Permit CITY OF TIGARD ELECTRICAL PERMIT
3 . '• COMMUNITY DEVELOPMENT Permit #: ELC2013 00450
T I GAR.O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/30/2013
Parcel: 2S109AD02700
Jurisdiction: Tigard
Site address: 14670 SW 130TH AVE
Project: Lapp Subdivision: WOODFORD ESTATES Lot: 19
Project Description: (3) branch circuits for remodel master bath, relocate existing shower and tub.
Contractor: WEBER ELECTRIC INC Owner: LAPP, RAYMOND UDONNA L
7007 SW ROBBINS RD 14670 SW 130TH AVE
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 819 -7380 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo /Purchase 07/30/2013 $71.02
Specifics: Service or Feeder
1 ea 12% State Surcharge - 07/30/2013 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 OAR 952 -00 0. Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: �L�
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 ske until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
Electrical Permit Application 1 ► ' 1 i FOR OFFICE USE ONLY
City of Tigard /3d 1 &, ^+ Received D Date/By: /j /3 .LC��3 --062 --062 �'5
g I I ' a eBy: Z errnit No.
EL 13125 SW Hall Blvd., Tigard,OR 97223 n Plan Review
' II ' Phone: 503.718.2439 Fax: 503.598.196 t J ., £ . , 1' It) ateB : Other Permit�L/ f �/,3 -e0 4 r 3
at , Inspection Line: 503.639.4175 3i it .�T . Ready/By: lulls: ® See Page 2 for
T GARD � Internet: www.tigard- or.gov B ,'� 41--9 4 =i I , °., fied/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction E 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
la 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
❑Emergency system. larger separately derived system.
JOB SITE :INFORMATION AND LOCATION
• ❑ Addition of new motor load of ❑ "A ", "E ", "1 - 2 ", "l - 3 ",
/�
10OHP or more. occupancy.
Job no.: Job site address: i 4 (7o 5-Li 1 3 a7 as A 1/4,..42_
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: Health -care facilities. ❑ Supply voltage for more than
1 t c 0 Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: J Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: � .4_1 J — ) r„ f2 c...0 Description I Qty. I Fee. I Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4
Tax map/parcel no.: Ea. add'! 500 sq. ft. or portion 33.92 1
Limited energy, residential
. DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
c t Limited energy, multi- family 75.00 2
, 3 c I r` kTh 13,11‘. . ( v....LA_ residential (with above sq. ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation, alteration, and/or relocation
13,PROPERTY 'OWNER ' I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: r, L `Pp 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) 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 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 ❑ 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 l 56 LL p 2
branch circuit .18 5 V t
Address: Each add'I branch circuit j 7.42 gft 84 2
Miscellaneous (service or feeder not included)
City /State /ZIP: 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: W �� �( a GT r- Signal circuit(s) or limited- energy See
`h v L 1� t_ panel, alteration, or extension. Page 2 2
Address: 7 o•.., T SO (2 a h13 1et. 1 gem Each additional inspection over allowable in any of the above
City/State /ZIP: Additional inspection (I hr min) 66.25/ hr
waA . ,.,
e.. r t'2 S 7 Co Z (I Investigation hr min) 66.25/ hr
Phone: ( a 9 ?3) p p 3 Fax: , Industrial plant (1 hr min) 78.18 / hr
�C0 ( 7 / ) Inspections for which no fee is
CCB Lic.: !.I Ito k 7r j Z Electrical Lic.3q, 'I e _ Suprv. Lic.: 4 C S specifically listed (%3 hr min) 90.00 / hr
^ ELECTRICAL PERMIT (FEES
Suprv. Electrician signature, required:
%�'� Subtotal: / . 0 Z
Print name: �jy� / , Date: Plan review (25% of permit fee):
1 " r � `-' G�t ?....10 ' l- State surcharge (12% of permit fee): ,, 2, /
Authorized signature: TOTAL PERMIT FEE: 7 9. 54 4 ✓
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
' Number of 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:
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
El Burglar Alarm Wind generation systems in excess of 25 kva:
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
❑ Heating, Ventilation and Air Conditioning OAR918- 309 -0040)
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 (1 hr min) 66.25/ hr 1
Inspections for which no fee is
specifically listed (%: hr min) 90.00 / hr
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.
❑ 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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