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Permit CITY OF TIGARD ELECTRICAL PERMIT #: ELC2014-00485 II _ Per COMMUNITY DEVELOPMENT 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/28/2014 TIGARD Parcel: 2S102AA03301 Jurisdiction: Tigard Site address: 12345 SW HALL BLVD 10 Project: Tigard Terrace Apartments Subdivision: TIGARD HIGHWAY TRACTS Lot: 24 Project Description: Replace(1)200 amp panel. Contractor: A TO Z ELECTRIC Owner: KC TIGARD TERRACE LLC 10117 SE SUNNYSIDE RD, F36 11030 NW 2ND CT CLACKAMAS, OR 97015 PORTLAND, OR 97231 PHONE: 503-481-5061 PHONE: FAX: 503-907-5483 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/28/2014 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 08/28/2014 $12 08 Type of Use: MF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total S112.78 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 OA 9 2-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1.800.332 2344 Issued By: Permittee Signature: OWAgib STALLATION ONLY The installation is being made on property I own which is i. int- -- or ren Lyy OWNER'S SIGNATURE '�� Date: ¶3//' ,e •5/* CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. 5-6c7fs 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. FIECEIVF 'Electrical Permit Application lt,ll 01.1 It I I �I c,Nl , a Received�Y G I/, Permit#:�//' City of Tigard AUG 2 8 2C ( DateB : " �d w Gat // e/ Lr� 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 CITYOF WARD DateB : Related Permit#: Inspection Line: 503.639.4175 �ff �� `�+ Ready Date/By: Juris: H See Page 2 for I 1 11i Internet: www.tigard-or.gov "v��Ull�� 5'� Notified/Method: 776-'' Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ,.lam/+ddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): ❑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. 1-and 2-family dwelling Commercial/industrial less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑ y g ❑ 0 building amps for all other installations. buildings. Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION t` ❑Emergency system. larger separately derived Job#: Job site address: /2 37 S SO / /054410 ❑l oOH Addition of new motor load of system. I OOHP or more. ❑"A" "E" "1-2" "1-3" City/State/ZIP: �j _,/,,� ./� �/� ❑Six or more residential units. occupancy. y /!��'"��+ T'T ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: /0 Project name: �/64€6 ❑Hazardous locations. ❑Supplylvonome for more than T ❑Service or feeder 600 amps or more. Cross street/directions to job site: /,99Z7?l_f EA/7=C 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'1500 sq.ft.or portion 33.92 1 PAse..1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 /�`� �� (with above sq.ft.) „ Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER I ❑ 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 ❑ APPLICANT I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit _ Contact name: B.Fee for branch circuits without Address: service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 70 2 e ?eic, Sign or outline lighting 67.84 2 Address: l0//7 s_ .al.,tf/�,� too Asi Signal circuit(s)er n or extension. ❑ See Page 2 2 panel,alteration,or extension. ,��s, t. 4,70 Each additional inspection over allowable in any of the above City/State/ZIP: Ceti 4,V- Additional inspection(I hr min) 66.25/hr Phone:(SIM 2 3'S' 9343 Fax:(Sus) 24.t c7Z six Investigation(1 hr min) 66.25/hr . Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is CCB Lic.: ( lectrical Lic.: 4.4 S Slows specifically listed('/z hr min) 90.00/hr �� ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: ,,,e Subtotal: Print name: 0 L. A' ` Date: / f// / 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: //2, 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. I:\Building\Permits\ELC_PermitApp_ELR_ERE.docx Rev 04/21/2014 440-46151(11/05/COM/WEB 2 zs Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each [ Total 1 Fee for all residential systems combined: $75.00 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 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 ❑ 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 over25 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 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(Y2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter Page 1): y • Number of inspections alllowed owed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems El Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* Fl 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 I.\Building\Permits\ELC_PermitApp_ELR_ERE.docx 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 12345 SW HALL BLVD 10, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2014-00485 Jeff Grove Violation Summary: Inspector Contractor