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Permit 11,1 p CITY OF TIGA ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2013 00262 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/08/2013 Parcel: 2S111AB03800 Jurisdiction: Tigard Site address: 9205 SW VIEW TER Project: Zadow Subdivision: PENMAR TERRACE Lot: 10 Project Description: Service panel and (4) branch circuits. Contractor: OWNER Owner: ZADOW, MARK D & DIANE S 9205 SW VIEW TER TIGARD, OR 97224 PHONE: PHONE: 503 - 348 -2695 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders - 200 05/08/2013 $100.70 Specifics: amps or less 4 crt Branch Circuits w /Purchase 05/08/2013 $29.68 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12% State Surcharge - 05/08/2013 $15.65 Electrical Type of Const: Occupancy Grp: Total $146.03 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. ATTE •: • - = • n law r- • uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0o 0 through OAR 9 -0' -0098. Ak may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800, 2.2344. Issuec By: Permittee Signature: / ci � / k OWNER INSTA ATION ONLY The installation is being made on property I own which is not intend for sale, lease or rent. / G� OWNER'S SIGNATURE � /C / ✓ Date: ./a /' J 2 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 1 - - ( ) 1 ( 0 1 1 . - 1 ( E I SE 0:\ I_ 74 City of Tigard nateIB �� 7 Permit No.: FL C -60.26.2- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review G Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: I I C. It Il Inspection Line: 503.639.4175 Date Ready/By: Imo: RI See Page 2 for Internet: www.tigard or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction 4F 3` P ddition/alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "I -3 ", _ loot -iP or more. occupancy. Job no.: Job site address: lv � i ` ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State /ZIP: `\o O ,e,,_ oi', 1:).4-1 ❑ Health-za douse ous l ocatications. ❑ Supply voltage for more than ❑ Huardoons. 600 volts nominal. Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • 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'I 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 residential (with above sq. ft.) - Renewable Energy ❑ See Page 2 Services or feeders installation, alteration, and/or relocation ROPERTY OWNER I ❑ TENANT 200 amps or less 1 100.70 /00, 7(6 2 � 201 amps to 400 amps 133.56 2 Name: if ti kLt Z 4 j Q% ) 401 amps to 600 amps 200.34 2 Address: 601 amps to 1,000 amps 301.04 2 �� ` e � v 1 / v i� "� ` T �� Over 1,000 amps or volts 552.26 2 City/State/ZIP: - : �:J ( b(L. ""11.1. Temporary services or feeders installation, alteration, and/or Phone: ( ) 3l1 g _It„ q 5 Fax: ( ) relocation 200 amps or less 59.36 1 Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale, lease, rent, or xchange, ac rding to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner signature: 77 3 - 4--' Date: 5 13 Branch circuits — new, alteration, or extension, per panel A. Fee for branch circuits with ❑ APPLICANT ❑CONTACT PERSON above service or feeder fee, 7.42 9, 2 Business name: each branch circuit B. Fee for branch circuits without Contact name: service or feeder fee, first 56.18 2 branch circuit Address: Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous (service or feeder not included) Each manufactured or modular 67.84 2 Phone: ( ) Fax: : ( ) dwelling, service and/or feeder Reconnect only 67.84 2 E - mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: 6 Glp 1` Signal circuit(s) or limited -energy 0 panel, alteration, or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above City/State /ZIP: Additional inspection (1 hr min) 66.25/ hr Investigation (1 hr min) 66.25/ hr Phone: ( ) Fax: ( ) Industrial plant (1 hr min) 78.18/ hr Inspections for which no fee is 90.00 / hr CCB Lic.: Electrical Lic.: Suprv. Lic.: specifically listed (LA hr min) - ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: /5o •3 g Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): / 5�• 4 5 Authorized signature: TOTAL PERMIT FEE: /cM p 3 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. for all other installations 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: El Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* p Other: COMMERCIAL WORK ONLY: Fee for each commercial system $75.00 (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 El 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 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 9205 SW VIEW TER, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal 2013-11-08 00:00:00 ELC2013-00262 PASS - No C of O Violation Summary: Inspector Contractor