Permit 1 1111- CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMEN Permit #: ELC2013 00369
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/02/2013
Parcel: 2S 112BD07000
Jurisdiction: Tigard
Site address: 14709 SW 79TH AVE
Project: Brown Subdivision: BRITTANY MEADOWS Lot: 6
Project Description: (2) branch circuits for ourdoor kitchen
Contractor: • OWNER Owner: BROWN, JAMES E & KRISTA M
BROWN, JAMES & KRISTA 14709 SW 79TH AVE
14709 SW 79TH AVE TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 352 - 871 -2433 PHONE: 352 - 871 -2433
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo /Purchase 07/02/2013 $63.60
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/02/2013 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
Required Items and Reports (Conditions)
This permit i • ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes a` all other a• •licable 1 w. All work will
be done accordance ' h approved plans. This permit will expire if work is not started within 180 days of issuance, / if work is s spende• for more the 180
days. ENTION: Orego la, requires you to follow the rules adopted by the Oregon Utility Not cation Cent= . Those rules ar: set forth in OAR
952 -00 0010 through OAR 9' -001 •fa. You may obtain a opy of the rules or direct questions to OUNC by calling 503,232.191 or 1.: r •. 32.23.4.
— _7
Issue. = . e Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on prope a' not intended for sale, lease or rent.
"� (e.L__
OWNER'S SIGNATURE Date: � �� ir.:�Lr:�.. /
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC' Date:
LICENSE NO.
Call 503.639.4176 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
RRCEWED
Electrical Permit Applicl$iAn0 2013 FOR t)FF1(1 1'si: ONI.YY
Cl of T i a C i � nom. /.�p� Received PerenitNo.:
1 31 2 5 SW Ha l B lvd., T tf '0F 3TIGt�RO Plan Review : 7Q��_ � /� �LC �3 � � 9
.1111 JN 1IVISION Date's
Phone: 503.718.2439 Other Permit:
Date/Bv:
I I i, :\ Ill) Inspection Linc: 503.639.4175 Date Ready/By: Saris: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: _ Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below):
❑ 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 nt 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings,
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "1d ",
Job no.: 1 Job site address: ' r ' c,p S 7 4 f'' IQOHP or more. occupancy.
j �v' ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: -t^�L� t2.0 G� 13 Health-care facilities. ❑Supply voltage for more than
['Hazardous locations. 600 voles nominal.
Suite/bldg. /apt. no.: Project name: egaThfran}f- yyf,6t4DQG✓S ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: -79 .tyg givaili Description 1 41v. I Pee. I Tout I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: ,;12.2-11-04.01 ✓Yl EA badk,15 Lot no.: 6, 1,000sq. R. orless 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
Limited energy, multi- family 75.00 2
P b residential (with above sq. ft.)
t' Renewable Energy ❑ Set Page 2
Services or feeders installation. alteration, and/or relocation
IS PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133,56 2
Name: J a n v s A K r i'S•k.4,_ 'g r o c,O n 401 amps to 600 amps 200.34 2
Address: tel - 7 0 5 , se,,. 7 C IL /94h 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City /State /ZIP: 1-4 4 ,42D . OP— Temporary services or feeders installation, alteration, and /or
relocation
Phone: (3 'l) - 7 / Z V 33 Fax: ( ) 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, le c, rent, or exchange, according to ORS 447, 449, 670, 12( 70, jand /701. 401 amps to 599 amps 168.54 2
Owner signature: � Date: / I _____ _ b Branch circuits— new, alteration, or extenston, er panel
El APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
7.42
Business name: each bran circuit -
B. Fee for branch circuits without Q
Contact name: A service or feeder fee, First 56.18 5- 2
branch circuit
Address: SA Each add'I bmnch circuit ' 7.42 4
City/State/ZIP: Miscellaneous (service or feeder not included)
Y Each manufactured or modular
dwelling, service and/or feeder
Phone: ( ) Fax: ) 67.84 2
_ Reconnect only 67.84 2
E -mail: 4 ta, .. ,i ,,„A. 'a • u ,,, f 1, Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Signal circuit(s) or limited- energy See
panel. alteration, or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above ,
Additional inspection (1 hr min) 66,25/ hr
City /State /ZIP: Investigation (I hr min) 66.25/ hr
Phone: ( ) Fax: ( ) lndusuial plant (1 hr min) 78.18/ hr
— Inspections for which no fee is 90.00/ hr
CCB Lic.: J Electrical Lie.: Suprv. Lie.: specifically listed (A hr min)
ELECTRICAL, PERMIT FEES
Suprv. Electrician signature, required: Subtotal: , , ()
Print name: pa1e. Plan review (25% of permit fee): -----
State surcharge (12% of permit fee): 7 • 4
Authorized signature: TOTAL PERMIT FEE: 7 i , 23
This permit application eapires if a permit is Dot obtained within 1
Print name: ( Date: days after it has been accepted as complete.
• Number or inspections allowed per permit.
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•
Electrical Permit Application – City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESID INTIALtWORK.ONLY: FEE SCHEDULE
Fee for all residential systems combined.. ».... $75.00 nrrt.rmtee I Ots 1 pee 1 rod 1 •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva orless 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to25kva 200.34 2
Burglar Alarm
Wind generation systems In excess of 29 kva:
g 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* .50.01 to 100 kva 552.26 2
>100 kva (fee in accordance with 552.26 2
El Heating, Ventilation and Air Conditioning OAR 918-3094040)
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva— no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/ hr
charged at an hourly (I hr min)
inspections for which no fee is 90.00/ hr
specifically listed (Si hr min)
COMMERCIAL WORK ONLY: ELECTRICAL 'FERMI? FEES
Fee for each commercial system ... $75.00 Subtotal;
(SEE OAR 918- 309 -0000) Plan review, if required (25% of permit fee):
State surcharge (12 %ofpermit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expire if a permit is not obtained within 180
❑ Audio and Stereo Systems days alter It has been accepted as complete.
• Number of inspections allowed per permit
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ 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
for all other installations
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