Permit q CITY OF TIGARD ELECTRICAL PERMIT
11111- g COMMUNITY DEVELOPMENT Permit#: ELC2013 00457
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2013
Parcel: 1 S134AD05000
Jurisdiction: Tigard
Site address: 10826 SW 108TH CT
Project: Byers Subdivision: BLACK BULL PARK Lot: 29
Project Description: Replace panel and add/alter(3)branch circuits.
Contractor: OWNER Owner: BYERS, STEPHEN J.
10826 SW 108TH CT
TIGARD, OR 97223
PHONE: PHONE: 503-887-2333
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 08/05/2013 $100.70
Specifics: amps or less
3 crt Branch Circuits w/Purchase 08/05/2013 $22.26
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 08/05/2013 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137.72
Required Items and Reports(Conditions)
This permit is ' ed—snbje t to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done ' accordance with .roved 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 -•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 -001-0010 th ugh OAR 952-0%1-0'•0 u may obtain a copy of the rules or direct questions to OUNC by calling 503.23 1987 or 1.8 .332.2344.
ssued By: ' \ �� Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on prope• •wn which is not'. •for sale,lease or rent.
OWNER'S SIGNATURE �_ Date: /6//
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 OFFICE USI ONLY
RECEIVED Received ,/
City of Tigard DateB : 4211 �� Permit No.: �'4,e ap`f-00 Vs-7
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
' C Phone: 503.718.2439 Fax: 503.598.19(� 5 2 013 DateB : Other Permit:
1'I c A K D Inspection Line: 503.639.4175 Date Ready/By: Juris. ® See Page 2 for
Internet: www.tigard-or.gov crrYOFTIGARD Notified/Method: Supplemental Information
TYPE oF1agINGDn1ISION 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 stones.
❑ 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 El 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
El Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","I-3",
Job no.: Job site address: 10826 SW 108th Ct. 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97223 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name:BYERS ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:SW North Dakota to SW 106th to Description I Qtr. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
SW Black Diamond Way to 108th Ct. Includes attached garage.
Subdivision:Black Bull Park Lot no.:29 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: 1S134AD05000 Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
Replace Federal Pacific electrical panel with modern 200A panel,Add 240V outlet residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
for shop equipment&fix sub-standard wiring from previous owner in garage area Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER ❑ TENANT 200 amps or less I 100.70 100.70 2
201 amps to 400 amps 133.56 2
Name:Stephen J.Byers 401 amps to 600 amps 200.34 2
Address: 10826 SW 108th Ct. 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts I 552.26 2
City/State/ZIP:Tigard,OR 97223 _ Temporary services or feeders installation,alteration,and/or
Phone:(503)887-2333 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.;ent,OP exchangeqc ording to ORS 447,449,670,and 701.
401 amps to 599 amps 1 68.54 2
Owner signature:`— �,a �%"1iti ji +-- Date: i ,� %' ; Branch circuits—new,alteration,or extension,per panel
E3,-API LICANT/ r ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 3 7 42 22.26 2
Business name: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first
branch circuit 56.18 2
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: 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(I hr min) 66.25/hr
City/State/ZIP: 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('/z hr min) I
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 122.96
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): 14.76
Authorized signature: ` TOTAL PERMIT FEE: 137.72
This permit application expires if a permit is not obtained within 180
Print name: PEEN 'ye n S Date: S/20/35 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
❑ 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
n Heating, Ventilation and Air Conditioning OAR 918-309-0040)
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
Inspections for which no fee is 90.00/hr
specifically listed(V: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.
❑ 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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