Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2015 00550
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2015
T 1
GAR P g Parcel: 2S102BA01400
Jurisdiction: Tigard
Site address: 9685 SW JOHNSON ST 1
Project: Woodard Apartments Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 54
Project Description: Installing junction boxes for exterior lighting on(4)buildings where siding is being replaced:Units 21 thru 40.
Contractor: CURRENT ELECTRICAL CONST CO Owner: JAX ASSOCIATES LLC
PO BOX 19652 PRIME INVESTMENTS LLC
PORTLAND,OR 97280 TWEDEN,WALLACE D REVOCABLE TRUS
1600 CEDAR HILLS BLVD, STE 101B
BEAVERTON, OR 97225
PHONE: 503-245-5997 PHONE:
FAX: 503-245-2919
FEES
Quantity Description Date Amount
11 crt Branch Circuits wo/Purchase 07/20/2015 $130.38
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/20/2015 $15.65
Type of Use: MF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $146.03
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 h 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. ATTEN : Oregon . requ' you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-00 through OAR 952-Or,-r••0. Y:u m m obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 . 344.
i / ����
Issued y: _ <_J�y., , Permittee Signature: i�
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 0e/s---
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.
Electrical Permit Applicatio C yfiff FOR OFFIC E O
1 NE NI 1
Received
City of Tigard
Date/By: 7 (s1/5- Permit#: �/S-
i - • 13125 SW Hall Blvd.,Tigard,OR 97223 e Plan Review ��s�4
Phone: 503.718.2439 Fax: 503.598.1960 U` .5 201 Date/B ; Related Permit#: t /� J l♦ ` + - ?
Inspection Line: 503.639.4175 "r, Ready Date/By: Juris: H See Page 2 for J
TI G A R D Internet: www.tigard-or.gov `� et Glow Notified/Method: •J Supplemental Information
RILIAN TYPE OF WO___ V r NL,,1_%� PLAN REVIEW
❑New construction �Addition/alteratiffi lent 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.
❑ -and 2-family dwelling ❑Commercial/industrial ❑ Accessory building Less to ground or exceeds 14,000 CI Commercial-use agricultural
...is?.
amps for all othe 'nstallations. buildings.
Multi-family 0 Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: A.)SO)n Job site address: /6 f(5 Std Jo k&/song 54 ❑100H Addition of new motor load of "A",100HP or more. ❑"A" "E","1-2","1-3"
City/State/ZIP: ❑Six or more residential units. occupancy.
ty gib, Cr a;2 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: waida r A r-,yrv, 3 ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site FEE SCHEDULE
Description I Qty. I I 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
b)+'S°CRII'TION OF WORK Limited energy,residential
1 ,� " (with above sq.ft.) 75.00 2
I N/5)-6.) J U,.k")-f(l J �K& "+' C.-1 J -n J Lip C,i ft -)i 4 '-j Limited energy,multi-family
a J residential(with above sq.ft.) 75.00 2
r V r 1 l Renewable Energy ❑ See Page 2
❑ PROPERTY OWN EEERRR ❑ TENANT i 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
❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
. A.Fee for branch circuits with
Business name: 5 4-S `,,,KJ/ above service or feeder fee,
7A2 V each branch circuit 2
Contact name: B.Fee for branch circuits without '/
Address: service or feeder fee,first 1 56.18 S6 J'b 2
branch circuit
City/State/ZIP: Each add'I branch circuit 10 7.42 -7440 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: f�1'cs„ I C j c 44. - t _l 0 Sign or outline lighting 67.84 2
Address: � hoof 116 y a 1I� �,e�1/ panel,circuit(s)er on or extension. ❑ See Page 2
�r��-.�IJJ'"' YY troo 2
panel,alteration,or extension.
City/State/ZIP: �y rn C� Each additional inspection over allowable in any of the above
7 V/ / 7?tv Additional inspection(1 hr min) 66.25/hr
Phone:(ZS)a 4/3'5-9c/7 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email: r Industrial plant(1 hr min) 78.18/hr
�/ofheyN�[ A' —el l.— l Grr,. Qry' Inspections for which no fee is
CCB Lic.:Z4(p C C Elect• -•... ,, 2� 2 , specifically listed('h hr min) 90.00/hr sir
p¢ �� ELECTRICAL PERMIT FEES
Suprv.Electrician sign r ,required: 1011 ilio Subtotal: (30,L e.
Print name: ``r 4 ,1) Jo tiff Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of pernut fee): /S.(o,ce
Authorized signature:
TOTAL PERMIT FEE /46,(23
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.doc Rev(W17/2015 440-4615T(I I/05/COM/WEB
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
9685 SW JOHNSON ST 1, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00550
Jeff Grove
Violation Summary:
Inspector Contractor