Permit CITY OF TIGARD ELECTRICAL PERMIT
S .. COMMUNITY DEVELOPMENT Permit#: ELC2022-00597
TIGAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 9/7/2022
Parcel: 2S102CD00300
Jurisdiction: Tigard
Site address: 9620 SW FREWING ST
Project: DUPERRIER Subdivision: FREWING'S ORCHARD TRACTS Lot: 25
Project Description: Reconnect only,
Contractor: Owner: DUPERRIER, JUNIOR
9727 SW QUAIL POST RD
PORTLAND, OR 97219
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 1 ea Reconnect Only 09/07/2022 $67.84
1 ea 12% State Surcharge- 09/07/2022 $8.14
Type of Use: SF Electrical
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75,98
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 =ll other af:'cable 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, . if wo is suspended for more the
180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Tho.e rules are set forth in OAR
952-001-0010 throuah OAR 952-001-0090. You may obt a coov 0 rules or direct Questions to OUNC by callino 503.232.1987 or 1.8i,,.•32.2344.
i
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 OFrlcl. I .SI ONI.I
City of Tigard R ECEIV,:; ; '
13125 S W Hall Blvd.,Tigard,OR 97223 l� ����
• // t1
C Phone: 503.718.2439 SEP ry 202 t Flan Review
i� C Date/B : Related Permit#:
T I G A R D Email: TigardBuildingPetmits@Tigard-or.gov ReadyDate
Inspection Line: 503.639.4175 Internet: ww C4i t64J MilSee Page 2 for
wA d G'A'� oGfied/Method: Supplemental Information
TYPE OF WORK BUiLDINUVI iSiON PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
ElSery Service or feeder 400 amps or more CI overthree stories.
❑Demolition 0 Other:
CATEGORY OF CONSTRUCTION where the available fault current El Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground or exceeds 14,000 0 Commercial-use agricultural
El Multi-familyamps for all other installations. buildings.
❑Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ,.,,; ❑Emergency system. larger separately derived
Job#: I Job Site address: ❑Addition of new motor load of system.
lv,.-i., ., c(c..- 34- T on..1 C 1-� L 100HP o more.
City/State/ZIP: , ��ryry pp ❑occupancy.
1 a r t' V K. 5...---
0 Six or more residential units. occupancy.
J I `� ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description I Qy. I Each I Total I
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add sq.ft.es or portion 33.92 1
` Limited energy,residential
l�yU (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
lia PROPERTY OWNER I 0 TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: J `uLirtylzIL-y.- 200 amps or less 100.70 2
Address: ,1:1 S,,,/ (.1✓a•I ru ac f 201 amps to 400 amps 133.56 2
City/State/ZIP: Fo rkl„i Q(� ,-? ..J`t 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone: (61 ' ) "jl 5-so - 3444 1l4I Over I,000 amps orvolts 552.26 2
Email: 1� d u p Z( t ti t •L Temporary services or feeders installation,alteration,and/or
This
°n' relocation
Owner insta ation: is 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 1 125.08 2
Owner signature: Date: 401 amps to 599 amps 1 168.54 2
0 APPLICANT 1 0 CONTACT PERSON Branch circuits—new,alteration,or extension, ,er panel
Business name: 4s..0 G:s. a 6in� A.Fee for branch circuits with
above service or feeder fee,
Contact name: each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first S6.]8
branch circuit 2
City/State/ZIP: Each add'I branch circuit 7.42 2
Phone:( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only r 67.84 2
CONTRACTOR Pump or irrigation circle t 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy
panel,alteration,or extension. ❑ See Page 2 2
City/StatelZIP: Each additional inspection over allowable in any of the above
Phone:( )
Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr rain) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: I Electrical Lie.: I Suprv.Lie.: specifically listed('/c hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
k------ Subtotal:
Print name: I Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
Print name: This permit application expires if a permit is not obtained within 180
c� V V P�L2 tuk I Date: C C -tLCOB
Lu L., I days after it has been accepted as complete.
LABoildiassPecmita\ELerermi[App_E11t_EttE.aoc RRev10/26rz 44
017 * Number of inspections allowed per permit.
0-0fi15TO1
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL �v �7� FEE SCHEDULE
WORK ONLY: Description Qty. I Each Total *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved: 5.01 to 1 s 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 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
>100 kva-no additional charge 0.0 3
n V• acuum Systems*
Each additional Inspection over allowable in any of the above:
Each additional inspection is 66.25/hr 1
ri O• ther: charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr min)
ELECTRICAL PERMIT FEES
COMMERCIAL WORK ONLY: Subtotal(Enter on Page I):
Fee for each commercial system: $75•00 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
I:\Building\Permits•EI.C_PumitApp_ELR_ERE.doc Rev 10/26/2017