Permit CITY OF TIGARD ELECTRICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: ELC2011 -00240
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
Parcel: 2S110CB10300
Jurisdiction: TIGARD
Site address: 15426 SW ARLINGTON TER
Project: Arlington Heights No. 3, Lot 91 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 91
Project Description: Solar photovoltaic system.
Contractor: LAUGHLIN ELECTRIC LLC Owner: JT ROTH CONSTRUCTION
3 MONROE PARKWAY STE P PMB205 12600 SW 72ND AVE SUITE #200
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
P
PHONE: 503 - 639 -2639
HONE: 503 - 449 -7389
FAX: 503 - 639 -0077
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/30/2011 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 06/30/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/30/2011 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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 rules are set forth in OAR
952- 001 -0010 through 0,:. 0: ' •.2- 001 -0090. You may obtain a copy of th or direct questions to OUNC by cal ng 503.23 .a987 7 oor 1.800.332.23.4.
Issued By: // –......---...L. _ — Permittee Signature: L `= ._ IT4 U 4 l . f It
J' � 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 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 01;1•1( USE (1N1 r'
,,, 11111 City of Tigard re L /ima � Permit No.: e// % 2 i
err 13125 SvTigard, OR 97223 = e i . ! Ian
i 16 Other Permit:
Phone: 503.718.2439 Fax: 503.598.1960 A /e Date/B : ! / i
MAY — 6 2011 Ready /By: ' Bair ® See Page2for I
. 1 : A . U Internet: www.tigard or.gov Inspection Line: 503.639.4175 Date ,'llri / #' .-- Supplemental lnformadon
z� -u " ate.a< a :.,_ w un.• a a �2t i1 '.
�5 , rm 3 . t A6 , t, _ d t, , . s* s 1;A .. '�7w _ "M1i \ y �..v. ,i , ,--;•
un r�a?n� -,3�. .`+�ara��;k �t��v� .;.�,,- �.�1 ,�- ....a. :> .. °./ ,.�..�;. :..�� s'�`� Y t'�a a ... }.c." �'i �,�, ni�'�' ��?.w t`�*....� - h•�*A��rL,G� -) ,
IA New construction 0 Addition/altera ° [r
ION Please check all that apply (subm a sets of plans w inems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
t "t� a� r •a t S, - y. i 3 '
�" x c.x ti •. mil. z x - :,� -.x°-a t v W �' 7 t
K :, , ,....,, , '.04,•6,114. , ......... ri ``Agv t ��� a la C r,I�1+ F r' iii . o 4 1 a y ` exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
` .a ` :, ,,.�'a < rsrocp,n nf; ,P#2..4 "' e••x•. " O `, , t , gZi i' t - ' ', " i , less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
IHI 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi family 0 Master builder ❑ Other: ❑ Fire pump. ❑ Installation of75 KVA or
w y u, r r TO , y . p . „,; . , y B r,, _ :Y Emergency system. larger separately derived system. I
din 4 h er. lk t �,�t7r:~ Wy Tl,(3 ♦fit 'i N .x"3�� `� a*,. f t ali :: 0 Addition of new motor load of ❑ `•A •`E'•, "1_2 "1 - 3•• 'I
Job no.: 10112 I lob site address: 15426 SW Arlington Ter. 1001*ormore. Recre
❑Six or more residential units. ❑ Recreational vehicle parks. 1
City/State/ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: 3
Cross street/directions 100 Oth ���� � % w ce or feeder 600 amps or moro i
� �,� a� G i ;) � .., k'�� �. ;�a at- �T. �i'��' t � tui �'� t �� s street/directions to job site: � t ( . y o �, io t (FORO A �t s
f � J � J •, L l V 9 ( llesaip I Q7. I Fee ( Total I • l
• VV t New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Ea. add'l 500 sq. ft. or portion 33.92 1 I
Tax map/parcel no.: Limited energy, residential I
-� -, .tP', .� i i �wx y r 5 a 4 - 8 y .11 p ' F "` k l 1F t i . (with above sq. It 75.00 2
1 ";.,, xf y b y ,r,u,cu.< 1 ,,R x''. - m x r� t � YQ ,.Fj .c a. ..A u �, ,C,1 f Ai b R:4,. A
Limited ener multi tt
- family 1
Installation of solar photovoltaic system.
residential (with above sq. ft.) 75.00 2 1
Services or feeders installation, alteration, and/or relocation i
200 amps or less ' 100.70 10 0.1 0 2 4
I .1 M i.x a " w 1 OIe " v w '1 A: t 1 Sig 201. amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: JT Roth Construction Inc. 601 amps to 1,000 amps 301.04 - 2
Address:12600 SW 72nd Ave, Suite 200 . Over 1,000 amps or volts 552.26 2
Temporary services or feeders Installation, alteration, and /or i
City/State/ZIP:Portland, OR 97223 relocation 1
Phone: ( 50a) 887.5903 Fax: ( ) 200 amps or less 1 59.36 1
201 amps to 400 amps 125.08 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, er panel 1
Owner signature: Date: A. Fee for branch circuits with
fee,
t d a fi- �� tt. z w tL t t k��_k•"�'•9s�p( "�^'" iz x t ;H � 1" VC 1CC Or feder U I
'�-. ��r '��. v p �'. `y'. e.4, ' . a f , `.S�i:.ra�1.` ., ` :3�y 1 ',tk1.-,.. C8C11 8b0 b71'171CSCrY11 CIICYIeI 7.42 �' 1 2 1
Business name: LiveLight Energy, LLC B. Fee for branch circuits without
service or feeder fee, first 56.18 2 i
Contact name: Jennifer Atkins branch circuit t
Each add'I branch circuit 7,42 2 1
Address:1750 SW 187th Ave Miscellaneous (service or feeder not included) _
City/State/ZIP: Beaverton, OR 97006 dwelling, manufactured or and/or I
� dwelling, service attdlor feeder 67.84 2 i
i
Phone: (51 682 -2168 Fax: : ( 5qa) 682 -6920 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E ennifer • liv Ii•htener• om Sign or outline lighting 67.84 2
$ 0 )� n ' e �y F wb 'k3t < , ,yFa '° +tq: r
.. , -r w . , s , ,. .... - ls_ab r .,. „ tc4';?. re .,,: •at? .�a ,,,,,. "r, Signal circuit(s) or limited-energy
Business name: Laughlin Electric LLC panel, alteration, or extension, Page 2 . 2 i
Each additional inspection over allowable In any of the above ?
Address: 3 Monroe Parkway, Suite P #205 Additional inspection (1 hr min) 66.25/hr 3
` investigation (1 hr min) 6625/ hr
City/ State/ZIP: Lake Oswego, OR 97035
Industrial plant (1 hr min) 78,18/ hr 1
Phone: (503) 449 - 7384 Fa ( ) Inspections for which no fee is
specifically listed ('h hr min) 90.00 / hr i
CCB Lie.: 165763 Electrical Lie.: .0 f 3u rv. Lic,: 5097 S G ,r . , ;i> L Ci' tit ` t- T ,>f ; t_ ,.? . a
Suprv. Electrician signature, required: / (25% Subtotal: %(�j�� V`�-
1
Print name: Grant Laughlin
Pl review (25 /o of permit fee): / Date: 5_5_11 State surcharge (12% of permit fee): {
TOTAL PERMIT FEE: / 2 - j f7
Authorized signature: 1
This permit application expires if a permit is not obtained within 180
Print name Date: days after it bas been accepted as complete. tilt
N um b er of inspections allowed per permit 1
t
1:: Buidmgtpermhs , ELC- PennitApp.doc 07'0110 440 - 4615Th t=05'COM'WEB 1
t
i
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ B urglar Alarm
❑ G arage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
® Other Solar Photovoltaic
H,,..Y.ml�m+ - .t+,..,.,v... IS4 �R�as'�h4 �i��.xI
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved: •
•
•
❑ A udio and Stereo Systems
•
❑ Boiler Controls
❑ Clock Systems
❑ D ata Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n I ntercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ O utdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:•Building 'Permi,s=ELC:- PermitApp.doc O7.OI!1O