Permit I1 a ;'1''. CITY OF TIGARD ELECTRICAL PERMIT
I1 .!.!11
COMMUNITY DEVELOPMENT Permit#: ELC2015 00920
;a 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/17/2015
TIGARD 13125 2S113AB01400
Jurisdiction: Tigard
Site address: 7358 SW DURHAM RD
Project: Coram Subdivision:COUNCIL VIEW ACRES(LOTS 21-44) Lot: 30
Project Description: (1)200 amp panel and(4)branch circuits for server.
Contractor: ACCURATE ELECTRIC OF OREGON INC Owner: PACIFIC REALTY ASSOCIATES LP
PO BOX 2155 ATTN: N PIVEN
OREGON CITY, OR 97045 15350 SW SEQUOIA PKWY#300
PORTLAND, OR 97224
PHONE: 503-631-3507 PHONE:
FAX: 503-631-3544
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 11/17/2015 $100.70
Specifics: amps or less
4 crt Branch Circuits w/Purchase 11/17/2015 $29.68
Type of Use: COM Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/17/2015 $15.65
Electrical
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 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 OAR 952-001-0090. You may obtain a cop .* irect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ' . —..___,-,,• _ Perm -- ignature:
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' 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 Application, .y\NIV FOR OFFICE USE ONLY
City of Tigard tJ ) Received ,` i
- Date/By: �� /7�rs- �dci 5-6�j(t.z0
" 13125 SW Hall Blvd.,Tigard, 97223 �( r�o1S Plan Review
9,(10
Phone: 503.718.2439 Fax: 503.598.11 1 Date/By: Related Permit#:
Inspection Line: 503.639.4175 NO ' Ready Date/By: fur ® see Page 2 for
TIGARD Internet: www.tigard-or.gov 1,.1 1�
61° 1 Notified/Method: Supplemental Information
TYPE OF.i PLAN REVIEW
❑New construction A Addition/a ; , t V`. ;cement Please check all that apply(submit a sets of plans w;items checked):
t ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current
0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings.
❑ 1-and 2-family dwelling gi Commercial/industrial ❑Accessory building less to ground.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: 7S5)? W D14 .- 100HP or more. ❑"A "E",'I-2","1-3",
City/State/ZIP: P#r.+-(rt,.,/ .`�
CI Six or more residential units. occupancy.
/Mr` ❑I lealth-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: COr t,k ❑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 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'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
5 J b (with above sq.ft.) 75.00 2
�c,.,,,p S�,rtrtr- (L1c1S , t.1- at,,.1
- Limited energy,multi-family 75.00 '
residential(with above sq.ft.) -
Renewable Energy _ ❑ See Page 2
❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less ( 100.70 160-70 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 I
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
(f,APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
__-, A.Fee for branch circuits with
Business name: /}"v,.u,d ti ka,L_ CJ above service or feeder fee, H 7.42 �/2
r��` each branch circuit �� N
Contact name: 14., Sw.,V B.Fee for branch circuits without
service or feeder fee,first 56.18 '
Address: pa bog 7_,N-s- branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 _
(' , �I 70 its
- f" Miscellaneous(service or feeder not included)
Phone:( su)) (p 31- '3 507 Fax: :(s-v3 ) 6 3 f- 35-‘-pi Each manufactured or modular
dwelling,service and/or feeder 67.84
Email: Reconnect only 67.84 _
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 4_,_,,,,,.....6„ Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy El See Page 2
Address: 6,„.. .t panel,alteration,or extension.
City/State/ZIP: U ��T Each additional inspection over allowable in any of the above
inspection(1 hr min) 66.25/hr
Phone:(YtY) ) (.31- 3307 Fax:(5t73) b 3 i- 3 Sy y Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
_ Inspections for which no fee is 90.00/hr
CCB Lic.: 19( 3y3- I Electrical Lic.:C(g 3 7 Suprv. Lie.: S(7')y s specifically listed(1/2 hr min) _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: ,o9 i Subtotal: /$O,'3`'
Print name: 14,-v S wti4 Date: i I -17-t ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): /ST 65-
Authorized signature: 4.,..,.." TOTAL PERMIT FEL I U3
This permit application expires if a permit is not obtained within 180
Print name: Kt y� 5i,....-(-4 Date: (t-1-7-t y days after it has been accepted as complete.
* Number of inspections allowed per permit.
I-Building Permits•ELC_PermitApp_ELR_ERE.doc Rev 06 17,2015 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
Description I Qtr. I Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
2
Check Type of Work Involved: 5 kva or less 100.70
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
with OAR 918-309-0040) 557'26 2
n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
n 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
charged at an hourly(I hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(Y hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
n Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC PennitApp_ELR_ERE.doc Rev 06/17/2015