Permit (11) CITY OF TIGARD ELECTRICAL PERMIT
�.
COMMUNITY DEVELOPMENT Permit#: ELC2023-00383
T(GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 6/22/2023
Parcel: 2S111 CC21400
Jurisdiction: Tigard
Site address: 10260 SW GREENLEAF TER
Project: Stenberg Subdivision: SUMMERFIELD NO.5 Project Description: Replace aluminum wiring for 10 circuits. Relocate washer,dryer and add range hood. Lot: 272
Contractor: Owner: STENBERG, MICHAEL J &JOYCE E
10260 SW GREENLEAF TER
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 1 ea Services or Feeders-200 06/22/2023 $100.70
amps or less
Type of Use: SF 1 crt Branch Circuits w/Purchase 06/22/2023
$7.42
Class of Work: ALT Service or Feeder
9 crt Branch Circuits wo/Purchase 06/22/2023 $115.54
Type of Const: Service or Feeder
Occupancy Grp: 1 ea 12%State Surcharge- 06/22/2023 $26.84
Electrical
Total $250.50
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 -s are set forth in OAR
952-001-0010 through 0 952-001-0090.. You
(/�av o in oov of the rules or direct questions to OUNC by calling 503.232.1987 1.8 . 2. 44.
Issued BY: m ),v/1 \ I IP
V � Permittee Signature: t �/
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 Received /
• 13125 SW Hall Blvd.,Tigard,OR 97223 Date/13y: �/ ,]'Z Permit It: ELC 1 ? -cc�g...;
III _ ' Phone: 503.718.2439 Fax: 503.598.1960Date/B Plan Review
\J nC l
Inspe..tion Line: 503.639.4175 Ready : Related Permit 4:
TIC.A R O. Internet: www.tigard-0or Ready Dare/By. hair I 0 See Page 2 for
Notified/Method: Supplemental Information
TYPE OF WORK
❑New construction PLAN REVIEW
2rAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/iterru checked):
0 Service or feeder 400 amps nr more 0 Building over three stories.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0.1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial use
agricultural
Multi-family ❑Master builder amps for all other installations, buildings.❑Other: 0 Fire pump.
JOB SITE INFORMATION AND LOCATIONy ❑lrrgerstpo ee15d derived
or
Job#: Job site address: ❑Ed nofnew system. Syster separately lcr ved
1 ❑Addition of new motor load of tem.
JobCit #:tatt lZlP: i 0 Z O 5 W cr,f„v.i e� rer 1TRIHp or more.
�G` or. 7 z z y 0 Six or more residential units. occupancy.
Suitr//bldgJapt,#: ❑Hazardoare facilities. ❑Recreational vehicle parks.
Project name: ❑Hazardous location& 0 Supply voltage for more than
Cross street/directions to job site: /7 0 Service or feeder 600 amps or more. WO volts nominal.
0 v('Mini`. h 0 To(� FEE SCHEDULE
Svr✓tw.a C-ep LO Dr. 10 9rc�l„ (2_c_$ Description I Qty. 1 Each I Total I :
Subdivision: S V tri New residential single-or multi-family dwelling unit.
Nt4 Nn-F1- "F s1,e_j eJ I Lot#: Includes attached garage.
Tax map/parcel It: 1,000 sq.R.or less 168.54 4
DESCRIPTION OF WORK Ea.add'1500 sq.ft.or portion 33.92
F p i r n Limited energy,residential 1
r <ctrtt_'i— At vt'vs.tnvr... w.iy�` /�/ tia+t✓n, Ll„ .�, r (with energy,
multi-family
y 75.00 2
_U,�®11 1 v 7T=ate ti,t Limited t;�.�,,multi-famil
❑ PROPl.�2TV O e�c� ��� c�t.r� (try residential(with above sq.$) 75.00 2
WNER ❑ TENANT Renewable Energy ❑ See Page 2
Name: Ai;✓ ` /_L �/ — Services or feeders installation,alteration,and/or relocation
�T amps or less I ii 100.70 2
Address: / //t� amps to 400 amps
Jo ZCop SL•) LrE�Vt GP4? rQJ�. 401 201 p 133.56 2
City/State/ZIP: r'r be. . 97 22 ti 601 pa to f00 amps 301.04.3a 2
Phone:(�j y t) amps to 1,000 amps 2
390 ^ S 7Zq I Fax:( ) Over 1,000 amps or volts 552.26 2
Email: M; ��Q�S#e j /f Temporary services or feeders installation,alteration,and/or
Owner installation:This installation is beingt onVtw�s relocation0ms o
intended for sale,l rent, r ex property that I own which is not zoo amps or less 59.36 i
according to ORS 447,449,670,and 701. 201 amps to 400 amps .54
Owner signature: 16 J 2
/" Date: 401 amps to 599 amps 168.54 2
.,tom n PLI ANT I ,(CONTACT PERSON Branch,circuits—new,alteration,or extension,per panel
Business name: /' A.Fee for branch circuits with
v./K'e[ above service or feeder fee,
Contact name: t ty" tom. each branch circuit 7.42 2 '
M ��� p V B.Fee for branch circuits without
Address: 5� ^ 1 '
f"` service or feeder fee,first
branch circuit 56.18 2
City/State/LIP: Each add'I branch circuit
p� 7.42 2 •
(service or feeder not included)
Phone:( ) Fax::( )
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
CONTRACTOR Reconnect only 67.84 2
Business name: Pump or irrigation circle 67.84 2
FA
47ir1'v2_ l.t,)� � Sign or outline lighting 67.84 2
Address:
Signal octal(s)or extensienergy
City/State/Lll': panel,alteration,or extension.
❑ See Page 2 2
Each additional inspection over allowable lbwabk in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) I Fax:( )
Email: Investigation(1 hr ruin) 90.00/hr
Industrial plant(1 hr min) 78.18/br
CCB LIC.: I Electrical Lie.: Inspections for which no fee is
Suprv.Lie.: specifically listed(A hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Print name: Subtotal:
Date: ❑Plan Review Required(25%of permit fee):
1 State surcharge(12%of permit fee):
Authorized signature: M t / ' T<4it_1 TOTAL PERMIT FEE: 5�
rC O��
Print name: ` This
Permit
appacadoa restive&4f a permit is not compete.
d within ISO
I Date:(o z2 /Z� I s days after it tin been accepted as complete.
l:rBuiW' • [.C_P µApp CLR_TRi Rev 06/I72e15 /r/ Number of inspections allowed per permit.
44(Wg15 (I 1/a5/COM/WBP