Permit CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
o COMMUNITY DEVELOPMENT Permit#: ELR2010 -00188
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/17/2010
Parcel: 2S111 CD04100
Jurisdiction: Tigard
Site address: 9500 SW BRENTWOOD PL
Subdivision: SUMMERFIELD NO.9 Lot: 500
Project: Catto
Project Description: Low voltage for photovoltaic system.
FEES
Owner:
CATTO, ELVIN & JANICE Description Date Amount
9500 SW BRENTWOOD PL Restricted Energy Permit 09/17/2010 $75.00
TIGARD, OR 97224 12% State Surcharge - Electrical 09/17/2010 $9.00
PHONE:
Contractor:
SUSTAINABLE SOLUTIONS UNLIMITED INC
1339 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 227 -2047
FAX:
Type of Use: SF
Class of Work: ALT
Total Number of Systems:
Audio & Stereo: N
Security Alarm: N
Garage Door Opener: N
HVAC: N Total $84.00
Vacuum System: N Required Items and Reports (Conditions)
Other Y
Other Desc:
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 rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You - • • = -• • - .. a rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued : . Li - 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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
'541 7548254 ZION � j � 1 17:15:14 09-16-2010 2 /3,.
Electrical lt'ermit Application 5 FOR OFFICE USE O?' LY
City of Tigard R � , c�0 Rtte,ycd •
° 13125 SR' Hall Blvd.. Tigard. OR 97? 3 *�� Alan Review — �� t I 1 i
`, Phone: 503.639.4171 Fax: 503.595.1960 - �Cj17, \11ate/T v: Oder Permit:
T.(GARD} Inspection Line: 503.639.4175 c* \ Date Ready/ny: 0 See Pare 2 for
- Internet: sttrnv.tigard.or.gov \ G � Nolit Supplemental Information
`
TYPE OF V1'O :' PL'AN : REVIEW . .
❑ New construction ❑ Addition /alteration /feplacement Please check all that apply (submit 2 scLC . plan w /itern; checked below):
{
f p ❑ Service or feeder 400 amps or more ❑ Building Dyer three stories.
'
❑ Demolition Other: go a f M where the available fault current ❑ Itlarinas and boatyards.
.. .,..... :.: : " CATGGORI , :OF : CONSTRUCTION .;' exceeds 10.01:0 amps at 150 volts or ❑ floating buildings.
less to ground. or exceeds 14.000 ❑ Commercial -we agricultural
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ installation rf 75 KVA or
❑ Emergency system. larger separately derived system.
:..,. :.:.: ;J OB : INFORMATION AND .LOCATION :::;. :
:: ,r..: , new motor load of
.. .. ❑ Add ition t r new m ❑ A , • g .... t ? � '.
Job no.: Job site address: co f n I(X)HP or man., occupancy.
c o ,S l/.. lj i G r'11 LUt C t I ❑Sig or more residential units ❑ Reereationai vehicle parks.
City/State/ZIP: q / ❑ Health -care facilities. ❑ Supply
voila; for more than
y T I C'J city{ ��t � ❑ Hazardous locations. 610 volts nominal.
Suite/bldg. /apt. no.: / Project name: Gc • r , ❑ Sertiicc or feeder 600 amps or more.
: •.FEE SCHEDULE ..
Cross street/directions to job site: D cription 1 Qtr. I F. I Total I •
New residential single- or multi- family dwelling. unit.
includes attached garage.
Subdivision: • Lot no.: 1,000 sq. 0. or less 168.54 4
Tax map /parcel no.: Fa. culd'I 500 sq. 0. or ponion 33.92 1
energy. residential
f -
,.., N. _
_ . ` .:'''DESCRIPTION',OF. `..: ,....:...; :: r : ; '.:::::`:.. :.. Limited (with above sq. ti.) n
Limiter1 energy, multi-family
t C f (s. c 75.IXi
.PC ;P... � o ) 0 � S'�'SL -•� f? r �,•• � �. � � � � (^ re s i d ential (with above sq. ft.) 1 !,
y, Services or feeders installation. alteration, and/or relocation
3 • 2- f` ■ p,.j 200 amps or less 100.70 3
❑ :: PROPERII' : .OWTIER ..... :.:.:.::. :.:.. :, . ❑.TENANT :::.:.:.: . 201 amps to -l(h'i amps 133.56 3
Name. f V, i (1 c. C•- 401 amps to 600 amps 20X1. i4 2
601 amps to I .(XH) amps 301.01 2
Address: CI I O . SL • L) t ,- e i. 1-11A-_ cx . �'? f i Over 1.000 amps or volts 552.26 2
City/State/ZIP: / (� r J �7 r Temporary services or feeders installation, alteration. and/or
3 / , 0 i' �C( C ( ( ?G 2_'/ relocation
Phone: Si'�) G � c J 2)0 amps or Ias 59.3n 1
> > , cj Fax: ( )
20) amps to 4(X) amps 125.0X 2
Owner installation: This installation is being made on property that I own which is not -
intended for sale. lease. rent. or exchange. according to ORS 447.449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits – new, alteration, or extension. per panel _
Owner signature: Date: A. Fee for branch circuits with
above service or feeder fee,
;.; : ❑ . APPLICANT : .'... i El CONTACT PERSON 7.42 2
each branch circuit
Business name: 11. Fee for branch circuits n•ithnnr
service or feeder fee, first
56.18
Contact name: branch circuit
Each aci branch circuit 7.42 2
Address: Miscellaneous (service or feeder not included)
Ci[ylState21P: Each manufactured or nodular 67 �a
dwelling. service and/or feeds
Phone: ( ) Fax: : ( )
Reconnect only 67.84 2
Pump or inigatiun circle 67.54 2
E - mail: 671a
: .............. : : :: CONTRACTOR . • .... ... 5 •
Sign or outline lighting
y 2
circuit(s) ur limited-energy
B �" (( , r panel. alteration. or extension. _ Page 2 2
Business name:
�1 ! ? 1 ��+ ■ .t >/.: ��i iti, C (; �l r' ( �` c'(I. Each additional inspection over allowable in any of the above
Address: 1 j Ci . t.. �{j�TV� A � Additional inspection (I hr min) 66.29 hr
� d /// investigation (1 hr min) 66.25; hr
City /State/ZIP: , -`j–� ( 2- ) Ct (_% C j l 7Z-/ `-/
Industrial plain 11 hr min) 78.1& hr
Phone: (S, Fax: ( ) Inspections for which no fee is
j') .Z �' (iy specific illy listed (1. hr nun)
CCB Lic.: i 90,00/ hr
r 1 Electrical Lic.: C Sur-. Lic.: '� ELECTRICAL PERMIT FEES .
.. •.:..,: Suprv. Electrician sis . required:'- 7 ` Subtotal:
I I bI 1 �) t
G L. u Plan review (25% of permit fee):
i .
Print name: IQ OA Date: l Slate surcharge (1 24 of permit fee):
I TOTAI. PERNiff1T :1: -1 .0
Authorized Signature: —., This permit applieation expires if a permit is not obtained within ISO
• Al , F _ T ,� kC 1 _ 1 / r (r i / � days after it lute ire�n accepted as complete.
Prim name: S t J Date: t r ^ Number of inx coons allowed r permit.
f
!Ahab) ing%Permits\li- C- NrmuAppaloc 07!01/10 34044615)11 I /05tCOMAVEH
�7 f e clv I'ilei
5417548254 ZION 17:15:54 09 -16 -2010 3 /3
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
.RESIDENTIAL• WORK ONLY:
Fee for all residential systems combined........ $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener* •
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
Other: Si: 16.4 PV — Ge . No
• - COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 91 5- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑
Fire Alarm Installation
❑ l-IVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Ocher
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:UtmiJwEV Perm's \EL('•Isenmi Al•.Jec 117 /0l /IO