The URL can be used to link to this page

Permit .,tltlir}:e R'lldklt}fiS 1iU711Y�tili{M11tHifNli4ff>1iLiiHifJY}f1H4ifblHNucuuuutKi3ifHF Ni ,n<.ralr 'i.iu.IRtk rlttrl tlRlif ) ! '}FiiRs.tts ut4ili.i Aaltus{t .Its+i t.0 rifr "e rAr.rr iarir... 1111 CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2021-00445 Date Issued: 9/2/2021 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CA00905 Jurisdiction: Tigard Site address: 13350 SW ASH AVE Project: Charbonneau Subdivision: VILLAGE GLENN Lot: 5 Project Description: (1)branch circuit. Contractor: OWNER Owner: CHARBONNEAU, CLAYTON& KACIA 13350 SW ASH AVE TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 09/01/2021 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 09/01/2021 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 throuoh OAR 952-001-0090. You may obtain a coov of the rules or direct Questions to OUNC by callina 503.232.1987 or 1.800.332.2344. Issued By: Holly VtMti f7. e4Vege Permittee Signature: Ovt'AppU.cat't on 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'N 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. .- $l1 Electrical Permit Applicatig1 E h E w , t 1,, t 1, , , , , ., t 1•, , CityofTigard 1 IC V Date/By:Received Z j ©©y99s g Receiv r� .z i e Perm;t a: G C 2 :IN _- I3 713125 SW Hall Blvd.,Tigard,OR 97223 [ 2021 Plan Review g Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Related Permit#: Inspection Line: 503.639.4175 OF Ready Date/By: y,/� I 1 la See Page 2 for 1 i 1' Internet: www.tigard-or.gov �� TIGARD Notified/Method: J r Sappkmestal information 6 t i C.07 iZ.r.d TYPE OF W PLAN REVIEW ❑New construction %Addition/alteration/replacement Please check all that apply(submit 1 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 ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 votes or ❑Floating buildings. a1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: i Job site address: ��?l - it A // ❑Addition 0H of new motor load of ..1...2 ---/,''.. r 1 l/�C.:r 100HP or more. ❑"A" "E" "I-2" "1-3>, City/State/ZIP: 7)j,7a(C.(, 0 f Cj 42 ❑Six or more residential units. occupancy. J" / 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: ,V 4 i Project name: 0 Hazardous locations. 0 Supply voltage for more than / / 0 service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: f Oksy if �/. ir? cse iof1 FEE SCHEDULE f j� 1 /' L� A,.. �" Description Qey. Each Total I�` 1,��1 `/P ,. T Ll Crew 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'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential _ t. (with above sq.ft.) 75.00 2 ,3Q M 1 ( i(� lL(/-( / /U/i -T' l)`l i f t',O N.( - ). 01,,,(I,' Limited energy,multi-family 75.00 2 Lai r.. ,, residential(with above sq.ft.) A PROPERTY OWNER ❑ 1rENANPIt Services or Energy El See Page 2 or feeders installation alteration,and/or relocation Name: ak k► ar j1't-,(i( 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: ��r 4 ^� 4 L • 401 amps to 600 amps 200.34 2 City/State/ZIP: f CU(L (? ��+ C 7 3 601 amps to 1,000 amps 301.04 2 Phone:(50 3)`-- II.,i/ -o�4 t I Fax:( ) Over 1,000 amps or volts 552.26 2 ` / Temporary services or feeders Installation,alteration,and/or Email: hj I/l✓ ia/Y, chid-'t 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 exe__nange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: 4'' c"z'" Date: (,,. / 401 amps to 599 amps 168.54 2 PPLICANT I 0 CONTACT EIfSON 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: B.Fee for branch circuits without service or feeder fee,first I 56.18 J‘ 2 Address: branch circuit 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 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 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:( ) 1 Fax:( ) Investigation(1 hr min) 90.00/lu Email: Industrial plant(1 hr min) 78.18/ter Inspections for which no fee is 90.00/hr CCB Lic.: I Electrical Lic.:29 i Suprv.Lic.: specifically listed(Y2 hr min) ` ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Clyl)i G & a t Date: / 1 0 Plan Review Required(25%of permit fee): j State surcharge(12%of permit fee): 6,7 TOTAL PERMIT FEE: ? -1 Authorized signature: b (Ill t This permit application expires if a permit is not obtained within NO Print name: ,41vi l ll ariMi4'dtt Date: S/" , � days after it has been accepted as complete_ �/r' r I * Number of inspections allowed per permit. 1:\BuildinipPermit,WFLC'_PermitApp FLR_F.RE.doc Rev06/17,2015 444-4615T(11/05/COM/WEB Property Owner Statement RECEIVED Regarding Construction Responsibilities 1 1 7 E Oregon Law requires residential construction permit applicants who are not licensed with t tY OF TIGAt Construction Contractors Board to sign the following statement before a building permit c e issued. (ORS 701.325 (2)) 3UILDING DIVISION' This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. t.0/1 (Aarh,, ti t. Print Name of Permit Applicant Signature Of Permit Applicant Date Permit#: Et-G 10 Zi '6.)O11`/S Address: _ �►.__`�„�,,,��,;�=.;� Issued by: \) __ Date: clV2 2-, 6 This Copy for Permit Offices Dianna Ornelas From: #Building Permit Technicians Sent: Wednesday, August 11, 2021 8:28 AM To: Clayton Charbonneau Subject: ELC2021-00445 - 13350 SW Ash Ave - Charbonneau Attachments: ELC2021-00445.pdf Hello Clayton, This permit is ready to issue and the balance due is$62.92 (see attached invoice). The fees can be paid online at https://aca-prod.acceia.com/TIGARD/Welcome.aspx by searching for the permit record number ELC2021-00445 under the Building tab. Payment can be made by'card'for a 3%service fee or select the 'check' payment option and there is no service fee. Please email the permit technicians at TigardBuildingPermits@tgard-or.gov once the fees are paid so that we can issue the permit and email a copy. Thank you. Dianna L. Ornelas Building Division Services Supervisor City of Tigard I Community Development 13125 SW Hall Blvd I Tigard, OR 97223 503-718-2430 Direct 1503-718-2439 Permits 1