Permit RI
t
CITY OF TIGARD ELECTRICAL PERMIT
11 '.• COMMUNITY DEVELOPMENT Permit#: ELC2015-00507
T I CARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/01/2015
Parcel: 2S 104BB07900
Jurisdiction: Tigard
Site address: 14350 SW BARROWS RD 2
Project: Mathnasium Subdivision: RUSSELL'S SCHOLLS FERRY Lot: A
Project Description: (5)branch circuits for TI and low voltage for data.
Contractor: OMNI ELECTRIC INC Owner:
16670 SW WRIGHT ST
BEAVERTON, OR 97007
PHONE: 503-747-0805 PHONE:
FAX: 503-649-2709
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 07/01/2015 $85.86
Specifics: I Service or Feeder
1 ea 12%State Surcharge- 07/01/2015 $10.30
Type of Use: COM Electrical
Class of Work: ALT 1 ea Signal circuit or Limited 07/01/2015 $75.00
Energy Panel
Type of Const: 0 ea 12%State Surcharge- 07/01/2015 $9.00
Occupancy Grp: Electrical
Total $180.16
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty odes and all other applicable law. All work will
be done in ac nce with -•proved plans. This permit will expire if work is not started within 180 days of :nce, or if ork is suspended for more the 180
days. ATTE ON: Oregon la, requires you to follow the rules adopted by the Oregon Utility Notific- • = t= . khose rules are set forth in OAR
952-001-00 through OAR 952-00 ••90.• ay obtain a copy of the rules or direct questions to OUNC by calling 51 •:7•r 1.:,I6.332.2344.
Issue By: / i • a% i / i 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' (-—!, , - /1 `�► " ��� Date: 7/ // s-
LICENSE NO. 44a 7C) ‘7
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.
i
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard RECEIVED Received t : .7S/EM LCD O/S=D 7
i, Permit W:
III
13125 SW Hall Blvd.,Tigard,OR 97223 1 2015 Plan Review j),.- POO 1 5"--450/2
B Phone: 503.718.2439 Fax: 503,598.1960 JUL Date/B ; Related Permit a: �+t,`
Inspection Line: 503.639.4175 Ready Date/By: luri> la See Page 2 for
I It., RD Internet: www.tigard-or.gov CITY OF TIGARD Notified Method: Supplemental Information
TYPE OF ' flLDING t�1VISION PLAN REVIEW
❑New construction ,Addition/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.
❑ I-and 2-family dwelling p-Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 ❑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
Job#: Job site address: (r-•+3C U �,I,f-rx,..5 ❑Addition moew motor load of system.
s � IOOHP or more. ❑"A" "E" "I-2""1-3"
City/State/ZIP: �` � Oct- q ❑Six or more residential units. occupancy.
ty v�I�-� \ I Z---2-3 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: J Project name: 1, ❑Hazardous locations. 0 Supply voltage for more than
2 I J ci-`x�S J
f' ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 34/2._ � S } Aktew k FEE SCHEDULE
Description I Qts. I Each 1 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
DESCRIPTION OF WORK Limited energy,residential
�n I ` L -c^�� (with above sq.ft.)
75.00 2
'r' `OVA 1/4)‘/Al l p / 1 T �Tk) Limited energy,gy,multi-family 75.00
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPEWPY OW I TENANT Services or feeders installation,alteration,and/or relocation
Name: C 1,1(6} J n C 200 amps or less 100.70 2
Address: [9 if 0 Std 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: t•Sip 601 amps to 1,000 amps 301.04 2
Phone:(S(j)) 9 C., ( Z.)-1 I Fax:( ) Over 1,000 amps or volts 552.26 2
11 11 Temporary services or feeders installation,alteration,and/or
Email: 56.4.4-L t • t relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 _
Owner signature: Date: 401 amps to 599 amps 168.54 _
❑ APPLICANT I $'CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
�, � A.Fee for branch circuits with
Business name: ej t,-1 1 J v i�nS o� /17 V- �d t>ic-a above service or feeder fee, 7 42 2
each branch circuit
Contact name: d' B.Fee for branch circuits without
y service or feeder fee,first r 56.18 2
Address: I l' d 5v .",,r., ;
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description Qq. Each I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 1 00.70 2
5.01 to 15 kva 133.56 2
n 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
with OAR 918-309-0040) 552.26 2
❑ 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:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
speciticall■ listed 1', hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
1:
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved: •
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
Data Telecommunication Installation
Fire Alarm Installation
HVAC
•
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
7 Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:Building\Penni ts\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015
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
14350 SW BARROWS RD 2, TIGARD, OR,
97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00507
Chip Barnett
Violation Summary:
Inspector Contractor