Permit Support Document (31) CITY OF TIGARD ELECTRICAL PERMIT
1Il: . COMMUNITY DEVELOPMENT Permit#: ELC2017-00145
9�'"'" ,tau„ Date Issued: 03/02/2017
T(c;,, :R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 r,
1 Parcel: 2S102AB90002
" ,_ i 7 i Jurisdiction: Tigard
Site address: 9210 SW CENTER ST 2
Project: House Happy Subdivision: WILLOW BEND CONDO,THE Lot: 2
Project Description: Re-route kitchen circuits,replace ceiling heat with wall fan forced heaters. 3/15/17:REPRINTED permit to add(1)
branch circuit for microwave.
Contractor: OMNI ELECTRIC INC Owner: IMPAC FUNDING CORP TR
16670 SW WRIGHT ST BY EDMONDSON, SHARON
BEAVERTON, OR 97007 19500 JAMBOREE RD
IRVINE, CA 92612
PHONE: 503-747-0805 PHONE:
FAX: 503-649-2709
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo/Purchase 03/02/2017 $100.70
Specifics: Service or Feeder
1 ea 12%State Surcharge- 03/02/2017 $12.08
Type of Use: MF Electrical
Class of Work: ALT 1 crt Branch Circuits w/Purchase 03/15/2017 $7.42
Service or Feeder
Type of Const: 45 Misc Administration Fee 03/15/2017 $45.00
Occupancy Grp: 0 ea 12%State Surcharge- 03/15/2017 $0.89
Electrical
Total $166.09
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 I
952-001-0010 through OAR 952-001-0090. Qu.may obtain a c of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: izetor're----
-0--
.r? 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' 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 -s � , I OR 01 I R 1�. 1 sI (xy 1.1
CityofTigard , . .
Received .�
IN g DateBy. 5fi) I(7 Peomt f: y C a 17—(1)I'C y
- a 13125 SW Hall Blvd.,Tigard,OR 97223 4,�'. Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 .,i y. Related Permit if:
Inspection Line: 503.639.4175 1' Dote/By: Juris: H See Page 2 for
TI G A R D Internet ov www.ti and-or. .-t ethod: Supplemental Information
g g 10'4,', g, arc.
TYPE OF WORK Oct 'I,-l'a PLAN REVIEW
1y\$ Please check all that apply(submit 2 sets of plans w/items checked):
❑New construction ®Addition/alteratian/reptac rte'.•
� ` 0 Service or feeder 400 amps or more 0 Budding 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-
El 1-and 2-family dwelling 0 Commercial/industrial 0 Acces 1 ;_ less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations- buildings.
®Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system- larger separately derived
❑Addition of new motor load of system.
Job#: I Job site address:9210 SW Center St I OOHP or more. ❑"A","E","1-2-,"1-3",
City/State/ZIP:Tigard,OR ❑ x or more residentialH
❑ ealdt�are facilities.
units. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Z., I Project name:House Happy 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 I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Microwave circuit
(with above sq.R) 75.00 2
Limited energy,multi-family 75.00 2
�`� residential(with above sq.ft.)
—"'mow(- (i j r j r-c-4'/� I S Renewable Energy 0 See Page 2
0 PROPERTY OWNER GIQ NANT r Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 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:( ) I 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,
each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
WIcnal 56.18 2
Address: branch
circuit
City/State/ZIP: Each add'I branch circuit r 7.42 .7. 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Omni Electric Inc Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 16670 SW Wright St panel,alteration,or extension.
City/State/ZIP:Beaverton,OR 97007 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)747-0805 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:omni_electric@hotmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90,00/hr
CCB Lie.: 176615 Electrical Lie.: c297 Suprv.Lic.: 4270s specifically listed('A hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: .2, a2...
Subtotal: 1--K y,
Print name: John M.Kelso V 'i Date:e3/15/17 0 Plan Review Required(25%of permit fee): --
State surcharge(12%of permit fee): ,rel
Authorized signature: TOTAL PERMIT FEE: /- '. S 1
This permit application expires if a permit is not obtained within 180
Print name: Date: 3/15/17 days after it has been accepted as complete.
* Number of inspections allowed per permit.
1:\Building\Permits\ELC_PernitApp ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9210 SW CENTER ST 2, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2017-00145
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor