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Permit CITY OF TIGARD ELECTRICAL PERMIT ' ' COMMUNITY DEVELOPMENT Permit #: ELC2011 -00359 TIGA. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011 • Parcel: 2S 104CA03500 Jurisdiction: Tigard Site address: 13672 SW LAUREN LN Project: Hansen Subdivision: HILLSHIRE Lot: 35 Project Description: Installation of solar photovoltaic system. Contractor: WEST SIDE ELECTRIC CO INC Owner: HANSEN, JACK 1834 SE 8TH AVE 13672 SW LAUREN LN PORTLAND, OR 97214 TIGARD, OR 97223 P PHONE: 503 - 524 -6580 HONE: 503 - 231 -1548 FAX: 503 - 736 -0677 FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 06/30/2011 $100.70 Specifics: amps or less 2 crt Branch Circuits w /Purchase 06/30/2011 $14.84 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 06/30/2011 $13.86 Electrical Type of Const: Occupancy Grp: Total $129.40 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. ATT ON: Oreg law re • es you to follow the rules adopted by the Oregon Utility Notificati.n Center. Those rules are set forth in OAR 952 -001- 10 thr gh OAR 952- 01 090. You y obtain a copy of the rules or direct questions to OUNC by calling 503.' , 1 987 o 800/��2.2344. Issue B y: ` Permittee Signature: ` �C OWNER INSTALLATION ONLY C. • 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' . .•,..7-. ��, 4 . Date: ��� �,/�� / LICENSE NO. L / 5—e/ 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 PO12 OFFICE USE ONLY lig City of Tigard Received • Date/B / l� `J :; ' /dr9G •.t . '"... r 5 `St 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review lir Phone: 503.718:2439 Fax: 503.598.1960 Date/By: i.!.:1.7!:070° // Permit No.: Other Permit: f:!.ii:elrl TtGAI:D Inspectio Line: 503.639 DateReady/By: :. / �)_ ranr: ®Sec Page 2 for Internet: www.tigard-or.gov Notified/Method: [af (I�LJ� f Supplemental Information TYPE OF WORK QService or feeder 400 amps or more Building over three where the available fault current stories. U New construction U Addition /alteration /replacement exceeds 10,000 amps at 150 volts or ❑ Marinas and boatyards. ❑ Other: 0 0 0 ❑ 0 less to ground, or exceeds 14 ❑ Demolition amps for all other installations. Floating buildings. CATEGORY OF CONS ❑Fire pump. ❑ Commercial -use agricultural X 1- and 2- family dwelling U Commercial /industrial U Accessory building ❑Emergency system. buildings. ❑ Multi- family ❑ Master builder El Other: 0 000 0 ❑Addition of new motor load of ❑ Installation of 75 KVA JOB SITE INFORMATION AND LOCATION I00HP or more. or ❑Six or more residential units. larger separately derived system. Job no.: 0 ❑ ❑ ❑ 0 I Job site address: 13672 SW Lauren Ln ❑ Health -care facilities. ❑ "A , ` E ° ` 1 -z I.3 " City /State /ZIP: Tigard /OR/97223 0 Hazardous locations. ❑ occupancy. Recreational vehicle ❑ Service or feeder 600 parks. Suite/bldg. /apt. no.: 0 0 0 ❑ 0 Project name: Hansen Solar amps or more. ❑ Supply voltage for Cross street/directions to job site: 99W to SW Walnut St. Turn RIGHT. LEFT on more than 600 volts nominal. SW 135th Ave. Turn RIGHT on Lauren Ln. 13672 on LEFT. FEE SCHEDULE Subdivision: Hillshire I Lot no.: 35 Description I or. I Fee. I Total I. Tax map /parcel no.: 2S1004CA03500 New residential single- or multi-family dwelling unit. Includes attached garage. DESCRIPTION OF WORK 1,000 sq. ft. or less Pri 168.54 ..., ., ' 4 Wiring of Roofing Integrated PV system and balance of system. Ea. add'I 500 sq. ft. or portion :; 33.92 :. I Limited energy, residential 75.00 2 00000 (with above sq. ft.) Limited energy, multi - family © PROPERTY OWNER I ❑ TENANT - residential (with above sq. ft.) ' " 75'00 2 Services or feeders installation, alteration, and /or relocation Name: Jack Hansen 200 amps or less 1 100.70 ' 100.70 2 Address: 13672 SW Lauren Ln 201 amps to 400 amps :.1 133.56 .. 2 401 amps to 600 amps ❑ CI 200.34 1 : .: 2 City /State /ZIP: Tigard, OR 97223 601 amps tol,000amps ❑H 301.04 ri!.::; Li: . 2 Phone: (503)524 - 6580 Fax: (00000)00000 Over 1,000 amps or volts Ci: 552.26 !." :' :.•:. 2 Owner installation: This installation is being made on property that I own which is not Temporary services or feeders installation, alteration, and/or relocation intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 200 amps or less l 59.36 M.;1-!! 1 Owner signature: Date: 201 amps to 400 amps [: ■ci 125.08 2 ❑ APPLICANT I' ©'CONTACT PERSON 401 amps to 599 amps 11D 168.54 .: _ : :. 2 Branch circuits - new, alteration, or extension, eer panel Business name: JBC Roofing A. Fee for branch circuits with above service or feeder fee, 2 14.84 Contact name: Brad Chisolm each branch circuit 7.42 2 13. Fee for branch circuits without Address: 12155 SW Grand Ave Suite B service or feeder fee, first branch circuit 56.18 2 City /State /ZIP: Tigard /OR/97223 Each add'I branch circuit 7.42 2 Phone: (503) 968 - 1235 Fax: : (503) 603 - 9967 Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 E -mail: bradc @jbcroofing.com dwelling, service and/or feeder CONTRACTOR Reconnect only . ■ 67.84 ' 2 Business name: West Side Electric Company Pump or irrigation circle x.1!.'1 67.84 r1Ci: 2 Sign or outline lighting _. • 67.84 i'G: 1; 2 Address: 1834 SE 8th Ave Signal circuit(s) or limited- energy panel, alteration, or extension. r' I. I Page 2 ' ' `' ` • • 2 City /State /ZIP: Portland /OR/97214 Each additional inspection over allowable in any of the above A dditional inspection (I hr min) 1:J11 66.25/ hr ,! i Phone: (503) 231 -1548 Fax: (503) 750 -5786 • CCB Lie.: 13306 I Electrical Lie.: 26 -I35C Suprv. Lie.: 4654S Investigation (1 hr min) Ii.; 66.25/hr - Suprv. Electrician signature, required: �i+. 4( 716' . Industrial plant (I hr min) 00 78.18/ hr Print name: Randall F Roberts Date:JUn 29, 2011 Inspections for which no fee is specifically listed CA hr min) _ 9"0/ hr ELECTRICAL PERMIT FEES Authorized signature: An„ f'Urt'�S Subtotal: 1 15.54 Print name: Aaron Watzig Date : Jun 29, 2U1 1 Plan review (25% of permit fee): State surcharge (12% of permit fee): 13.86 1 1 TCST nCnn4!Tcrr. teo -in