Permit (96) CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: ELC2019-00094
f c;A R.D13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2019
Parcel: 25101 8000301
Jurisdiction: Tigard
Site address: 12360 SW KNOLL DR
Project: Knoll Commons Subdivision: None Lot: None
Project Description: Installing(2)sub panels,(1)feeder.and 41 branch circuits.
Contractor: ACE ELECTRIC&CONSTRUCTION LLC Owner: ELITE CARE KNOLL SUMMIT LLC
9210 SW 28TH AVE 4444 SE OATFIELD HILL RD
PORTLAND, OR 97219 MILWAUKIE, OR 97267
PHONE: 503-244-0078 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 ea Services or Feeders-200 02/19/2019 $302.10
Specifics: amps or less
41 crt Branch Circuits w/Purchase 02/19/2019 $304.22
Type of Use: MF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 02/19/2019 $72.76
Electrical
Type of Const:
Occupancy Grp:
Total $679.08
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 -001-0090. You , obtain a y of the rules• direct questions to OUNC by calling 503.232.1987 or 1.800.332344
Issued By: na// rmittee Signature: te.44,47rI
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 503.639.4176 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.
v- w`` fk *..,5
Electrical Permit Application - ' -- i o►z 0141( I. t SI 0y1.1
City ofTigard and FEB 1 9 2019 Received
Date/B :�� �0/s
, •• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' 1 Phone: 503.718.2439 :'' Date/B : Related Permit#:
Email: TigardBuildingPermits@Tigard-orou. , :a Ready Date/By: loris: Ei See Page 2 for
I I c'A R I) Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction t1 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑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
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: 12 3 4 0 j u, Kik `1 ❑Addition Hof new motor load of system.
100HP or more. ❑"A" "E" "1-2" "1-3„
City/State/ZIP: 0e-eye/is/ ❑Six or more residential units. occupancy.
�! t y'4e'� + 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: ✓ Project name: 1C ru,L G/y( 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: Kit 6 t, r 4/141,.
6/41 /1"1FEE SCHEDULE
1' t/ Description I Qty. I Each I Total I •_
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'►500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
/ (with above sq.ft.) 75.00 2
I^>l r-<< Z cal ?c.+,.r.1$ \ l e✓ . t C'e t_ Limited energy,multi-family -
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER 1 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 3 100.70 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:( ) 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
PLICANTONTACT PERSON Branch circuits-new,alteration,or extension,per panel
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
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) 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: A C c £-(o e j- Coif /t- Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 11 4 e 5 to S fee)k,---fes,, Cf panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Pi,.-11-rC; ! Q rcq z^H Q 7Z c/' Each additional inspection over allowable in any of the above
J' Additional inspection(1 hr min) 66.25/hr
Phone:( s-,,,7) 3 f C ` 4 5 3 Investigation(1 hr min) 90.00/hr
Email: t*-
Industrial plant(1 hr min) 78.18/hr
fh Gi c •l r `,` , 0``cL i c' ...--
J 7 Inspections for which no fee is
CCB Lie.: Electrical Lie.: Suprv.Lie.: c specifically listed(Y.hr min) 90.00/hr
r4¢ 2�"7 �� 3 ? p ��` +�'f'
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: 1L. - LA.,>- t0/2-P1 Subtotal:
Print name: p ,�f—' 'fy 1 6-6,� , Date: Z - ) t - Z�I7 ID Review Required(25%ofpermit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
- 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\ELCPermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qty Each- I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
COMMERCIAL WORONLY• r 171, alf, Tiuc 'I7[ *00$714:‘'"r ;