Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2020-00637
T IGARL} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/18/2020
Parcel: 2S112BA03800
Jurisdiction: Tigard
Site address: 14115 SW 80TH CT
Project: 20R297 Subdivision: WAVERLY MEADOWS Lot: 17
Project Description: (8)branch circuits for kitchen remodel.
Contractor: OWNER Owner: FASTENOW,AARON M
14115 SW 80TH CT
TIGARD, OR 97224
PHONE:
PHONE:
FAX:
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo/Purchase 12/17/2020 $108.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/17/2020 $12.97
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $121.09
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 9,52-001-0090. 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: l ' / 7i' { C[ l— Permittee Signature: e `1/ r Ge% r✓ " (I Vr
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.
e-/2/n 2.0
Electrical Permit Application CC FOR OFFICE USE ONLY
City of Tigard RECEIVED Daatte/By:/z1/7/20 .Q £LGZp70 '"OD co 3 7
Permit k
ed
13125 S W Hall Blvd.,Tigard,OR 97223 Plan Review
• Phone: 503.718.2439 Fax: 503.598.19tts1+EC 1 1 202U y: Related Permit 4:
Date/B
Inspection Line: 503.639.4175 Ready Date/By: , ��qq luris: ® See Page 2 for
TIGARD Internet: www.tigard-or.gov • TIGAU i Notified/Method:lZll7/ `1 1TET Supplemental Information
)
TYPE OF t L w1 PLAI REVIEW
❑ ® :li 1a1NG DIVISION 4 /9-4- I "
New construction Addition/alters ion rep replacement Please check all that apply(submit 2 sets of plans w,tems checked):
0 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 ❑Floating buildings.
1-anddwellingCommercial/industrialless to ground,or exceeds 14,000 ❑Commercial-use agricultural
® 2-family ❑ D Accessory building
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder ❑Other: El 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#: Job site address:14115 SW 80th Court 1001-IP or more. ❑"A","E","I-2","I-3",
City/State/ZIP:Tigard OR 97224 ❑Six or more residential units. occupancy.
Recreational vehicle parks.
0 Health-care facilities.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site:SW Fanno Creek Dr is closest cross street FEE SCHEDULE
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'I 500 sq.ft.or portion 33.92
' DESCRIPTION OF WORK i Limited energy,residential
(with above sq.ft.) 75.00 2
Kitchen remodel - 3 new circuits, replaced alum. wiring for range Limited energy,multi-family
with 8-3 copper, 4 additional circuits altered/updated
residential(with above sq.ft.) 75.00 2
is PROPERTY OWNER W. 0 TFN*NLINIIMII
Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Aaron Fastenow 200 amps or less 100.70 2
Address:same as job site above 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:(503) 881-1775 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:aaron.fastenow@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,rent,or exchan e,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: //QJL9IL P jL9G) Date: 12/11/2020 401 amps to 599 amps 168.54 2
it
0 APPLICANT El CONTACT PERSON Branch circuits-new,alteration,or extension, l er 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
branch circuit 1 56.18 56.18 2
City/State/ZIP: Each add'I branch circuit 7 7.42 51.94 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
CA dwelling,service and/or feeder
Email:
•east-e now i t`i t-pg lr p. t re\ Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: %y LL7 �2—_ Sign or outline lighting 67.84 2
V Signal circuit(s)or limited-energy El See Page 2 2
Address: panel,alteration,or extension. g
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr
Email: Industrial plant(I hr min) 78.18/hr
•
Inspections for which no fee is 90.00/hr •
CCB Lic.: Electrical Lie.: Suprv.Lie.: specifically listed(%hr min)
ELECTRICAL PERMIT :-
MOM
Suprv.Electrician signature,required: Subtotal: 108.12
Print name: Date: 0 Plan Review Required(25%of permit fee): 0.00
�1 State surcharge(12%of permit fee): 12.97 /
Authorized signature: �l di2.9Hi Pa Z9GU TOTAL PERMIT FEE: 121.09 1 "
This permit application expires if a permit is not obtained within 180
Print name: Aaron Fastenow Date:12/11/2020 days after it has been accepted as complete.
Number of inspections allowed per permit.
t:\Boilding1PermitskELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COMIWEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description
Fee for all residential systems combined: $75.00 Qa• each I Total)' 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:
n Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
s ecifiicall listed 'h hr min
COMMERCIAL WORK ONLY: na Subtotal
Page
1):
Fee for each commercial system: $75.00 lowed (Enter t.o Page 1):
�' • Number of inspections 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
n H• VAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ L• andscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n O• utdoor Landscape Lighting*
n P• rotective Signaling
n O• ther:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
Mauilding\PermitstELC_PermitApp_ELR ERE.doc Rev 06/17/2015