Permit CITY OF TIGARD ELECTRICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit#: ELC2014-00429
Ti GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2014
Parcel: 1 S135BA00102
Jurisdiction: Tigard
Site address: 10206 SW WASHINGTON SQUARE RD
Project: Destination XL Subdivision: OAKBURG Lot: 9
Project Description: (2)services and(76)branch circuits
Contractor: ADVANCED WIRING SERVICES INC Owner: PPR SQUARE TOO LLC
PO BOX 644 401 S.WILSHIRE BLVD.
CLACKAMAS, OR 97015 SANTA MONICA, CA 90401
PHONE: 503-310-3655 PHONE: 310-899-6437
FAX: 503-698-6372
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 08/04/2014 $201.40
Specifics: amps or less
76 crt Branch Circuits w/Purchase 08/04/2014 $563.92
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 08/04/2014 $91.84
Electrical
Type of Const:
Occupancy Grp:
Total $857.16
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 other a••''cabl- 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 work is spec. d for more the 180
days. ATTE : Oreg• law requires you to follow the rules adopted by the Oregon Utility Notification Cente Thos= leslr- - , h in OAR
952-001-0 through OAR 952-•;1-••=' You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.198 r 1 •• -
/ t ��
Issue By: _�'A4' : Permittee Signature: j
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:
•NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' �/ Date: V4///y/ r ..
LICENSE NO.
277 ,7 S-
Call 51;N:39.4175 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 Applicatign CEIVEI) FOR OFFICE USE ONLY
Received
- City of Tigard Date/By: g y is{ — PermitNo.: �'t.�o/i/-G; .0-9
11111 't 13125 SW Hall Blvd.,Tigard,OR 9'p��} Plan Review
Phone: 503.718.2439 Fax: 503.59$1.fll�b 2014 Date/By: Other Permit: t pa,:v`,/-p60P g'
T 1 c;A K f wInspection Line: 503.639.4175 ` Date Ready/By: funs: I 0 See Page 2 for
Internet: ww.tigard-or.gov CITY OF !r IUARD Notified/Method: Supplemental Information
TYPENIMMIC DIVISION PLAN REVIEW
ID
construction LI Addition/alteration/replacement Please check all that apply(submit 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 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","I-3",
Job#: �f D 14'44 Job site address: � Z 7o _� 1t/ •6 • 100HP or more. occupancy.
!� ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 7'//4 &R. 97 ; ❑Health-care facilities. ❑Supply voltage for more than
s ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.#: 1 Project name: beST/AlkjUlit/ ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: actitg -- ,IZ, Description I Qty. I Each I Total I '
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Wi41/AJo tl jq -TO 0 Lot#:Odi,e 1,000 sq.ft.or less 168.54 4
7 Ea.add'1 500 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,mufti-family 75.00 2
dr l residential(with above sq.ft.)
/Yf/V(/ Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 2 100.70 2,01.4Q 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 I
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
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 7, 7.42 6ô .1,4 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 2
branch circuit
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: mi j'�je /.I)`,e/A . C iL� he` Signal circuit(s)or limited-energy See
tea- / / panel,alteration,or extension. Page 2 2
Address: Pe 4o)( 641 Each additional inspection over allowable in any of the above
City/State/ZIP: 1'�L,�O� o 97Q,5 Additional inspection(1 hr min) , 66.25/hr
Investigation(I hr min) 66.25/hr
Phone:(mil,) 310 3 5S I Fax:(9)j) 3 !- r 4e q g 9 Industrial plant(I hr min) 78.18/hr
/ Inspections for which no fee is
CCB Lic.: A2�^9/ Electrical Lic• a :srv. Lic.: ,,,A7gs specifically listed('/hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
�/
�, �r Subtotal: 744. �.
Print name: C 11 1Alt/Al ,4 Date: OR/jet Plan review(25%of permit fee):
State surcharge(12%of permit fee): II . 04
Authorized signature: TOTAL PERMIT FEE: 57, /
Print name: Date: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
• Number of inspections allowed per permit.
1.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 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 Q1Y. I Each 1 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
El 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
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
ElOther: 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('/:hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El 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 04/21/2014
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
10206 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Electrical
120 Electrical rough-in
FAIL
ELC2014-00429
Herb Stabenow
Cancelled by contractor
Violation Summary:
Inspector Contractor
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
10206 SW WASHINGTON SQUARE RD,
TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00429
Jeff Grove
Violation Summary:
Inspector Contractor