Permit 111 CITY OF TIGARD ELECTRICAL PERMIT
I° COMMUNITY DEVELOPMENT Permit#: ELC2016-00228
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/23/2016
Parcel: 2S 102AB03600
Jurisdiction: Tigard
Site address: 12271 SW MAIN ST
Project: Johnson Building Subdivision: None Lot: None
Project Description: Electrical reconnect only
Contractor: N/A Owner: JOHNSON TRUST"A"SURVIVOR'S TRU
JOHNSON, REES C TRUST
JOHNSON, MARYANNE G TRUST
3112 SW SANTA MONICA
PORTLAND, OR 97239
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 03/23/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 03/23/2016 $8.14
Electrical
Type of Use: COM
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75.98
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. • - ' •1: c -gon law requires you to follow the rules adopted by the Oregon Utility Notifica.• Center. Those rules are set forth in OAR
952-•.1-0010 through OAFS9552-11! -.,m•S. You may obtain a copy of the rules or direct questions to OUNC b .232.1987 or 1.800.'32.1344.
sued By: �/ /IP r Permittee Signatu ' �'/r / • %��
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.
03/23/2016 17: 16 5032458260 ESP PROPERTIES PAGE 02/03
Electrical Permit Application 101:: OFFI(F I ST. O\l.\
City of Tigard eived
Dae/ + i Penn"'E/-4096 to-cc agg'
q e 13125 SW Flan Blvd.,Tigard OR 97223 Plan Review
2 Phone: 503.7182439 Fax
x: 503,598.1960 Date/B Related Permit�:
z., ,,r..•. .r.,.....S' "vab°'__ monsminsmasmiammaNINtaraseramameromemmimili
.. - :... . . ... Please check all that apply(submit 2 sets of plans w/items checked)!
CI New construction ❑Addition/alteratioll/replacement
0 Service or feeder 400 or more ❑Buildingover three stories.
❑Demnlltlof ❑Other: where the available fault current in Marinas and boatyards.
exceeds 10.000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 7-family clwel lin¢ NI Commercial/industrial fl Accessory buildiaz less to ground,or exceeds 14,000 0 Commercial-use agricultural
=oyes it...,41 Oh..•inetanet;eee. b-:la:«ee.
❑Multi-family 0 Master builder ❑Other: ❑Fire pump. C]Installation of 150 KVA or
Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address: 12271 SW Main Street 10DHP or more. 0"A","E","1-2",-1-3",
❑Six or mora residential utdffi- occupancy.
1 ' 0 Recreational vehicle parks.
Tigard, _ ❑i#ealth-care facilities.
Suite/bl
❑hazardous locations. 0 Supply voltage for mon than
❑Service or feeder 600 amps or mon.
• • Building 600 volts nominal.
New residential single-or multi-family dwelling unit.
Includes attached" garage.
1,000 sq.ft.or less 168.54 4
Prrn-Or•boo b000 phut off 11.0e elx AO' OrIttig.on 1.;:.;:i;ret—e0"fl' 'o:;prr-rira"i'Florin n mni-le- ... •. . . (VIItlLehnvn"" Q
Ltmtten urwrlSY,1u111u-ftutitly 75.00 2
residential(with above sq.ft.)
inspection - ... Renewalble En ,i. 0 Seel' •e 2
. :..::.. ..•,.--.—• ••- •••.•• .. •-Belriees.7.7iccdere laetal1atisa alteration menti/nr.r�elnee1inn. ...
..
Shannon D. 1 : + 200 amps or less 100.70
��
201 am,•-to 400 amps 1 133.56
, AddroSS:12271 SW ' 401 amps to 600 amps 200.34
City/State/ZIP:Tigard,oregon 97224 601 amps to 1,000 amps _ 301.04
OwnerTemporary services or feeders installation,alteration,end/or
Email: relneation
installation iS being made . property . 200 amps Or less 59.36 1
intended for sale,lease,rent, . exchange,according1 :.. 1 201 amps to 400 amps 125.08 2
• signature: Date: 401 amps to 599 amps 168.54 2
Rranrh rirP•t1tt new al*ration.or extension.per panel
PropertyBusiness name:ESP above service or feeder foe, 7.42 2
barh hrenrh r remit
K 'reit for nrancn ClTC1c1r5 wrnc�'w
service or metier Ivo,Aust 56.18 2
hrnnrh rirrvit
n....1....aan 1....,...4,...rer.ie • 7 67 7,
Clry/5tate/z1r:Canby,e�ceguu y'/ui�
Miscellaneous(service or feeder not included
A LOAM.. ,JVJJ LIMN—A A,, / ___.—_____... • • -
dwelling,service and/or feeder III=
•
Email:espcorUAtercl-wl@gninkfxWn 'MOM-- on y NIIIMM
Pump or irrigation circle
Business name..n/a Sign or outline lighting -
Signal circuit(s)or limited-energy
Address: rime! alterdti. or extension. -
Each additional inspection over allowable In any of the above
Additional inspection(1 hr min) 66.25/hr
• Investigation(1 hr min) 111 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
a 6,,-rifiral lictetl AS, ii ,
required:Supry,Electrician signature, Subtotal:
Pr'i t name: Date: ri Plan Review Re•uired(25%of! • it fee):
__4_-_-1110/..{'..-.++•i.s...1-
(---- -. )8L.0)
� TOTAL PERMIT FEE:
Authorized signature: This permit applicadon eapires If a permit Is not obtained within 180
Print name: Robinn Rudd Property Manager Date: 3/23/16 deye abler it has been accepted as complete.
* Number of inspections allowed per permit
r n,,adinewervella\P.t_C_Pe mitAuv ELtt EaE.doc Rev 06/1712017 440-4615T(1I/05/COM/WER
MO/00/0W C 17. 1[ A POr)C fl CCD DDfDCDTTCC DA( C MO/MO
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
L11111LC11 i!uti y 1 VA mat .a.%A-a•
IMBIENIESSEMIlanarnallainEBROMMIN1)eaee+pe ... Cy rarh Toto) •
T...for all rraislenttnl%vetemR combined: $75.00 frnewahlr.elec. y =14-2 ine:
le-va nrlr_nc 100.70 2
1.11Ciif lyilr Vl v�VAA►iuvvivcu. 5.01 to 15 lcva 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 B• urglar Alarm 25.01 to 50 kva 301.04 2
' ` 50.01 to 100 kva 552.26 2
n C• it age Door Opener* >1 W 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
>100 lova-rlo additional charge vv
❑ Vacuum Systems*
Each additional inspection over allowable is an of the above:
i J lifter: rroot,a,sAi nn 1 in-w
cgargCa ai 9r1�l0ur 1�1�(t�n MINI --�
Iv.P1Cung
�,ta1(Enter n
ee or eae [411 Mercia Sys em: • Number of inspections Mowhted par pemut. Pane 11: I
(SEE OAR 918-309-0000)
Check Type of Work Involved:
[2 Audio and Stereo Systems
0 Xsolier Go1lufu15
Q Clock Systems
[2 Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Landscape Irrigation Control*
.❑ Medical
[] Nurse Calls
Q Outdoor Landscape Lighting*
n Protective Signaling
O Other. electricity for 2800 sf.
rnrol numhvr A ir I-rle enirn I.led S'Vat'.Gll]J:
"No license°aro requirod. Licenoaa sere rmiiiretl for all
other installations
03/23/2016 17:16 5032458260 ESP PROPERTIES PAGE 01/03
S w /►'I,GrI-f St:
. �
To: Debbie,City of Tigard From: Robinn Rudd
Fax: 503598-1960 Date: March 22,2016 ^
Phone: Pages: 2
Re: CC:
o v.��__. ..__ .._ .. _ r ..•____ w_—J.�.�� .,Or...r..n....l.. ifl Ols�an Rrarvrtlp
Debbie,
Thank you, Attachea is tile signed CIei 1rlcdl rer.nit A�pli...dtlon.
ROBINN RUDD
ESP Property Factors, Inc.
Phone 503-245-1 177 Fax: 503-245-8260