: 503-631-3544
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 06/25/2014 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/25/2014 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports(Conditions)
This permit i •-• -••'- t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be don- accordance with :••roved •fans. 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 la '•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-.01-0010 through OAR 952-1- -0090. ,u °7 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Is- ed By: _ _ , Permittee Signature: k
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' /y 4`��� � Date: (47`Ai
LICENSE NO.
•7) V 5
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 Applicati f ErEIVF FOR OFFICE USE ONLY
Received �` / Permit#:�'' �� 3�
City of Tigard
Date/By: /',
• 13125 SW Hall Blvd.,Tigard,OR 9722 U N 2 5 2014 Plan Review
I Phone: 503.718.2439 Fax: 503.598.1960
Date/By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Ions HI See Page 2 for
T 1 G A RD Internet: www.tigard-or.gov �I �����^��1 Notified/Method: Supplemental Information
TYPE OFIl11��'ivilsl(i�. - PLAN REVIEW
❑New construction ogr Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building less to Bound,or exceeds 14,000 0 Commercial-use agricultural
'
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
❑Addition of new motor load of system.
Job#: Job site address: I 2(07O,S LA., 1�i tj./ 100HP or more. ❑"A","E","t-2","t-3",
t��-t,!r �'t ❑Six or more residential units. occupancy.
City/State/ZIP:
V 4/(� 9 23 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Q Q ❑Hazardous locations. ❑Supply voltage for more than
!Tr C
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'1 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
b (with above sq.ft.) 75.00 2
CO A e L-+ RO Oh r coN a 3 V Olt u V m 1 J m Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 - 2
ESCAPPLICANT 1 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension, •er panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
R«� �Cl�rtL 0 ���h 3 7.42 22,2(0 2
each branch circuit
Contact name: 14,h 4S(,Q w B.Fee for branch circuits without
service or feeder fee,first Q
Address: Po a S^S branch circuit 56.18 Slrs v 2
City/State/ZIP: 0 e_.,.. .. !,Qi.S Each add'I branch circuit 7.42 1 2
h` t Miscellaneous(service or feeder not included)
Phone:(°17 I) (0 Lj -.. (iv? Fax: :(503 ) (1.3 3S 4-pi Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: //�� c r I� Sign or outline lighting 67.84 2
I TLL.vre ll. c.ted p tL 1' (,�I^�L rtJ�
/ Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: P a box A(sS panel,alteration,or extension.
City/State/ZIP: (�p � p� c Each additional inspection over allowable in any of the above
/ n / f J Additional inspection(1 hr min) 66.25/hr
Phone:(q 71 ) (p b 5 .. (0(9.71 Fax:(SCI ) (v3p. 35-1.#.1 Investigation(I hr min) 66.25/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: I ' Icy S' Electrical Lic.: C.(,37 Suprv.Lic.: 50,16 specifically listed(Y:hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 7 _ Subtotal: 7 '
Print name: J _ S w CO Date: (e•XS •/4../ ❑Plan Review Required(25%of permit fee): '--r"
State surcharge(12%of permit fee): q•`II
.
Authorized signature /.7.4„,......,= ... .
TOTAL PERMIT FEE: 5•7, `6 S
This permit application expires if a permit is not obtained within 180
Print name: /44.v. S w c t) Date: (o•1 t —/y days after it has been accepted as complete.
Number of inspections allowed per permit.
1:\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 04/21/2014 440.4615T(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 Qty. I Each I Total I *
' Renewable� able electrical energy systems:
Check Type of Work Involved: 5 kva orless 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.o1 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2•
El Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
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:
El Other: Each additional inspection is 66.25/hr
charged at an hourly(I hr min)
Inspections for which no fee is
specifically listed(Y:hr min) 90.00/hr
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system:. $75.00 Number of ins
(SEE OAR 918-309-0000) pections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014