Permit (76) CITY OF TIGARD ELECTRICAL PERMIT
1114 -
COMMUNITY DEVELOPMENT Permit#: ELC2018-00107
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/12/2018
Parcel: 2S 101 AB03100
Jurisdiction: Tigard
Site address: 12115 SW 70TH AVE 200
Project: Dr.Steven Gabel MD PC Subdivision: 2012-009 PARTITION PLAT Lot: 3
Project Description: Adding(3)200 amp service panels and(51)branch circuits for medical office TI.
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
3 ea Services or Feeders-200 03/12/2018 $302.10
Specifics: amps or less
1 ea 12%State Surcharge- 03/12/2018 $81.66
Type of Use: COM Electrical
Class of Work: ALT 51 crt Branch Circuits w/Purchase 03/12/2018 $378.42
Service or Feeder
Type of Const: 1 ea Info Process/Archiving-Lg 03/12/2018 $2.00
Occupancy Grp: $2.00(over 11x17)
3 ea Info Process/Archiving-Sm 03/12/2018 $1.50
$0.50(up to 11x17)
Total $765.68
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
952-001-0010 through OAR 95 •: -.i•'. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: > Permittee Signature: ``/ .(9-75/06../
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 Applicatio FOR 014-1(4. t SE (1y1.1
City D,f Tigard Received �J / f r
IIIa ' ,-0 i : Z��U f� Date/By: oC ll-1 ! 0 rmit# /..C�/��/l O tN to 7
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review v a,- 42,��
Phone: 503.718.2439 Fax: 503.598.1960 OF' Date/By: 20 i ►.1Related Permit#: /s(,( 0,(j
Ti G A R p Inspection Line: 503.639.4175I� r , Ready Date/By: _ ris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Metho
ds� Supplemental
DIG DIVISION 9'
TYPE OF eiL— L
PLAN REVIEW _
❑New construction ®Addition/alteration/replacement 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 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-family dwelling ®Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑Multi-familyMaster builderOther: amps for all other installations. buildings.
0 0 0 Fire pump. 0 Installation of 150 KVA or
dOB SITE INFORMATION,AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 12115 SW 70th Ave ❑Addition of new motor load of system.
10011P or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,Or 97223 0 Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: eg(7 Project name:Dr.Gabel 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: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
3-200a>feeder/Panel,51-BC (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER 0 Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 3 100.70 302.1 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:( ) 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: above service or feeder fee, 51 7 42 378.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit 56.18 2
City/State/ZIP: Each add'l branch circuit 7.42 2
Phone: Miscellaneous(service or feeder not included)
( ) 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:KEC Electric,Inc Sign or outline lighting 67.84 2
Address:761 SW Bailey Ave Signalnel,alcteration,
n or extension. 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Hillsboro,Or 97123 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)439-0904 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:kenc@kecelectric.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 99267 Electrical Lic.: 4-426C Suprv.Lic.: 4489S specifically listed(%2 hr min)
.
PERMIT FEES
Suprv.Electrician signature,required: r, ELECTRICAL Subtotal: 680.52
Print name: Kenneth E Conway ate: 02.14.18 la Plan Review Required(25%of permit fee): 170.13
State surcharge(12%of permit fee): 81.67
Authorized signature: TOTAL PERMIT FEE: 932.32
This permit application expires if a permit is not obtained within 180
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(t 1/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
12115 SW 70TH AVE 200, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2018-00107
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor