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Permit ,, CITY OF TIGARD r `, .'> ELECTRICAL PERMIT ` .: '! 111' '• COMMUNITY DEVELOPMENTMil= Permit#: ELC2019 00303 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/07/2019 Parcel: 2S 102AD00300 Jurisdiction: Tigard Site address: 12555 SW HALL BLVD Project: KEN-McMonalge-20124 Subdivision: TIGARD HIGHWAY TRACTS Lot: 19 Project Description: Fire damage, Panel set for Construction. 9/30/2019: REPRINT permit to add(1)200 amp service,(20)branch circuits and(1)data telecommunications system. Contractor: CLACKAMAS ELECTRIC INC. Owner: HARRIS, MCMONAGLE ASSOC INC PO BOX 51 12555 SW HALL BLVD BEAVERCREEK, OR 97004 TIGARD, OR 97223 PHONE: 503-969-5684 PHONE: FAX: 503-632-2421 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 05/07/2019 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 05/07/2019 $12.08 Type of Use: COM Electrical Class of Work: ALT 1 ea Limited Energy 09/30/2019 $75.00 Type of Const: 1 ea Services or Feeders-200 09/30/2019 $100.70 amps or less Occupancy Grp: 20 crt Branch Circuits w/Purchase 09/30/2019 $148.40 Service or Feeder 0 ea 12%State Surcharge- 09/30/2019 $38.90 Electrical Total $475.78 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 may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: Zzi _ Permittee Signature: �'✓✓ '`,7"/'c_-/"C.'':.7-27.7 Z' 1 ��� 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. w Electrical Permit Application FOR Orel( 1. I. OMEN RECEIVE 1 'eceived' ., City of Tigard DateBy: c?��.7. ,'r",.. -,- # "- ©/e._oo 3O IN -a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie Phone: 503.718.2439 Fax: 503.598.1960 SEP 2 7 2019 Related Permit#: Date/By; I I CARD Inspection Line: 503.639.4175 Ready Date/By: Iuris: H See Page 2 for Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information 'n.: UILDi NG DI`lISIO . .;STYPE OF wU PLAN REVIEW ❑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 ❑Other: where the available fault current ❑Marinas and boatyards. CATFGORY OF CONSTRUCTION: exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-familydwellingCormnercial/industriailess to ground,or exceeds 14,000 ❑Commercial-use agriculhual ❑ 0 Accessory building amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or i:3Q8.SITE INFORMATION'AND LOCATION x_ . ❑Emergency system. larger separately derived ❑Addition of new motor load of system Job#: 2,0 1'l4 I Job site address:1 2. - ) ilettA i v 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: —r-1-6-•\ yy�^vv�� ( .a ❑Six or more residential units. occupancy. C_1 e ~1Recreational vehicle arks. 0Health-carefacdities. ❑ P Suite/bldg./apt.#: (- I Project name: li t uln V v i L� Ii,— ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: yV FEE SCHEDULE Description. i Qty. 1 Each I rota! 1 " New residential single-or multi-family dwelling unit. Subdivision: 1 Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 ' 'DESC1IIPTION OF WORK ' Limited energy,residential 75.00 2 { 40 , (with above sq ft.) "' °� Limited energy multi-family 75.00 2 E Lc- 2,01 0o 3c) -w�,? a.. ,f ,1, fie, residential(with above sq.ft.) 4 r C 0','TENANT Renewable Energy 0 See Page 2 0 PROPERTY O 4'NER' Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 1 100.70 /00: 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:( ) i 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 ❑-APPLICA;NT 1 Q CONTACT PERSON Branch circuits—neve,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7 42 lyet1 2 e 20 ach branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) I Fax: :( ) Each manufactured or modular dwelling,service and/or feeder Email: 67.84 2 Reconnect only 67.84 2 CONTRACTOR. Pump or irrigation circle 67.84 2 Business name: tACte,i4st_vro s E�J c 1....„..,,,, y Sign or outline lighting 67.84 2 I C, ..1 o..-.g rB Signal circuit(s)or limited-energy Address:, 1) "2, -�,( C ( panel,alteration,or extension. "See Page 2 -7 2 " Each additional inspection over allowable in any of the above Ci /State/ZIP: - i';:z. 611( )LF Additional inspection(1 hr min) 66.25/hr Phone:(1>3) 2. , I Fax:( (,3 2- , ")—`-'2, Investigation(1 hr min) 90.00/hr Email: { P"0 Industrial plant(1 hr min) 78.18/hr �*� Inspections for which no fee is CCB Lie.: 10 I `'1'�" Electrical.Lic. ' Suprv.Lic.: specifically listed(%1 hr min) 90.00/hr —1 �- p �ief�... ELECTRICALE PERMIT FEES Suprv.Electrician signature,required: eV' . � vvv Subtotal: 32-1. 10 „ ik Print name: ;''� , V k Date: e , 0 Plan Review Required /°25 of permit fee): e State surcharge(12%of permit fee): , # , a ' 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. 3/ �3 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-46151(11/05/COM/WEB W.J Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIALWORK©NL r vn , : EE SCHEDIiC — Description Fee for all residential systems combined: $75.00 I Q�. Each Total Y,, y 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: F. Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 C 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: n Other: Each additional inspection is 66.25/hr i charged at an hourly(1 hr min) Inspections for which no fee is specifically listed('4 hr min) 90.00/hr COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 allowed Number of inspections per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: E Audio and Stereo Systems ❑ Boiler Controls Clock Systems Z.. Data Telecommunication Installation E Fire Alarm Installation 7 HVAC ❑ Instrumentation • Intercom and Paging Systems - Landscape Irrigation Control* E Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: I *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015