Permit CITY OF TIGARD ELECTRICAL PERMIT
° • COMMUNITY DEVELOPMENT Permit#: ELC2013-00578
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2013
Parcel: 2S102DD02300
Jurisdiction: Tigard
Site address: 8543 SW MERLYNE CT
Project: EDSON Subdivision: FINLEY PARK Lot: 7
Project Description: Reconnect only.
Contractor: Owner: EDSON,MATTHEW S
REINHARDT,ALYSSA A
8543 SW MERLYNE CT
TIGARD,OR 97224
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 09/26/2013 $67.84
Specifics:
1 ea 12%State Surcharge- 09/26/2013 $8.14
Electrical
Type of Use: SF
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75.98
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 Cen . Those rules are set forth in OAR
952-001-0010 through OAR 95 -001-0090. You may obtain a co• • •-rul=questions to OUNC by calling 503.23 JJ.r:•;.-
Issued By: . Permittee Signature: /_�'�
/-
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 site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
•
Electrical Permit Application hole OFFICE USE ONLY
City of Tigard eceived
Vol)1,11 DateB f/ Permit No.: DLO Cr 7,
u 13125 SW Hall Blvd.,Tigard,!1'1!,t Plan Review
C ' Date/By: Other Permit:
Phone: 503.718.2439 Fax: S i,:,j,,: .' t y:
;1 I c].�! D Inspection Line: 503.639.4175 6 `tO13 Date Ready/By: Jaris: ® See Page 2 for
Internet: www.tigard-or.gov C��Q Notified/Method: Supplemental Information
' . TYPE OF rWO *'�r�N p_ PLAN REVIEW .
Cl New construction El Addition/alP� hient Please check all that apply(submit 2 sets of plans w/items checked below):
'l ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: V.3 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.
0 Addition of new motor load of ❑"A","E","1-2","1-3",
(� .^ I00HP or more. occupancy.
Job no.: Job site address: gs / 5 st✓ M"1 ed)/tip �. ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: I--; (/ I ❑Health-care facilities. ❑Supply voltage for more than
CA 2�/ ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: --Project-name: - — ❑Service or feeder 600 amps or more. -
r, _. FEE SCHEDULE
Cross street/directions to job site:
N CI I -1-1.;. FC '1'' C) Cr Ce K J Description I Qty. I Fee. I Total I •
q / New residential single-or multi-family dwelling unit.
1
/"\J... C - 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
•
. -DESCRIPTION OF WORK • (with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
>:`CL C0D RQCDlnNec4-- •'S lec4t0•-.h residential(with abovesq.ft.) - _ __
S� Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
gPROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2_
^ 201 amps to 400 amps 133.56 2
Name: V�c�j +(��� 1�� /� 401 amps to 600 amps 200.34 2
Address: 1 S l3 v S i. ' L 'e -�✓tn f,,S.4-� UJ 4- 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: —^�'c j,_<7( 0 ILL `I - ,,1y Temporary services or feeders installation,alteration,and/or
Phone:( 561-,.;) L! 5 q — 9_6 y e 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 . ' ' 1111 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 6-z fly 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
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 Lie.: Suprv.Lie.: specifically listed(%2 hr min)
•_ ELECTRICAL PERMIT:FEES - -
Suprv.Electrician signature,required: Subtotal: (p?,.'J
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): $`-• /y
Authorized signature: / TOTAL PERMIT FEE: -7S,' r
Print name: Date:7/2,6A This permit application expires if a permit is not obtained within 180
jpv, 7/ /// 13 days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440.46151(1I/05/COM/WEB
•
Electrical Permit Application–City of Tigard
Page 2–Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees::
•
fe?RESIDENTIAL.WORK,'ONLY: . , '. . . ',. FEE'SCHEDULE.: . ;,+<.a;a , $, :,
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 1
k__
❑ Audio and Stereo Systems*
15.01 to 25,kva 200.34 2
,i
ElAlarm 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 j
' >100 kva(fee in accordance with 552.26 2 i
❑ Heating,Ventilation and Air Conditioning
OAR 918-3o9-ooao) ;�.
System* Solar generation'systems in excess of 25 kva:
Each additional kva over 25 742 3`
❑ Vacuum'SyStems* >100 kva—no additional charge 0.0 3 •
I=1 Other: additionalinspection 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 y
specifically listed(%z hr min).' 90.00/hr
COMMERCIAL'WORK ONLY: , • . , . ' - iELECTRICAL,PERMIT FEES ':.V. 7?;
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 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 i
❑ Intercom and Paging'Systems
❑ Landscape Irrigation Control*' .,
❑ Medical
•
❑ Nurse Calls .)
❑ Outdoor Landscape.Lighting* •
r
❑ Protective Signaling
❑ Other
Total number of commercial systems: —
*No licenses are required. Licenses are required f
for all other installations
I:\Building\Penults\ELC_PennitApp_ELR_ERE.doc Rev 05/21/2013
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