Permit (10) CITY OF TIGARD ELECTRICAL PERMIT
.'= COMMUNITY DEVELOPMENT Permit#: ELC2016 00530
T[GA.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/06/2016
Parcel: 1 S133CC80101
Jurisdiction: Tigard
Site address: 14180 SW BARROWS RD 2
Project: Scholls Village Condominiums Subdivision:SCHOLLS VILLAGE CONDO STAGE 3 Lot: 10-1
Project Description: Reconnect only.
Contractor: Owner: BRECKENRIDGE PROPERTY FUND 2015 LLC
2015 MANHATTAN BEACH BLVD SUITE
100
REDONDO BEACH, CA 90278
PHONE: PHONE: 503-640-3070
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 06/29/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 06/29/2016 $8.14
Electrical
Type of Use: SF
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. ATTENTIO • regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 rough 0 952- 1-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B -1 Permittee Signature: Gu�. -_
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' A)/4— 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 o►z or11( F. t SI.()NIA
ived / permit#:
City of Tigard '"" DateBy: 623 /b 477"` -r lv~1 5'430 .
a 13125 SW Hall Blvd.,Tigard,OR 97223 atk'` Plan Revie
I : Phone: 503.718.2439 Fax: 503.598.1960 -1 '�O'�p DateBy: Related Permit#:
Inspection Line: 503.639.4175 ASN Ready Date/By: Juris: ® See Page 2 for
1 1 G A R D Internet: www.tigard-or.gov ,� (:::kik tt ied/Method: %rev Supplemental Information
TYPE OF WORK 'C,���� ,� c iiNi is PLAN REVIEW
❑New construction 0 Addition/alteration/re meet" Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ►1 Other:Power reconnect where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
►� 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address:14180 Barrows Rd ❑Addition of new motor load of system.
100HHP or more. ❑«A» «E» <`i-2""I-3„
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: 10-2 Project name:Wedgewood Barrows 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description ( Qty. l Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:Scholls Village Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:1S133CC-80102 Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Service Reconnection;power (with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
CI PROPERTY OWNERRenewable Energy 0 See Page 2
0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Breckenridge Property Fund 2015,LLC 200 amps or less 100.70 2
Address:2015 Manhattan Beach Blvd.Suite 100 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Redondo Beach,CA 90278 601 amps to 1,000 amps 301.04 2
Phone:(503)640-3070 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
0 APPLICANT ® CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
• A.Fee for branch circuits with
Business name:Wedgewood Inc. above service or feeder fee,
7.42 2
each branch circuit
Contact name:Eric Wold B.Fee for branch circuits without
serAddress:700 Briercliff Ln branchce it feederitfee,first 56.18 2
branch circuit
City/State/ZIP:Lake Oswego,OR 97034 Each add'i branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)440-2444 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:ewold@wedgewood-inc.com Reconnect only X 67.84 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr mm) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: (r�,'7,$LJ
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): (F Jy ,/
Authorized signature: 2.---e---7TOTAL PERMIT FEE: 6 4 �ra
.47—.1:‘ This permit application expires if a permit is not obtain 180
Print name: �t/C �0��>{ Date: 6/ �'b * days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Building\Permits\ELC PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB