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Permit CITY OF TIGARD ELECTRICAL PERMIT II II • COMMUNITY DEVELOPMENT Permit#: ELC2013-00640 T I G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718 2439 Date Issued: 10/24/2013 Parcel: 1 S 134ACO2646 Jurisdiction: Tigard Site address: 11040 SW COTTONWOOD LN Project: SWEARINGEN Subdivision: ENGLEWOOD NO.3 Lot: 212 Project Description: (1)branch circuit for hall bathroom remodel Contractor: ANCHOR ELECTRIC INC Owner: SWEARINGEN, LARRY PO BOX 16123 ROBERTA PORTLAND, OR 97292 11040 SW COTTONWOOD LN TIGARD,OR 97223 PHONE: 503-201-7123 PHONE. FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 10/24/2013 $56 18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 10/24/2013 $6 74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 en.-r. Those rules are set fo b•R 952-001-0010 through OAR 952-001-0090 You may obtain a copes he rules o • •-ct questions to OUNC by calling 503 32 198' or 1 800. • .2344 At/ • Issued By>! _• </ Permittee Signature: /_ .4 _ _A �i/ Ailloppd,411- 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 site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application ' ,, . _FO OFFICE tSE.O LY_ - _ii. Cl of Tigard } Received f _•J g r A \\!4:1�-c� Date/B /v 1 �� Permit No _ ,L n 13125 SW Hall Blvd,Tigard,O R /;-Jr. L Plan Review - ' 9 ._ Phone. 503.718 2439 Fax: 503.58. 60' ��13 Date/By. Other Permit it i Ci A RD Inspection Line 503.639.4175 � Date Ready/By tuns El See Page 2 for Internet: www.tigard-or.gov O r j N' Notified/Method. .Cy Supplemental Information TYPE OF WOlt10 Jr 11.01 iA0P‘ • PLAN REVIEW• �,� 'x.•56 �Z '�t�°` Please check all that apply(submit 2 sets of plans w/items checked below) ❑New construction gddition/altera epic ent liW/I''''' ❑Service or feeder 400 amps or more ❑Building over three stories ❑Demolition ❑Other: where the available fault current ❑Mannas 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 ,-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","l-2","1-3", Job no.: Job site address: ``b S(�t/ Six or or more occupancy �t1/ ]�1`�1C ❑Six or more residential units ❑Recreational vehicle parks City/Slate/ZIP: �j �Z5 / 1 ❑Health-care facilities ❑Supply voltage for more than (. A Hazardous locations 600 volts nominal Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more FEE SCHEDULE Cross street/directions to job site: 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 1_4 Ea add'I 500 sq ft or portion 33.92 1 Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK / l ' (with above sq ft) 75 00 2 �� " Limited energy,multi-family — . �.t (�-"G residential(with above sq ft.) 75.00 2 Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100 70 2 201 amps to 400 amps 133 56 2 Name: 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 12 City/State/ZIP: Temporary services or feeders installation,alteration,and/or Phone:( ) I 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 I ❑ CONTACT PERSON A Fee for branch circuits with above service or feeder fee, 7 42 2 Business name: each branch circuit 13.Fee for branch circuits without Contact name: service or feeder fee,first ( / branch circuit ( 56 18 4 2 Address: Each add'I branch circuit 7 42 I2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67 84 2 Phone:( ) I Fax: :( ) dwelling,service and/or feeder Reconnect only 67 84 2 E-mail: Pump or irrigation circle 67 84 2 CONTRACTQc R Sign or outline lighting 67 84 2 Business name: nGh". / ^'G Signal circuit(s)or limited-energy i See /� r"" ✓ panel,alteration,or extension Page 2 2 Address: /g g, aD� / 2-3 Each additional inspection over allowable in any of the above _ City/State/ZIP: ,,4 /,1 l �j�� /- Additional inspection(1 hr min) 66 25/hr (/ / l !/ Investigation(I hr min) 66 25/hr Phone:0 47' ." Fax:( ,.----r' Industrial plant(1 hr min) 78 18/hr r't! •' Inspections for which no fee is 90 00/hr CCB Lie. / Suprv. W specifically listed(%s hr min) Suprv.Electrician signaturr t ELECTRICAL PERMIT FEES _ d//�� A Subtotal: - . (8' Print name:_ �,�/ �,�r`�/.� Date: d Plan review(25%of permit fee) — State surcharge(12%of permit fee): 6.7y Authorized signature: ` / TOTAL PERMIT FEE: 6,a..'1)— �� /P'— This permit application expires if a permit is not obtained within 180 Print name: �/ • days after it has been accepted as complete. • Number of inspections allowed per permit 1\Budding\Permits\ELC_PermitApp_ELR_ERE doe Rev 05/21/2013 440-4615T(I I/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 Qtr. 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 El 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 918-309-0040) 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 ElOther: additional inspection over allowable in any of the above: Other: Each additional inspection is charged at an hourly(I hr mm) 66 25/hr I Inspections for which no fee is 90 00/hr specifically listed(V5 hr mm) 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 ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El 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 I\Budding\Permits\ELC_PermitApp_ELR_ERE doc Rev 05/21/2013 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 11040 SW COTTONWOOD LN, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal 2013-12-11 (null) ELC2013-00640 PASS - No C of O Violation Summary: Inspector Contractor