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Permit (27) CITY OF TIGARD ELECTRICAL PERMIT II ' COMMUNITY DEVELOPMENT Permit#: ELC2023-00510 T f[;A R. 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 8/23/2023 Parcel: 1 S 134DA04900 Jurisdiction: Tigard Site address: 11390 SW 108TH AVE Project: Foster Subdivision: DOREEN COURT Lot: 6 Project Description: (1)new 200 amp feeder. Contractor: BRIGHT ELECTRIC S CORPORATION Owner: FOSTER, KIRSTEN L&PAUL L 1122 NE 122 AVE 11390 SW 108TH AVE PORTLAND, OR 97230 TIGARD, OR 97223 PHONE: 360449-2102 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/23/2023 $100.70 Specifics: amps or less 1 ea 12%Slate Surcharge- 08/23/2023 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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: •regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throuah •'' '52-0r -0090. You may obtain a copy of the rules or direct ouestions to OUNC by calling 503. .1987 or 1.80 t3 2344. 1® Issued By: Permittee Signature: OWNER INSTALLA 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. D Electrical Permit ApplicationEC l V E FOR OFFICE USE ONLY ,� City of Tigard AUG 2 3 2023 Received • 13125 S W Hall Blvd.,Tigard,OR 97223 Date B ` Perm _ OQ S f O t Phone: 503.718.2439 Fax: 503.598.19 Plan Review CITY Oi=TIGARD Dale/B Related Permit it: TIGARD Inspection Line: 503.639.4175 BUILDING DIVISION Ready Date/By: ruris: la Seep Internet: www.ti and-or. ov age 2 for g g Notified/Method: 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): El or feeder 400 amps or more El over three stories. 0 Demolition ❑Other where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or P El Floating buildings, al-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑Multi-familyamps for all other installations. buildings. ❑Master builder ❑Other: 0 Fire pump. ❑Installationof 150 KVA or JOB SITE INFORMATION AND LOCATION El Emergency system. larargerrseparately derived Job#: I Job site address: ,,� Q V.) rN pp a ❑Addition of new motor load of system. S 1\J` 100HP or more. ❑ «F,. <`1-2", -3", City/State/ZIP: -IA 3c.021 I ©R 1 1 rl -Z72.3 ❑Six or more residential units. occupancy. El Health-care facilit es. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name: 0 Hazardous locations. ❑Supply voltage for more than Cross street/directions to job site: ElService or feeder 600 amps or more. 600 volts nominal. FEE SCHEDULE Description I Qty. 1 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'I 500 sq.R.or portion 33.92 1 n(� Limited energy,residential i( `c- .M 1 0 tc4 PA vet_ (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 ❑ PROPERTY OWNER I 0 TENANT Renewable Energy 0 See Page 2 Name: Services or feeders installatio alteration,and/or relocation 200 amps or less I 100.70 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 amps to 1,000 amps 301.04 2 Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 1 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: 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 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7p2 2 Phone: Miscellaneous(service or feeder not included) ( ) I Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: V Q•i - �L'� (-L.�, Sign or outline lighting 67.84 2 Address: 1 O QO 'ti \2Z N ASignal circuit(s)or limited-energy El See Page 2 panel,alteration,or extension. g 2 City/State/ZIP: *�ti 0 Qv., i o Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:(3(10) 1(tt ct- 2102_ I Fax:( ) Investigation 1 hr min 6R. �� - ial ( ) 78.18/hr Email: r �..�.�7 M A, k ,COfs Industrial plant(1 hr min) 78.I8/hr ri ��..C� Inspections for which no fee is CCB Lic.:"2-2. 5 L4 I Electrical Lic.:IC\4(`3 I Suprv.Lic.: (-t(p 25-S specifically listed('/,hr min) 90.00/hr Suprv.Electrician signature,required: a.l n ELECTRICAL PERMIT FEES Subtotal: Print name: ey £tf p_1J S I Date:Z.2 .ZQ2-9> ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: R e � N S This permit application expires if a permit is not obtained within 180 Print name: , c-Q. t� Date: p ^2,� J Q.� . C.Lt2:1 days after it has been accepted as complete. * Number of inspections allowed per permit. 1:13ulldinglPermitslELC_PernutApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: FEE SCHEDULE RESIDENTIAL WORK ONLY: Description I ety I Each I Total I * 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 15 kva 133.56 2 ❑ 15.01 to 25 kva 200.34 2 Audio and Stereo Systems* 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 ❑ Vacuum Systems* 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(Yz hr min) ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1): 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 1:03unding PermitsTLC_PerxmtApp_ELR_ERP.doc Rev 06/17/2015