Permit (102) . ,,e.
II CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00340
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/23/2018
D9 Parcel: 2S 110AA01200
Jurisdiction: Tigard
Site address: 14300 SW PACIFIC HWY
Project: Spec Space Subdivision: CANTERBURY PLACE,AMENDED Lot: 8
Project Description: Electrical for TI:(9)branch circuits.
Contractor: PHOENIX ELECTRIC CO Owner: JAW INVESTMENT LLC
PO BOX 14037 14300 SW PACIFIC HWY
PORTLAND, OR 97293 TIGARD, OR 97224
PHONE: 503-231-8006 PHONE:
FAX: 503-235-4300
FEES
Quantity Description Date Amount
9 crt Branch Circuits wo/Purchase 05/23/2018 $115.54
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/23/2018 $13.86
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $129.40
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are sett orth in OAR
952-001-0010 through AR 952-001-0090. obtain a copy oft rules or direct questions to OUNC by calling 503.232.1987 or 800.332.2344.
. „4.--,
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY "%7
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application RCEI FOR OFFICI: 1 SI:0N1.1
City of Tigard DDac ed
-.. . Permit#: r- i
14 • 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 2 3 )A Plan Review
.11 Phone: 503.718.2439 Fax: 503.598.1960 Date/ : Related Permit#: iie4 '• /'.�
r._
Inspection Line: 503.639.4175 ti y Date/By: l3 See Page 2 for
T I G AR I) ini
Internet: www.tigard-or.gov 3+1 TI(; ed/Method: b Supplemental Information
❑New construction { Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
C X �aO' 11}$S1 w(:ljO 1 exceeds 10,000 amps at 150 volts or 0 Floating buildings.
O 1-and 2-family dwelling [+]Kommercial/industrial 0 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 sP ° . .,j�l xt" ❑Emergency system. larger separately derived
Job#: 0 ® Job site address:/ 1 s 0 Addition of new motor load of system.
P- 01— lt3 (u me/Fie,, f'/ 1001-1P or more. ❑«A» «E» «1 2»«1 3»
City/$tate/ZIP: ;� 2--.2-4- ❑Six or more residential units. occupancy.
T 4 4 e ) (7� /Q 7 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: �jj G 5 i®A) J((6,gtQQ,(D ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:
fi 4
Description I Qty. 1 Eac6 ,�1 Notal 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
� [:,W)R1 k <. Limited energy,residential 75.00 2
®r.F.at a E /ti (with above sq.ft.)
i Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
-, I itOIER m 4 ,, .. oNmax. 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:( ) 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
k6 s� ,S �� Branch circuits—new,alteration,or extension,per panel
' - �� A.Fee for branch circuits with
Business name: above service or feeder fee, 7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit / 56.18 ,5-6.6(s 2
City/State/ZIP: Each add'l branch circuit 4{ 7.42 3' 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
Pump or irrigation circle 67.84 2
Business name: 0Eitj a y( g i 2(e, Sign or outline lighting 67.84 2
AD,.. ��0 J 2
Signal circuit(s)or limited-energy ❑ e Page 2 2
Address: el,alteration,or extension.
ri Paw—AA-A.)6�6 az. 9 7 �,3 Each additional inspection over allowable in any of the above
City/State/ZIP:
Additional inspection(1 hr min) 66.25/hr
Phone:6-03) ?3i -i-OO C, Fax:( ) Investigation(1 hr min) 90.00/hr
n J Industrial plant(1 hr min) 78.18/hr
Email:
. /F AAV� �l r+-X • (.0 YI1 Inspections for which no fee is 90.00/hr
CCB Lic.:., -42 Electrical Lic.: Suprv.Lic.: 5/4,55 specifically listed(,Y2 hr mm)
RKAAt R IT'°FE , ,k
Suprv.Electrician signature,required: �� � Subtotal: // :S�'
Print name: K a G({ Date: 5--/7-J Y 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 1 3 '4,
iciAuthorized signature: TOTAL PERMIT FEE: JA 9.4-0
�_ / This permit application expires if a permit is not obtained within 180
Print name:` ibiz2 3 i pc Date: 1-... (7../'( days after it has been accepted as complete.
J/ • Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(1 1/05/COM/WEB