Permit (154) CITY OF TIGARD ELECTRICAL PERMIT
g:• COMMUNITY DEVELOPMENT Permit#: ELC2016-00879
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/09/2017
TIGARD Parcel: 2S101AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE
Project: Red Rock Center Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Building C-New medical office building shell.
Contractor: KEC ELECTRIC INC Owner: TIGARD TRIANGLE PARTNERS LLC
761 SW BAILEY AVE 18187 SIERA DR
HILLSBORO, OR 97123 LAKE OSWEGO, OR 97034
PHONE: 503-439-0904 PHONE.
FAX: 503-640-3838
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 03/09/2017 $201.40
Specifics: amps or less
1 ea Services or Feeders-Over 03/09/2017 $552.26
Type of Use: COM 1000 amps or volts
Class of Work: ALT 13 crt Branch Circuits w/Purchase 03/09/2017 $96.46
Service or Feeder
Type of Const: 1 ea 12%State Surcharge- 03/09/2017 $102.01
Occupancy Grp: Electrical
1 ea Plan Review Electricial 03/09/2017 $212.53
Total $1,164.66
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 ac • == - 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. AT ' TION: Oreg• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001 $010 through OAR 9 $$1-06•0. You may obtain a copy of the rules or direct questions to OUNC by cal •• $3. 2.1987 or 1.800.332.2344.
/
Issu d By: � r 1 Permittee Signatu =•
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' lDate:
07l
LICENSE NO. r 5
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 f O R O 1 1-1( l: 1 "1. ON 1.1
City of TigardRECEIVE -.me.teBived
fPit No.:
IN _ ili _ /
13125 SW Hall Blvd.,Tigard,OR 97223 p R�1eµ ,,r
It Phone: 503.718.2439 Fax: 503.598.1960 Date/B : �� Other Permit:
�.l t i l) Inspection Line: 503.639.4175 1d n Date Ready/By: See Page 2 for
16
Internet: www.tigard-or.gov .+N�� Olt U Notified/Method: /A �7 yMj. Supplemental Information
EV
TYPE OF WOR Y I OF TIGAIU) dit-wJh '(w n/', PLAN REVIEW
®New constructionAddition/alteratiQp� t j t Please check all that apply(submit 2 sets of plans w/items checked below):
0 UAW � � 51�� ®Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other: 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-familyless to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ dwelling ®Commercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
0 Addition of new motor load of ❑"A","E","1-2","1-3",
Job no.: Job site address: 12115 SW 70th Ave 1001-1P or more. occupancy.
❑Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:Tigard,Or 0 Health-care facilities. 0 Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Red Rock-Bld C ®Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
1-1200a service,2-200a feeder,13-branch circuits residential(with above sq.ft.)
Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
0 PROPERTY OWNER I 0 TENANT 200 amps or less 2 100.70 201.4 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 1 552.26 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) I Fax:( ) relocation _-
200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
0 APPLICANT I 0 CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 13 7 42 96.46 2
Business name: each branch circuit
a Fee for branch circnitc without __ _
Contact name: _ service or feeder tee,first 56.18 2
branch circuit 4
•
Address: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Each manufactured or modular
Phone:( ) I Fax::( )
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:KEC Electric,Inc Signal circuit(s)or limited-energy
panel,alteration,or extension. Page 2 2
Address:761 SW Bailey Ave Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Hillsboro,Or 97123 Investigation(1 hr min) 66.25/hr
Phone:(503)439-0904 I Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 99267 I Electrical Lic.: .'-426C S .Lic.: 44895 specifically90.00/hr
listed(Yz hr min)
Suprv.Electrician signature,required: /x �.• ELECTRICAL PERMIT FEES
Subtotal: 850.12
Print name: Kenneth E Conway Date: 11/11/16 Plan review(25%of permit fee): 212.53
State surcharge(12%of permit fee): 102.01
Authorized signature: TOTAL PERMIT FEE: 1164.6(k
This permit application expires if a permit is not obtained within 180
Print name: I Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_040913.doc 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2016-00879
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor