Permit (182) CITY OF TIGARD ELECTRICAL PERMIT
'' COMMUNITY DEVELOPMENT Permit#: ELC2018-00580
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2018
T t i.A I=.Dg Parcel: 2S112AD00200
Jurisdiction: Tigard
Site address: 6830 SW BONITA RD
Project: JH&DK,LLC Subdivision: BONITA GARDENS Lot: 4
Project Description: Installing(6)branch circuits for TI. Install outlets/switches for new trimming and upper mezzanine. Install outdoor
security lights.
Contractor: POWER ELECTRIC INC. Owner: STEMS FAMILY HOLDINGS LLC
PO BOX 14692 BY JOHN E SMETS
PORTLAND, OR 97293 PO BOX 560
AURORA, OR 97002
PHONE: 503-703-2801 PHONE:
FAX: 503-786-5462
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo/Purchase 09/04/2018 $93.28
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/04/2018 $11.19
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 952-001-0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permf`e 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.
El ctt-ical Permit Application FOR OFFICE USE ONLY
,o y
City of Tigard Date/By:
at a ed
?A(//1:00/...")...Permit N L! /7��f 2 -
III - a 13125 SW Hall Blvd.,Tigard,OR 97223 ,-'s Plan Review r}�, 7 /� /
Phone: 503.718.2439 Fax: 503.598.1960 '' Other P r`1 ci7 (4.,ai
Date/By:
TIGARD Inspection Line: 503.639.4175 • Date Ready/By: Juris: H See Page 2 for
Internet: www.tigard-or.govNotified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW'
Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction ddition/alteration/replacement
Q 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 0 Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
❑ 1-and 2-family dwelling ommercial/industrial 0 Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
0 Addition of new motor load of ❑"A","E","1-Z","1-3",
<`, b .. 100HP or more. occupancy.
Job no.:J g.iyt�+,t ; Job site address: '?S �14 I �t 1 1S * Q Recreational vehicle parks.
m� t .oi 0Six or more residential units.
C! /State/ZIP: ij ❑Health-care facilities.
0 Supply voltage for more than
#1 C 1ryi `+� 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:, do_ 0 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'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
DES IPTION OF WORK (with above sq.ft.) 75.00 2
4 tr .,i� 1 ,, Limited energy,multi-family
75.00 2r✓5!a ,.„ .1, r~ W tc NQ iNow( fi v� vi residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0.4.41 1.1` 4.(` any`\c-C r,,,,, \'r4,�,'�"-ry% ,O,l* . 61::,,' 1 g0. %1 y„' a Services or feeders installation,alteration,and/or relocation
OWNER 0 TENANT i` 200 amps or less 100.70 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 552.26 2
Cit}'/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) 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
APPLICANT 0 CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name: - each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18 ,( 2
branch circuit +�
Address: Each add'I branch circuit ,S° 7.42 37,/0 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone: dwelling,service and/or feeder
( ) Fax: ( ) Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: q{ /` / .4 ' ' Signal circuit(s)or limited-energy See
,� f- ,''t` t` i(' ', C .4.-44."` . panel,alteration,or extension. Page 2 2
Address: }� 1 i" f j Each additional inspection over allowable in any of the above
City/State/ZIP: er e' '/ L°'zf �,/—" { Additional inspection(I hr min) 66.25/hr
r i't(,:i. , . j ,i Investigation(I hr min) 66.25/hr
Phone:(�7 ) /3 "y �(t Fax ( 1 ) /‘ L�z -"'} Industrial plant(1 hr min) 78.18/hr
- '' , Inspections for which no fee is
CCB Lic•to *.. :-, , tf Electrical Lic.: `r, .. 7.(* Suprv.Lic.: ,b specifically listed(%hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ', ,
} Subtotal: 9,, '. 's,
Print name: _ Date:' C,+ Plan review(25%of permit fee):
/`" State surcharge(12%of permit fee): /I,/
Authorized signature: TOTAL PERMIT FEE: /p y, 4/7
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.
1\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
6830 SW BONITA RD, TIGARD, OR, 97224 March 20, 2019 at
10:24:12 AM
Record Type: Record ID:
Commercial - Electrical ELC2018-00580
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor