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Permit
Electrical Permit Application FOR OFFICE USE ONLY City of Tigard Received ... 13125 SW Hall Blvd.,Tigard,OR 97223 Date _ t r sR Phone: 503.718.2439 Fax. 503.598.1960 IESEM Plan Review Rela ed Perm t x: DateB T I CARD Inspection Line: 503.639.4175 Ready Date/By Duds: H See Page 2 for » Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction ©Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wtitems checked): ❑ Demolition ❑Other: ❑Service or feeder 400 amps or more 0 Building over three stories. 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 X❑ Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural snips for all other installations. buildings. ❑ Multi-family ❑ Master builder ❑Other: CI Fire pump.p 0 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: 16786 SW LEAF LN I00HP or more. ❑"A", e','I-2",`1-3', City/State/ZIP: Tigard,Oregon 97140 0 Six or more residential units. occupancy. 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: South River Terrace ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts noninal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I New residential single-or multi-family dwelling unit. Subdivision: South River Terrace Lot#: 19 Includes attached garage. Tax map/parcel#: 1,000 sq,ft.or less 168.54 4 Ea.add''500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential Sales office located in the garage, �'frrn 5k".# 3u?2o2 2- Col 5 S (with above sq.ft.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 TENANT 0 PROPERTY OWNERServices or feeders installation,alteration,and/or relocation Name: Taylor Morrison Northwest LLC 200 amps or less 1 100.70 2 Address:710 Broadway St,STE 710 201 amps to 400 amps 33.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Vancouver,WA 98660 601 amps to 1,000 amps 301.04 2 Phone:(360 )695 7790 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: PermitSubmittals@taylormorrison.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 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 I 0 CONTACT PERSON Branch circuits—new,alteration,or extension, r panel A.Fee for branch circuits with Business name: Taylor Morrison Northwest LLC above service or feeder fee, each branch circuit 7.42 2 Contact name: Omar Alami Abouhafs B.Fee for branch circuits without Address: 710 Broadway St,STE 710 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Vancouver,WA 98660 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(360 695 7700 Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:PetmitSubmittals@taylormorrison.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Sunlight Electric Inc Sign or outline lighting 67.84 2 Address:2804 NE 65th Ave, Sutie D panne.,alteration, or limited-energyxtsi 0 See Page 2 2 panel,alteration,or extension. City/State/ZIP:Vancouver WA 98661 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( 971) 222-5758 Fax:( ) Investigation(1 hr min) 90.00/hr Email:Peter@SunlightElectriclnc.com Industrial plant(1 hr mm ) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.:172549 Electrical Lic.:C 0 Suprv.Lie.:6652S specifically listed(v hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal. Print name:Yegor Shevchenko Date: 0 Plan Review Required(25%of permit fee): ^^^iii State surcharge(12%of permit fee): Authorized signature: 9. TOTAL PERMIT FEE: � '150 ���"' T�+�"'y This permit application expires if a permit is not obtained within 180 Print name:Peter Kozarez v Date: days after it has been accepted as complete. • Number of inspections allowed per permit. 1:1Building\Permits\ELC_PernitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COMIWEB