Permit CITY OF TIGARD ELECTRICAL PERMIT
' Permit#: ELC2020-00409
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/18/2020
Parcel: 2S 101 DB00620
Jurisdiction: Tigard
Site address: 7530 SW VARNS ST
Project: Strauss Subdivision: ROLLING HILLS Lot: 22
Project Description: Replace(1)200 amp or less panel.
Contractor: OWNER Owner: STRAUSS, IAN I & MINDY L
7530 SW VARNS ST
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 08/18/2020 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 08/18/2020 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 0 -952-001- . You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19877„or 1.800.332,2344.
Issued By: r. ci . ''i hL{-/ C ._. - Permittee Signature: /✓ r '/ r/`1L-! C.'./ --/-7Q/v/
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 FOR OFFIch: usi oNI.Y
CityofTigard RECEIVE Iveceived u C
g Date/By: ° IZ/`7iC' �,/Permit#:&Le.-ZEl'�(`•—(may { f
'a 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
C Phone: 503.718.2439 Fax: 503.598.1960 J U L 3 0 2020 Date/By: Related Permit#:
T l c A R n Inspection Line: 503.639.4175 " Ready Date/By: Inds: 91 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified Method: Supplemental Info rmanon
TYPE OF WOR UILDING DIVISION
PLAN REVIEW
❑New construction Q Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked)
❑Demolition 0 Other: ❑Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
i ❑Addition of new motor load of system.
Job#: Job site address: /'5j S i G � iLL,'1is G�f. I00HP or more.
^ ❑"A","E","I.2","I-3",
City/State/ZIP: 1 f JtA/C/ 0 R 7 722 3 ❑Six or more residential units. occupancy.
❑Health-care facilities, ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 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: (4 NAG:: 0 tt , (e f ICr 0. �d rµ- FEE SCHEDULE
ati� 6 Description I I Qty. i Each I Total
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'I 500 sq.ft or portion 33,92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
Y` PliZG4j eice I r a
I�bba e' Limitedgy,multi-family
'
75.00 2
residential(with above sq.ft)
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: J_.Lfh 5 fre.,ass 200amps or less 0 100.70 ( 2
Address: 753o Sc.?) (II.yt,tq Si- 201 amps to400amps 133.56 2
401 amps to 600 amps 200.34
City/State/ZIP: `1`t 4v OR. q 72 2 32
fJ �� 601 amps to 1,000 amps 301 04 2
Phone:(5o 3 )61G-/(I' ' Fax:( ) Over 1,000 amps or volts 552.26 2
Email: 6LSs )J Temporary services or feeders installation,alteration,and/or
a t Lt S iTa 1. t.bur^t1.G prat relocation
Owner installation:This instaation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,le� �seltt la el change,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125 08 2
Owner signature:LAk. ( Date: 7-2`1-20 401 amps to 599 amps 168.54 2
CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
Et APPLICANT {
A.Fee for branch circuits with
Business name: above service or feeder fee, 7.42 2
--r-,2[ each branch circuit
-1-
Contact name: 5-,-L£L, S B.Fee for branch circuits without
service or feeder fee,first
Address: 7 )47 / 1/ branch circuit 56.18 2
City/State/ZIP: 7-,5 / 0 R I? 7;22 5 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(50 3 ) 6/6-fii g/ Fax: :( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: ictyc'lg''}y-ci,,tgge L44.-cz.vl, GP1.�1 Reconnect only 67.84 2
'
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: panel.alteration_or extension. 0 See Page 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:( ) Fa(—)--- Investigation(I hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is I
specifically listed CG hr min) 90.00/hr
CCB Lic.: Electrical Lie.: Supn`.Lie.: s P2
ELECTRICAL PERMIT FEES 1
Suprv.Electrician signature,required: Subtotal: IC17,70
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): ( ,d if
Authorized signature: TOTAL PERMIT FEE: j(2 .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.
I:IBuilding\Permns'ELC PrrmitApp ELR ERE.doc Rev 06/17/2015 440-0615T(I t/05/COM/WEB