Permit (41) CITY OF TIGARD ELECTRICAL PERMIT
' I`. . COMMUNITY DEVELOPMENT Permit#: ELC2019-00049
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/30/2019
T �'�� ' g Parcel: 2S 101 DC04201
Jurisdiction: Tigard
Site address: 7190 SW FIR LOOP 200
Project: Maher&Tolleson Subdivision: 72ND BUSINESS CENTER Lot: 2
Project Description: (4)branch circuits for TI.
Contractor: BRIGHT STAR ELECTRIC COMPANY Owner: VIKING TWINS II LLC
3143 SW 22ND ST NORTHWOODS WEST LLC
GRESHAM,OR 97080 7190 SW FIR LOON
TIGARD, OR 97223
PHONE: 971-998-8459 PHONE:
FAX: 503-907-9809
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 01/30/2019 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/30/2019 $9.41
Type of Use: COM Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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.Q{4R 952-001-0090. 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: K ''-le Permittee Signature: '/ '97"-70,1/
-70
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 y,,,, ,, FOR OF FIC F I SE ON 1.1
City of Tigard N et .f t— 'J Received
II
Ill 13125 SW Hall Blvd.,Tigard,OR 97223 Date/BY: L/3�� i y /} - Perm": a `7-J00217
Pla
C Phone: 503.718.2439 Fax: 503.598.1960 ,,A N 3 0 2019
019 DatneBRy:eview
Related Permit#:ezr/0,261 J _ext.1i v
Inspection Line: 503.639.4175 Ready Date/By: Juris: 0 See Page2 for
T I G A R D Internet: www.tigard-or.gov CITY
- k tt ii Notified/Method: ,----,-- - Supplemental Information
TYPE OFj
"w LDING DIVISION PLAN
REvxEw
❑New construction 72 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 ❑Other:
where the available fault carseat ❑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
amps for all other installations. buildings.
❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: 1 (C o SGs j9 ❑Additioo of ore.motor load of system.
L-C.>b� 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: ,/�,,,(_ j 9-7 ❑Six or more residential units. occupancy.
C, l ""� ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldgp/a t.#: Pro ect name' .,- f-�0/�G��� 0 Hazardous locations. ❑Supply voltage for more than
� Jla��► ❑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
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
IN S lku__ t l t') FLU C1 4 S'kJ ( 7 C F 11 '• ji /b (with above sq.ft.)
l V + t- J ! ' �+ t t 1�� T I r v Limited energy,multi-family
deCLO CA-17c L.164+-IT ' 1!V 4 cl Tie-1 iU C"7 a o(L residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT 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
0Branch circuits-new,alteration,or extension,per panel
'APPLICANT" _ CONTACT . 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
service or feeder fee,firstr(g
Address: branch circuit 56.18 2
City/State/ZIP: Each add'1 branch circuit 3 7.42 22,2C 2
Phone: Miscellaneous(service or feeder not included)
( ) Fax: :( ) Each manufactured or modular
67.84 2
Email: dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: 'gel & j4. ������ c_ Sign or outline lighting 67.84 2
/j/ A) �+- Signal circuit(s)or limited-energ0 See Page 2 2y
Address:
3( .j , SC) 2 1 ! panel,alteration,or extension.
City/State/ZIP: � 5 -�,�( G� ��'' 'C:' Additional
additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:j1( ) q -' eCt Fax:( ) Investigation(1 hr min) 90.00/hr
0 Email: -'4)k) / .e-_t v* S 1 A-e- �,x , 1.„k Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.:2c l(Q Electrical Lic.: -iii.
6/ ric.: z.Jt(C�' S specifically listed('A hr mi )
ELECTRICAL PERMIT FEES
Sup .Electrician signature,required - Subtotal: 78 ,44
Print name: ac t..4 (r 4,� Date: I 1". c..;
/ (9 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: g7,g5--
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
s Number of inspections allowed per permit.
I:\Building\Permits'ELC_PermitApp_ELR_ERE.doe 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:
7190 SW FIR LOOP 200, TIGARD, OR, 97223
Record Type: Record ID:
Commercial - Electrical ELC2019-00049
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor