Permit (252) p CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT 1 ' ' • { Permit #: ELC2013 -00119
Date Issued: 02/20/2013
TEGAt.O 13125 SW Hall Blvd., Tigard OR 97223 503.718.24 • Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY A
Project: Anytime Fitness Subdivision: 1994 -028 PARTITION PLAT Lot: 2
Project Description: (71) branch circuits for receptacles, lights and water heater. 3/25/13 REPRINT add (2) low voltage for audio and
stereo system and Data telecommunications
Contractor: JAMES DOUGLAS ELIAS & ADAM LEONARD ELIAS Owner: SN PROPERTIES PARTNERSHIP
PO BOX 152 1121 SW SALMON ST
PHILOMATH, OR 97370 PORTLAND, OR 97205
PHONE: 541 - 760 -0577 PHONE:
FAX:
FEES
Quantity Description Date Amount
71 crt Branch Circuits wo /Purchase 02/20/2013 $575.58
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/20/2013 $69.07
Type of Use: COM Electrical
Class of Work: ALT 2 ea Limited Energy 03/25/2013 $150.00
0 ea 12% State Surcharge - 03/25/2013 $18.00
Type of Const: Electrical
Occupancy Grp:
Total $812.65
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 9 01-0090. You ma obtain a copy of the rules or direct questions to OUNC by calling 503,232.1987 or 1.800.332.2344.
Issued By: /iLi'L.�X�/ 4 t 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.
,
CITY OF TIGARD ELECTRICAL PERMIT
.11 11 11 COMMUNITY DEVELOPMENT Permit #: ELC2013 00119
• T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/20/2013
Parcel: 2S115AB01900
Jurisdiction: Tigard
Site address: 16200 SW PACIFIC HWY A
Project: Anytime Fitness Subdivision: 1994 -028 PARTITION PLAT Lot: 2
Project Description: (71) branch circuits for receptacles, lights and water heater.
•
Contractor: JAMES DOUGLAS ELIAS & ADAM LEONARD ELIAS Owner: SN PROPERTIES PARTNERSHIP
PO BOX 152 1121 SW SALMON ST
PHILOMATH, OR 97370 PORTLAND, OR 97205
PHONE: 541 - 760 -0577 PHONE:
FAX:
FEES
Quantity Description Date Amount
71 crt Branch Circuits wo /Purchase 02/20/2013 $575.58
Specifics: Service or Feeder
1 ea 12% State Surcharge - 02/20/2013 $69.07
Type of Use:I COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $644.65
Required Items and Reports (Conditions)
This permit is • • -ct to the regulations contained in the Tigard Municipal Code. State of OR. Specialty Codes and all other applicable law. All work will
be done i accordance with - • •roved plan his permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT ENTION: Oregon la requi = you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -6010 through OAR 952- 001 -•0• 0. You a ob -in a copy of the rules or direct questions to OUNC by calling 503.232 or .800.332.2344.
Issue. By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease or rent. �7
OWNER'S SIGNATURE Date: a" ' / /
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' ! Date: o ) •aG r
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.
i
Electrical Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard R e � 3 > Permit No.:
11,4 q 1 , / 2of3 - oO!(
° 13125 SW Hall Blvd., Tigard,OR 97223 MAR 2 2013 Plan Review
17 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D' Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Juris El See Page 2 for
Internet: www.tigard- or.gov BO' .DING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
E l Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
['Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
L / _ �� �� 04-e___ 1001-1P or more. occupancy.
Job no.: • Job site address: (Q y
/ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ 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' 1 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
-P� v IC0 !9 GC7 V O /CJ n Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
4..-t'l.JO J.+ S I ?j - 00( 't 200 amps or less 100.70 2
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 ' 2
Address: Over 1,000 amps or volts 552.26 2
City/State/ZIP:
Temporary services or feeders installation, alteration, and/or
_ relocation
Phone: ( ) Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee 7.42 2
each branch circuit
Business name: /--- E F-7 t^t sr 4 ty1 pg. t L / 4 S' B. Fee for branch circuits without
service or feeder fee, first
Contact name: 0 - 1 15 L /4-- branch circuit 56.18 2
Each add'I branch circuit 7.42 2
Address: D ; Q. g° x $ � - Miscellaneous (service or feeder not included)
City/State /ZIP: pH J L G W1 H Q Each manufactured or modular
/ 7 J 7 V dwelling, service and/or feeder 67.84 2
Phone: (E'1 t f) 7 6-0 - 0 7 7 Fax:: ( ) Reconnect only 67.84 2
VV �� Pump or irrigation circle 67.84 2
E - mail: Sign or outline lighting 67.84 2
CONTRACTOR y� Signal circuit(s) or limited - energy / �t oU
...,.=Business name: 5-A. I, 'j " i/ 4-C P1 Roo l� \ panel, alteration, or extension. Page 2 (51/ 2
Each additional inspection over allowable in any of the above
Address: Additional inspection (1 hr min) . 66.25/ hr
City/State /ZIP: Investigation (1 hr min) 66.25/ hr
Industrial plant (1 hr min) 78.18/ hr
Phone: ( ) Fax: ( ) Inspections for which no fee is 90.00 / hr
specifically listed (%3 hr min)
CCB Lic.: Electrical Lic.: Suprv. Lic.: ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ° Subtotal: / 5-v .G-C- Plan review (25% of permit fee):
Print name: vtJ; ... ► L / ' _ Date: M " 1 n, Q �.� State surcharge (12% of permit fee): 49. O e.
Rio Authorized signature:
A I TOTAL PERMIT FEE: obtained pd
This permit application expires if a permit is not obtained within 180
� days after it has been accepted as complete.
Print name: \ 1 0 vv.), �fi� Date: � f/J )f _ / � a (� N umber of inspections allowed per permit.
t \Building\Permits\ELC- PermitApp.doc 07/01/10 440 -4 /05 /CO o M/WEB
Electrical Permit Application FOR OFFICE USE ONLY
c ;.,,- F
! �d
City of Tigard 1 ,, A ,•, Da te / Recei 13 ved v 5 Permit No.: C $ N� a
• 13125 SW Hall Blvd.. Tigard. OR 97 2 Plan Review �'
Phone' 503.718.2439 Fax: 503.598.1060 ' ' 3 Dale /13v. Other Permit: 4 ��
T[GARD Inspection Line: 503.639.4175 FEB Date Ready /By' tuns lid See Page 2 for
Notified/Method. Supplemental lemental Information
Internet: wtivw.tigard- or.gov . i I t
- , , ;' ' .ti '' 4c :i ;O,� OI�fC�� 1 .. *fRE ,
• c o „ � b 'all'
el ilh , ' iJ � ., Please check all . that apply ( 2 sets of plans w /items checked below):
❑ New construction (Addition /altcra t, inenl
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
' " r' `- ° "`" ` ' exceeds 10,000 amps at 150 .'oils or ❑ Floating buildings.
r - `.. URY ` F, ONSIRUCatIOY . i • ' '�
`t.• "`F- " ..es�. - -d ", .r, '- 't ^t<:,S•:r � " less to ground, or exceeds 14,000 0 Commercial-use agricultural
❑ I- and 2- family dwelling [z Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
.- _ »..,1., ,�•. ., .. „ ` N'rA N :�. . .. .• ❑ Emergency system larger separately derived system
JOB''SITE•t FORMATIO 'OCA fIO ,' "
. ' - ;-',- • , ❑ Addition of new 110101 load of ❑ A F I.2 „ 1.3
10011P or more. occupancy.
Job no.: Job site address: j / ,
(( 1 n O S WI :?Re / N/ C i ci- gJ j ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: I n n ❑ Health -care facilities. 0 Supply voltage for more than
Q ' R 0 '& / Q 7 -7 2..� x� _ ❑ Hazardous locations- 600 volts nominal.
Suite/{l-t TO.: x ' Project name: ❑ Sers ice or feeder 600 amps or more.
1 ---:S Ei ',AS
' :; _G�I" E DULE. ,i -t. :.� ..
::,
Cross street/directions to job site(') r ffA 1 _ - - Description 1 Qty. I Fee. I .. Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq R. or less 168.54 L
Ea add 500 sq. R. or portion 33.92 1
Tax map /parcel no.:
Limited energy, residential 75 00 2
'' ,. - r:. ''� . " ',`DE S R,IP770 0 .. i.V.OR - • I, (with above sq. R.)
Limited energy, multi - family 75.00
i g e A-C (r'
(FA / L /bf r,S //'f0 % i/46/46 ti)A - /46-47-6?_ E residential (with abovesq.11.) -
t
Services or feeders installation, alteration, and /or relocation
200 amps or less 100.70 2
• r:PROPERTY O W 4 ' S TENANT,. 1 201 amps to 400 amps 13356
401 amps to 600 amps 200.34 '
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation, alteration, and /or
City/State/ZIP: relocation _
Phone ( ) I ( ) 200 amps or less 59.36 1
201 snips to 400 amps 1 25.08 2
Owner installation: - Phis installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange. according to ORS 447. 449, 670, and 701. 401 amps to 599 amps 163 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A Fee for branch circuits with
®
I F P, • above service or feeder fee,
AP "LICANTl. ; . :'.O.'.CON'�AC P' CERSON 7.42 2
each branch circuit
Business name: 13. Fee for branch circuits widlour
— - -- --- - - - - -- . -. service or feeder fee, first 56.1 8 r i
Contact name: branch circuit
- I Each Ad branch circuit 70 7.42 Si 7 2 .
Address: Miscellaneous (service or feeder not included)
Each manufactured or modular
City/State/ZIP: dwelling, service and/or feeder 67 R4 2
Phone: ( ) I'ax:: ( ) I nnect only 67.84 2
— -- v 1/ — - — 1 - Reco Pump or irrigation circle 67.84 2
E -mail:
�y Sign or outline lighting 67.84 '
r ,,ONTRA-CTOR . Signal circuits) or limited- energy
Business name: i LtoioRt x 224 R � j , panel. alteration, or extension I Page 2 2
,f Q / `I F S EG / /� S — Each additional inspection over allowable in any of the above 2
Address:' A X 7 7 - - -- __— — — Additional inspection (I hr min) 66 25/ hr I
CiIyISLate / %IP: ! p Investigation (1 hr min) 6625/ hr
� H / 1. 0,'1 4 7-Y �}
I f / Ir. 9 7 �5 7 0 — Industrial plant (I hr min) 73.18/ hr
Phone: ( ) 1 �.': ( ) I ns pections for which no fee is
specifically
�� /(4 o" /a ; /, listed (Y hr min) 90.00 /hr
7� /� 3
C B ,�../ 9 4 .9 9 q Electrical Lic.: 9D I, Suprv. Lic.:3 2 / ` " ELEC'RICAL . PERMIT,'FEES " '
/ S , s i �
Subtotal: 7 " ` -
, u Electrician signature. required: A.--a- ,Q , ��_ - �d
Plan review (25 %of permit fee): ' 1 J `
Print name: I -- State surcharge (t2 % permit fee): q ,
J R ti e S 6- 1.1 /- S I Date: r l 9 -1 I014L PERMIT f 1a::
AUl Or17.0 signature: - phis permit application expires if a permit is not obtained within 1811
days after it has been accepted as complete.
Print name: I Di11C: • Number of inspections allowed per permit. )
t+ .iluiiding\Permns'ELC- PermilApp doe 07,01/10 .116 -46 I S ri I I•OS;i'USLwiin
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
)7(Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
O Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical ,
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I.\ Building \Permits\ELC- PermitApp.doc 07/01/10
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
16200 SW PACIFIC HWY A, TIGARD, OR, 97224
Commercial - Electrical
120 Electrical rough-in
02/26/2013 00:00
ELC2013-00119
FAIL
Plastic bushings required on conduits for low voltage. Protective connectors required on
flex chases for low voltage
Violation Summary:
Inspector Contractor