Permit CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: ELC201300751
T t G A R L) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/24/2013
Parcel: 2S104DD02200
Jurisdiction: Tigard
Site address: 12858 SW RIDGEFIELD LN
Project: WRIGHT Subdivision: MOUNTAIN HIGHLANDS NO.2 Lot: 19
Project Description: (1) branch circuit for hot tub.
Contractor: BENTLEY ELECTRIC INC Owner: WRIGHT, CHRISTOPHER B & SUSAN L
41330 SW EDNA LANE 12858 SW RIDGEFIELD LN
GASTON, OR 97119 TIGARD, OR 97223
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PHONE: 503 - 789 -4229 PHONE:
FAX: 503 - 985 -9595
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 12/24/2013 $56.18
Specifics:, Service or Feeder
1 ea 12% State Surcharge - 12/24/2013 $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 Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 -001 -0090. You may obt ...' • • • • • =i ' =s • • -ct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. c
Issued By:f Permittee Signature:
j
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.
Dec 24 13 12:06p Bentley Electric, Inc. 5039859500 p
1
Electrical Permit Application r( lit OFFICE USE ONLY
City of Tigard
• 13125 SW Hall Blvd. ,Tigard, OR 97 CEIVV Date/By; ti J. I ? e .T Permit Na.. � /3 _ov Icy
I N
C Plan Review
Phone: 501718.2439 Fax: 503.598. Dine/By: Permit:
TI G A r D Inspection Line: 503.639.4175 Date Ready,By: hair ® See Pane 2 for
Internet ww.tigard or.gov D EC 2 4 7-013 Notified/Mothod - �� a I Supplemental ft
W
TYPE OF WORK►
• PLAN REVIEW
ritrta0 O Please check all that apply (submit Z sets of plans w:'ittm; shacked bcln I
0 New construction ® Addjtion/alterati
12 Demolition 0 Other:
1. p�V1S ❑ Service cr feeder 400 amps or more ❑ Braiding over three stories. i
e' '' {� where the available ;suit current ❑ Marinas sent boatyards.
CATEGORY OF CONVIAvs.r ON exceeds 10,000 amps iii 150 volts or ❑ Floating buildings
.
® 1- and 2 famil dwelling less to ground. or eexeds [4,000 0 Commercial-use agricultural
5 0 Commerciallindustrial 0 Accessory building maps for all other installations buildings.
❑ Multi- family 0 Master builder 0 fro
Other: ❑: 1nP ❑ Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larder separately derived systan.
DAddihonof motor load of
Job no.: I Job site address: 12858 SW Ridgefield Lane 1001-1P or mom. occupancy
❑ Six or more residential units_ 0 Recreational vehicle, parks.
City!State/Z•IP: Tigard, OR 97223 ❑ Health -care facilities OSupply voltage for more than
❑ hazardous Ic cation s. 600 volts nominal,
Suite/bldg./apt. no.: I Project name: Wright 0 service of (ceder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE
Deli rlPltan I On. I Fee. I 'foul I
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or le% : 168.54 4
Tax map /parcel no.: Fa. add'I 500 sq. it or portion 33.92 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq ft.) 75.00
Hot tube wiring. Limited energy, multi- famiiv '
residential (with above sq. fl.) 75.!10 '
Renewable Energy 1 0 See Page 2
Services or feeders installation, alteration, and/or relocation
® PROPERTY OWNER 0 TENANT 200 amps or less 100.70 2
Name: Chris Wright 201 amps to 40ri amp 133.56
401 amps to 60G amps 200.34 2
. Address: 12858 SW Ridgefield Lane ^ 601 amps to 1,000 amps 301.04 2
cjty/StateizlP: Tigard, OR 97223 Over 1.000 snips or volts 552.26 2
Temporary services or feeders installation, alteration, and/or
Phone: (503)750 -2711 Fax: ( ) relocation
Owner installation: This installation js bein made on m 200 amps or less I [ 59.36 I
g p perty that I own which is nut 201 amps to 400 amp, I 125.08 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
401 amps to 599 amps 1 i 168.54 r 2
Owner signature: Dale: Branch circeits — new, alteration . or extension,
per panel
® APPLICANT i 0 CONTACT PERSON A. Fee for branch circuits with I ( `
above service or feeder fee,
Business name: Bentley Electric, Inc. each branch circuit 7.42
B. Fee for branch circuits without
Contact name: Jay Bentley service or feeder fee, first , I e 56.18 ,
Address: 41330 SW Edna Lane branch circuit -
Each addl branch circuit I 7 42 2 •
City/State!ZIP: Gaston, OR 97] 19 Miscellancoas (service or feeder not included)
Each manufactured or modular
Phone: (503) 789 - 4229 I Fax: : (503) 985 - 9595 dwelling. service and /or feeder 67.84
E -mail: jay@.bentleyeIeetricinc.com Reconnect only 67.84 2
Pump or irrigation circle 67.84 .
CONTRACTOR Sign or outline lighting 67.84 2
Business name: Bentley Electric, Inc. Signal ti ICU iI( a)or limited - energy See 1
Address; 41330 SW Edna Lane . panel. alteration, or extension. Pag 2 J 2
Each additional inspection over allowable in any of the above '
City/State/ZIP: Gaston, OR 97119 Additional inspection (I hr min) 66.25/ hr
Phone: (503) 789 -4229 I fax: (503) 985 - 9595 Investigation (1 hr min) 66.25/ hr
CCB Lie.: 44467 I Electric I Lic.: 2 Suprv, Lic.: 3635S • Industrial plant (I hr min) 78.18! hr
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Supra'. Electrician signature, require d' I`'ry Inspections for which no fee is i I
7 specifically listed (Si hrmin) ( 90.00/hr
Print name: James Powell i Dale: 12/24/13 ELECTRICAL PERMIT FEES 111
ffff Subtotal: I 56.18
Authorized signature: Plan review (25% of permit fee): .
Print name: Slate surcharge (12% of permit fee): 6.74
I Date: TOTAL PERMIT FEE: + 62.92
1:lBuitdnikPerr itidELC- PermitApp_r1R_EREdoe Rev OS,2t/2e13 440.161 ST(11A75/COM/WE9
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12858 SW RIDGEFIELD LN, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
2014-01-03 00:00:00
ELC2013-00751
PASS - No C of O
Violation Summary:
Inspector Contractor