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Permit CITY OF TIGARD ELECTRICAL PERMIT _ COMMUNITY DEVELOPMENT ELECTRICAL ELC2021-00224 Date Issued: 5/3/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S112BB10500 Jurisdiction: Tigard Site address: 14330 SW FANNO CREEK LOOP Project: Eggers Subdivision: COLONY CREEK ESTATES NO.3 Lot: 87 Project Description: Run electrical from main panel to AC emergency shut off Contractor: OWNER Owner: EGGERS, MATTHEW 14330 SW FANNO CREEK LOOP TIGARD, OR 97224 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 05/03/2021 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 05/03/2021 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total S62.92 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 1.800.3322344. Issued By: gaily VLLvuDe,Wage Permittee Signature: (0 in.ArrlJcai;n-vt 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 503.639.9175 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 ApplicatiECEIVEDinimumisiiriiii.3-- CityReceived Permit#: • 13125 SW ofTigard MI ail Blvd.,Tigard,OR 97223 APR 2 9 1011 Date/By:Plan Review L�ZoZA-OU"L2 Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#: Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date/By: !J'•1512,� „yi ru ® See Page 2 for TtGARD Internet: www.tigard-or.gov DUILDINO DIVISION Notified/Method: y 1I (l' Supplemental Information TYPE OF WORK PLAN REVIEW 0 New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition 0 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 0 Commerciallindustrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑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:l_T&3 0 Fang Creel( Gooc ❑100I Addition of new motor load of system. } 100HP or more. ❑"A" "`1?'"1-2" "1-3" City/State/ZIP: � (`(/ ©j.. q 72.2.it 0 Six or more residential units. occupancy. i f ❑Healthcare facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than ` r(v ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: F,006 GC2e1� YW?I re,y Noe_ FEE SCHEDULE •\60,Se, . &CUV'c8 (,�)1,de b aC, l Description , 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#: Fa.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK �\ Limited energy,residential 1-0V)11 eletti'c l eralq M41f\ .PJ�nCI ICJ (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 h(" , e fltie f cAo/YJ S $- residential(with above sq.ft.) [PROPERTY OWNER I ❑ TENANT Renewable Energy 0 See Page 2 ',` IJ( Services or feeders installation,alteration,and/or relocation Name: M 2/ e W efs 200 amps or less 100.70 2 Address: l slu - 11 t o `-i ee K 1,..00 201 amps to 400 amps 133.56 2 City/State/ZIP: f, 'd! O. 9 1 u(.i 401 amps to 1 0 amps200.34 2 3 ` 601 ampsto 1,000 amps 301.04 2 Phone:(q t) Fax:( ) Over 1,000 amps or volts 552.26 2 Pi Q � � i' Temporary services or feeders installation,alteration,and/or Email: `M 1 ter al' I CZ I. 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,leas ent, e,according to ORS 447,449,670,ay 70 . 201 amps to 400 amps 125.08 2 Owner signature: Date: Cr-rag 401 amps to 599 amps 168.54 2 0 APPLICANT ❑ CONTACT 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 h 7.42 2 Contact name: B.Fee for branch circuits without 1 Address: service or feeder fee,first krS 56.18 2 branch circuit {% City/State/ZIP: Each add'l 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: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0See Page 2 2 Address: g panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 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 Lic.: Suprv.Lie.: specifically listed('a hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: �02 q 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:\BuildinglPernun\ELC_PermitApp_ELR_ERE.doe key 06/17/2015 440-4615T(I 1/05/COMIWEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE • Fee for all residential systems combined: S75.00 Description I a I e.ea I Tool 1 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: ❑ Burglar Alarm 25.01 to 50 kva 301.04 2 a 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 Er 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(i hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotale permnter t.o Page 1): Y + 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 ❑ 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 t,/nuitdingTermits'ELC PermitApp_ELR ERE,doc Rev 06/17/2015