Permit IN U CITY OF TIGAR ELECTRICAL PERMIT
e , COMMUNITY DEVELOPMENT Permit #: ELC2013 00404
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/17/2013
. Parcel: 2S103CA00202
Jurisdiction: Tigard
Site address: 13215 SW HOWARD DR
Project: Hunter Subdivision: WOODCREST NO.2 Lot: 16
Project Description: Electrical reconnect for service off more than 6 months
Contractor: Owner: HUNTER, GEORGE JR & VICKIE LYNN
13215 SW HOWARD DR
TIGARD, OR 97223
PHONE: PHONE: 971- 570 -3976
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 07/17/2013 $67.84
Specifics:
1 ea 12% State Surcharge - 07/17/2013 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
Required Items and Reports (Conditions)
This permit is is •• to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law, All work will
be done i - ccordance with a• .roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more t - 180
days. • TENTION: Oregon law equire you to follow the rules adopted by the Oregon Utility Notification Center. Those rules = e set fort i OAR
952 -0' 1 -0010 throu'h OAR 952- 001 -10• :. Y•u,z obtain a copy of the rules or direct questions to OUNC by calling 503.'32.1987 or 11
By: / — g ,, ter, 2.2 t�1,Li►'v
Iss ed B L /i Permittee Si nature: \�.
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 503.639.4176 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.
•
Electrical Permit ApplicatifiECEN ED FOR OFFICE USE ONLY
City of Tigard II11'' Received i. :
13125 SW Hall Blvd., Tigard, OR 97223 2013
� Date/By: 7 �r Permit No � 013 Ov 04/
m Phone: 503.718.2439 Fax: 503.598. TIGARD DateB Other Permit:
I' I G A K u Inspection Line: 503.639.4175 � GAR Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 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 at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: 13 Z IOOHP or more. occupancy.
l V WC) W �� ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP:'' ( %. i D 9-7 Z �3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
N
Suite/bldg. /apt. no.: Project name: v + E y_ ❑ Service or feeder 600 snips or more.
1 1 FEE SCHEDULE
Cross street/directions to job site: Description I Oty. 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
❑ PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: C - � -Ep 2 . J o '. � 401 amps to 600 amps 200.34 2
Address: I Z I 6-3 S vo `to W -1 eD 0 (L_ 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
�
City/State /ZIP: 1 1 / � (L d 012 9 '1 2 7 3 Temporary services or feeders installation, alteration, and/or
Phone: (Gf �1 )5-7 p . 39-3 Fax: ( ) relocation
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 exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with
above service or feeder fee,
7.42 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'l 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 4 7 8 2
E - mail: Pump or irrigation circle 67.84 2
CONTRACT Sign or outline lighting 67.84 2
.Business name: Signal circuit(s) or limited- energy See
panel, alteration, or extension. Page 2 2
Address: I Each additional inspection over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
City/State /ZIP: Investigation (1 hr min) 66.25/ hr
Phone: ( ) ' Fax: ( ) Industrial plant (I hr min) 78.18/ hr
Inspections for which no fee is 90.00 / hr
CCB Lic.: Electrical Lic.: Suprv. Lic.: specifically listed (%3 hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required:
Subtotal: 4 7. £Se
Print name: Date: Plan review (25% of permit fee): —
State surcharge (12% of permit fee): g. ' 9
Authorized signature yL _ TOTAL PERMIT FEE: 75
oes L ci_o 1 1 I )1_ I3 This permit application expires if a permit is not obtained within 180
Print name. t �i fl Date: days s aftter r it has bees n accepted as complete.
• Number of inspections allowed per permit.
I :\Building\Pcnnita\ELC _PermitApp_ELR_ERE.doe Rev 05/21/2013 440- 4615T(II /05 /COM/WEB
Electrical Permit Application — City of Tigard
Page 2 — Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined ... $75.00 Description I Qty. I Fee I Total I •
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 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
❑ Heating, Ventilation and Air Conditioning OAR 918-309-0040) 552.26 2
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
• charged at an hourly (I hr min) 66.25/ hr 1
Inspections for which no fee is 90.00/ hr
specifically listed (V5 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT 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% of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
❑ Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building\ Permits \ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013