Permit CITY OF TIGARD ELECTRICAL PERMIT
• COMMUNITY DEVELOPMENT ee Permit#: ELC2022-00238
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 4/13/2022
Parcel: 1 S 125DD05600
//, J Jurisdiction: Tigard
Site address: 9870 SW VENTURA CT
Project: Dream Maker Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 64
Project Description: kitchen remodel. 4/13/22: REPRINTED permit to include(1)panel replacement.
Contractor: P DICKINSON ELECTRIC Owner: SODERQUIST, DAVID R & PAMELA E
20719 SW LIDO CT. 9870 SW VENTURA CT
ALOHA, OR 97078 TIGARD, OR 97223
PHONE:
PHONE: 503-740-6100
FAX: FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 04/13/2022 $100.70
Specifics: amps or less
5 crt Branch Circuits w/Purchase 04/13/2022 $37.10
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 04/13/2022 $16.54
Type of Const:
Electrical
Occupancy Grp:
Total $154.34
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. se rules ar forth in OAR
952-001-0010 throw R 952-001-0090. +rNa obtain a coov of the rules or direct questions to OUNC by calling 503.232. 0 0.332.2344
Issued By. Permittee Signature:
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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard ReceivedD e/By: y/ii,/ Permit#: G�2}�-Lz.91, gr
• 13125 SW Hall Blvd.,Tigard,OR 97223 ``�ri' PI Review 6
C Phone: 503.718.2439 ��� 9 17 ° °bate/By: Related Permit#:
Email: TigardBuildingPermits@Tigard-or.gov _ ., Ready Date/By: Juris: 0 See Page 2 for
TIGARD Inspection Line: 503.639.4175 Internet: www.tigardorgov ' Notified/Method: Supplemental Information
TYPE OF WORK I 01 1 ,�h',iii) PLAN REVIEW
D 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 ❑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] 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
less to ground,or exceeds 14,000 El Commercial-use agricultural
0 Multi-familyMaster builder amps for all other installations. buildings.
0 ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job site address: Li � jJ Ve. �/ ❑100H Addition mf ore.motor load of system.
'-✓ I OOHP or more. ❑`A" "F" "1-2" "1-4"
City/State/ZIP: ❑Six or more residential units. occupancy.
1��i/f�a/�� ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: V Project name: ,SI 70' ❑Hazardous locations. El Supply voltage for more than
A-1/a r+'Cross street/directions to job site: 1/ ElService or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description I Qty. I Each I 'fatal
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
/1 ��2. ,ce. 0 6LCe ��d A- _p (with above sq.ft.) 75.00 2
/'t' T�/t/� Limited energy,multi-family 75.00 2
a1 .C , [ .0 ex \.S- ),L 3 }fie.('µ F,}- residential(with above sq.ft.)
` t� ` t Renewable Energy ❑ See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less ' 100.70 1."2 t) 2
Address: 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:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
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 exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
0 APPLICANT El CONTACT PERSON
Branch circuits—new,alteration,or extension, .er panel
A.Fee for branch circuits with
Business name: ' 1‘Cti4 NSdN 6-1 e c-t''c•c_ A-A) C.- above service or feeder fee, 7.42 2
1,. each branch circuit
Contact name: PZycg- (CKitiSON B.Fee for branch circuits without
servAddress: dl p"7(q 5 Li/ ;d C7 ! t. branh cirrcuteder fee,first 56.18 2
t
City/State/ZIP: AAA a a p A 7o ?9 Each add'1 branch circuit 7.42 2
( Miscellaneous(service or feeder not included)
Phone:6b3 ) 7c0 —6/0 a Each manufactured or modular
D _ dwelling,service and/or feeder 67.84 2
Email: G ® �,(k:il.�c.).;h e(. ck.`r.0 ,CCU.ram_
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 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:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
Inspections for which no fee is 90.00/hr
CCB Lie.: Electrical Lie.: Suprv.Lie.: specifically listed(%hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal:
Print name: Nest n`,Ck;,)Sc)-t-) Date: VI 3/�0, s. ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature:
This permit application expires if a permit is not obtained within 180
Print name: Date: Y/13/ao-4)— days after it has been accepted as complete.
' Number of inspections allowed per permit.
I:\Building\Permits\ELC_PematApp_ELR_ERE.doc Rev 10/26/2017 440-46151(11/05/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
Description I Qty. I Each I Total `
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n 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:
❑ Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
11
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
n Other:
Total number of commercial systems: _
*No licenses are required. Licenses are required for all
other installations
19Banding\Permite1ELe_PermitApp_ELR_ERE.doc Rev 10/26/2017