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Permit qCITY OF TIGARD ELECTRICAL PERMIT II 1 ' COMMUNITY DEVELOPMENT Permit#: ELC2016-00116 T IG ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2016 Parcel: 1S134BC00200 Jurisdiction: Tigard Site address: 12198 SW SCHOLLS FERRY RD Project: Spec Space Subdivision: GREENWOOD TERRACE CONDO Lot: 17 Project Description: Rough-in and finish for new TI: (1)201-400 amp service&(10)branch circuits. Contractor: WELL DONE ELECTRIC Owner: ATLAS GREENWAY LLC 17045 SE ROYER RD 333 NW NINTH AVE, STE 1009 DAMASCUS, OR 97089 PORTLAND, OR 97209 PHONE: 503-209-4006 PHONE: FAX: 503-558-1297 FEES Quantity Description Date Amount 1 ea Services or Feeders-201 to 02/16/2016 $133.56 Specifics: 400 amps 10 crt Branch Circuits w/Purchase 02/16/2016 $74.20 Type of Use: COM Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 02/16/2016 $24.93 Electrical Type of Const: Occupancy Grp: Total $232.69 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 appl -ble law. All work will be d in accordanc- ith approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is su-•- •ed for more the 180 da . ATTENTION: Orego, -quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rule .re set forth in OAR 9 2-001-0010 through OAR•' -001-d0 O. ou may obtain a co.y of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344 Issued By: ► l 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' � � �CCS 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 l UR Orli( 1 1 Sl.0y1.1 Received '_��i� ' 1! City of Tigard DIVED Date/B : i a� Permit#:��[�� > 13125 SW Hall Blvd.,Tiga 7 Plan Review INB Phone: 503.718.2439 Fa Date/B : Related Permit#:-` /�/o-. i Inspection Line: 503.639.4175 FEB 1 b 2016 Ready Date/By: Juris: El See Page 2 for I I :I> Internet: www.ti8and-or. ov Notified/Method: Supplemental Information TYP IG��AgA�► PLAN REVIEW,:. .. '> ❑New construction EtAd �Yi►1i teN Please check all that apply(submit 2 sets of plans w/items checked): �1 D V IJ 1 t v 0 Service or feeder 400 amps or more 0 Building over three stories. ( NJ ❑Demolition ❑Other: where the available fault currentUUV// ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ID1-and 2-family dwelling ElCommercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural -o amps for all other installations. buildings. 0 Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 installation of 150 KVA or r�CT JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: /2//1.22_3 ___CP.W, a ❑Addition of new motor load of system. 9 �"�� -QOOHPormore. ❑..A„ ..E,. ..1_2„ `.l_4.. �7occupancy. � �{� IBJ Six or more residential units. City/State/ZIP: / ' � , "�' i a ❑Health-care facilities. ❑Recreational vehicle parks. gliktSuite/bldg./apt.#: ' Project name: 4-1 C4�iy�'/ ❑Hazardous locations. ❑Supply voltage for more than�'L[//(t ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE; t 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 sqftor portion 33.92 1 DES P ION OF WORK Limited energy,residential 1 (with above sq.ft.) 75.00 2 g61•Cil54,- I �'4/�`Y til/ �� / Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ❑ PROPERTY OWNER 0 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 /3s 4 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps 10 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: above service or feeder fee, f 0 , zs 2 74 each branch circuit 7.42y Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZiP: Each add]branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR /- Pump or irrigation circle 67.84 2 Business name: ekv--7,,,,,,,,,, �jq-y/,S^ ei i� _. t G� Sign or outline lighting 67.84 2 Address: /--7-0 " / /fSignal circuits)or limited-energy ❑ See Page 22 /'7/1 panel,alteration,or extension. t — 9.39 �/�(fEach additional inspection over allowable in any of the above City/State/ZIP: t/�l �J,� . �� - J Additional inspection(1 hr min) 66.25/hr Phone:_..,4"));) / ✓_ eo , Fax:( 3)3 ; - /e, 97 Investigation(1 hr min) 90.00/hr Email: p - t -A� t /''�� Industrial plant(1 hr min) 78.18/hr • .r- • - / Il e_ / 1 .l ' �' 'fd'h ✓ Inspections for which no fee is / V I,/ / 90.00/hr t/t B Lie.: / / Electrical Lic.:3 G Suprv. Lic.:�-025— specifically listed(/hr min) t Suprv. Electrician signature,required: /e ELECTRICAL PERMIT FEES JJ f/(/{D Subtotal: 2407, 44 Print name: 34 A S f ' / gel)ty Date:/� ,_/6-)D,,‘ 0 Plan Review Required(25%of permit fee): Vr' V V State surcharge(12%of permit fee): 24. •7 Authorized signature: TOTAL PERMIT FEE: 232• Flan`'• This permit application expires if a permit is not obtained within 18� 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 06 17.2015 440-4615T(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: a t *SCHEDULE.. Description I QtY. I Each I Total I * 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 n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 2 n Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 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 specifically listed('/hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 l(EnteSubtotal per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation Fl HVAC ❑ Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:Building Permits FLC PermitApp ELR_ERE.doc Rex 06 17'_015 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 12198 SW SCHOLLS FERRY RD, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2016-00116 Jeff Grove Violation Summary: Inspector Contractor