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Permit
CITY OF TIGARD ELECTRICAL PERMIT i _ COMMUNITY DEVELOPMENT \ Permit#: ELC2020-00452 / Date Issued: 9/11/2020 T I t;A R.0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.24 c ;!J parcel: 1 S136AD00501 I or 'may/] Jurisdiction: Tigard Site address: 10465 SW 66TH AVE Project: Monto Subdivision: VILLA RIDGE NO.2 Lot: 5 Project Description: Upgrade electrical panel to 200 amp panel. 12/01/20-Contractor added.em Contractor: P DICKINSON ELECTRIC Owner: MONTO, ANDREA KAILYN 20719 SW LIDO CT. 10465 SW 66TH AVE ALOHA, OR 97078 TIGARD, OR 97223 PHONE: PHONE: 503-740-6100 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 09/11/2020 $100.70 Specifics: amps or less 4 crt Branch Circuits w/Purchase 09/11/2020 $29.68 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 09/11/2020 $15.65 Electrical Type of Const: 45 Misc Administration Fee 12/01/2020 $45.00 Occupancy Grp: Total $191.03 Required Items and Reports(Conditions) This permit is issued subject to the regulation 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 plan is 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 require- .0 to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-00•6 -.0 -y obt.i a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. A Issued By: _ /� �� Permittee Signature: L OWNER INSTALLATION ONLY The installation is being ma - 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. CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT Permit#: ELC2020-00452 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 ,r Date Issued: 9/1 t/2020 TIGARD 9 s `t I �` Parcel: 1S136AD00501 Jurisdiction: Tigard Site address: 10465 SW 66TH AVE Project: Monto Subdivision: VILLA RIDGE NO.2 Lot: 5 Project Description: Upgrade electrical panel to 200 amp panel. Contractor: P DICKINSON ELECTRIC Owner: MONTO,ANDREA KAILYN 20719 SW LIDO CT. 10465 SW 66TH AVE ALOHA, OR 97078 TIGARD, OR 97223 PHONE: PHONE: 503-740-6100 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 09/11/2020 $100.70 Specifics: amps or less 4 crt Branch Circuits w/Purchase 09/11/2020 $29.68 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 09/11/2020 $15.65 Electrical Type of Const: 45 Misc Administration Fee 12/01/2020 $45.00 Occupancy Grp: Total $191.03 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. 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 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 Y. a obtai : copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: /A Permittee Signature: 6t/ I OWNER INSTALLATION ONLY The installation is being made o• 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. • 3, Electrical Permit Application , ,,,t,,, , ,f, I �, „" , City of Tigard Received Datelg Permit#: 13125 SW Hall Blvd.,Tigard,OR 97223 ��+at A pia a Review Phone: 503.718.2439 Fax: 503.598.1960 �A 1111111 ti9�a Date/By: Related Pem»t N: Inspection Line: 503.639.4175 Ty, Ready Date/By: funs: I 0 See Page 2 for T Ix;\li ll Internet: wuw.ligard-or.gov O� /J' t;olit)ed/Method. Supplemental Information ITYPE OF WORK PLAN REVIEW ll0New construction .X Addition/alteration/replacement Please check all that apply(submit 2 sets of plans iv/items checked): ❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories. i where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings. I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. i El Multi-family0 Master builder El Other: ID Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived f�l16SS�t1 r�1(1 a ,� ❑Addition of new motor load of system. Job#: Job site address: �-!!v b L- I1 tJ , 100HP or more. ❑"A","f", '1-2", I-3 �` occupancy. Suite/ ldgl pt I t Ar 0 (]� 9 7;a 3 ❑Six or more residential units. J / ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: /u onto 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:-c' FEE SCHEDULE umrip0°n ] <6. J Each I rem ( • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.it.or less 168.54 4 Ea.add'I 500 sq.R.or portion 33.92 I ` A DESCRIPTION OF.WORK Limited energy,residential 7500 2 ,Yv1S it'NS a001 A-AAp Se`CS/1G�jakre /S' `44¢6 10 ,BY' (with sq. lti g Ozt u 3 C Limited energy,multi-family 75.00 2 QQr a ELC a 0 ,— OO 7 Se. residential(with above sq.R.) 0 PROPERTY OWNER I 0 TENANT Services Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 I 2 Address: 201 amps to 400 angx 133.56 2 City/StatelZlP: - 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 i Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 1 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on properly that I own which is not 200 amps or less 59.36 1 I intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 Owner signature: Date: 401 amps to 599 amps 168.54 /22 Q APPLICANT ❑ CONTACT.PERSON Branch circuits-new,alteration,or eatenskn,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 service or feeder tee,Grst Address: branch circuit 06.IA 2 City/State/ZIP: Each add'I branch circuit 7.42 2 -- -- ----- Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) 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: P DICtSINSON Ele(+via q.,l,a Sign or outline lighting 67.84 2 Address:A071• - Signal circuit(s)or limited-energy 0 Sec Page 2 1 '- S 14 `rdo $1, 74Eif alteration.panel,alteration.or extension. City/State/ZIP: a f41n k / O R / to 7 o70 Each additional don over allowable in any ut the above / Additional inspection ion(1(I hr min) 66.251 hr Phone:(So3) 75'0-_ROO Fax:( ) Investigation(1 hr min) 90.00ihr Email: Ic`ec©aic!5. 01^se.kc4 'c-aCOWS Inspectiosforwichal plant(1 hr no) 78.167hr p Inspections for which no fee is 90.00/hr CCB Lic.:d o9947 I Electrical Li�e..,:C/1� 1 0 Suprv.Lie.:60 ay 5 specifically listed('!hr min) Suprv.Electrician signature,required: !a'� ✓. ELECTRICAL PERMIT FEES / Subiotal�. Print name: PP�-e x(•' 1;('S t H Sc 0 Date: I l/70/(3,09.a ❑Plan Review Required(25%of permit fee)•. Y State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within In Print name: I Date: I days alter it has been accepted as complete. * Number of inspections allowed per permit. LIBs IdinglPermirslELC PcrmitApp_ELR ERE.dec Rev 06/17/2015 440-46151(I1105/COMRI'E0 r F9 F1O F17 F12 PrtScr Insert Delete Pip to PgDn Home Erd ..7 P tine CITY OF TIGARD ELECTRICAL PERMIT S. N`° � COMMUNITY DEVELOPMENT Permit#: ELC2020-00452 Date Issued: 9/11/2020 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S 136AD00501 Jurisdiction: Tigard Site address: 10465 SW 66TH AVE Project: Monto Subdivision: VILLA RIDGE NO.2 Lot: 5 Project Description: Upgrade electrical panel to 200 amp panel. Contractor: OWNER Owner: MONTO,ANDREA KAILYN 10465 SW 66TH AVE TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 09/11/2020 $100.70 Specifics: amps or less 4 cr1 Branch Circuits w/Purchase 09/11/2020 $29.68 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 09/11/2020 $15.65 Electrical Type of Const: Occupancy Grp: Total $146.03 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 0 952-001-00 ..1 You" may obtain a copy of the rules or direct questions to OUNC by calling 5003.232.1987�oor 1.800.332.2344. a / Issued By: ) 14 v-1��2_. �,v—�� Permittee Signature: (%.� 4T141/ 3 G`7 // 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 RECEIVE I FOR OFFICL. I sic()NIA Received permit# - City of Tigard AUG 31 2020 Date/B : R I Ze Q 0 Et-C 0' 0--0/ i15 2- 1114 • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By. q Reis: 10 See Page 2 for TIGARD r'7 1 ,1 fl \! ' r�n/I C I rI ')Notified/Method:! 1 1 77O Supplemental information Internet: www.tigard-or.gov PP TYPE OF WORK E'14-f ice— 0' egt,67l 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 0 Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ® I-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND..LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: I Job site address:10465 Sw 66th ave 100HP or more. ❑"A","E',"1-2","1.3", ❑Six or more residential units. occupancy. City/State/ZIP:Tigard, OR 97223 ❑Heal h-ca a facilities ❑Recreational vehicle parks. Suite/bld /a t.#: I Project name:Monto-owner upgrade 0 Hazardous locations. 0 Supply voltage for more than 600 volts nominal. g P j p9 ❑Service or feeder 600 amps or more. Cross street/directions to job site: Closest cross street SW Oak and 66th FEE SCHEDULE Description I Qtr. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision:North TigardI Lot#:R278853 Includes attached garage. 1.000 sq ft.or less 168.54 4 Tax map/parcel#:1 S 136AD-00501 Ea.add'1 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Upgrade electrical service to 200 amp panel, add 1 120 v 20 amp,11 (4 40 v 30 amp 4 Limited energy,multi-family -- 1, I ebrid' 4 L' i 'c'tt T ( tL �fjif residential(with above sq.ft.) 75.00 2 r Renewable Energy ❑ See Page 2 ® PROPERTY OWNER 1 ❑ TENANT 9/tl/.7.0 Services or feeders installation,alteration,and/or relocation Name:Andrea Monto `atc0, 200 amps or less 1 100.70 1 2 201 amps to 400 amps 133.56 2 Address:10465 SW 66th Ave 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard, OR 97223 601 amps to 1,000 amps 301.04 2 Phone:(503)519-8596 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:andrea.k.nnonto@gmail.com 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, /,1 sJe,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: .fl'IltI�� E+0. Date: 8/31/20 401 amps to 599 amps 168.54 2 ® APPLICANT I ® CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name:Andrea Monto B.Fee for branch circuits without service or feeder fee,first Address: 56.18 2 10465 sw 66th ave branch circuit City/State/ZIP:Tigard, OR 97223 Each add']branch circuit 7.42 2 Miscellaneous(service or feede not included) Phone:(503) 519-8596 I Fax::( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:andrea.k.monto@gmail.eom Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Not applicable 0141 AJ ev .-� Sign or outline lighting 67.84 2 a- Signal circuit(s)or limited-energy 0 See Page 2 2 Address: panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) I Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: I Electrical Lic.: I Suprv.Lic.: specifically listed(Vs hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal ]49c40— 6 Print name: Date: 0 Plan Review Required(25%of permit fee): 130 f 3 0 State surcharge(12%of permit fee). (S.toy Authorized signature: TOTAL PERMIT FEE: I Li(P t b•j This permit application expires if a permit is not obtained within 180 Print name:Andrea Monto Date:8/31/20 days after it has been accepted as complete. • Number of inspections allowed per permit. 1 Bolding\Permits$ELC_PermitApp_ELR ERE.doe Rev 06/17/2015 440-4615T(I 1105/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 Fee for all residential systems combined: $75.00 Description Q°` rash Total y Renewable electrical energy systems: Check Type of Work Involved: s 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: E Burglar Alarm 25.01 to50 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 charged at an hourly(I hr min) 66.25/hr 1 Inspections for which no fee is 90.00/hr specifically listed(Yz hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1). Fee for each commercial system: $75.00 Number of inspe Lions allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1 AnuildingtPermits\ELCPermitApp_ELRERE.doc Rev 06/17/2015