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Permit CITY OF TIGARD ELECTRICAL PERM �i Pe rmit # ELECT ELC20 - 00 7 55 IT COMMUNITY DEVELOPM Date Issued: 12/30/2013 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 15 30/20/ 0902 Jurisdiction: Tigard Site address: 10200 SW 90TH AVE Project: DENT Subdivision: STEWART - MCCORMIC ACRES Lot: 9 Project Description: Reconnect only. Contractor: OWNER Owner: DENT, MICHAEL MICHAEL DENT 10200 SW 90TH AVE 10200 SW 90TH AVE TIGARD, OR 97223 TIGARD, OR 97223 PHONE: PHONE: 503 - 841 -3051 FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 12/30/2013 $67.84 Specifics: 1 ea 12% State Surcharge - 12/30/2013 $8.14 Electrical Type of Use: SF Class of Work: ALT 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 Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR • -.:1 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: P Permittee Signature: OWNER INSTALLATION ONLY The installation is being m eon property I ow hich is not intendec/or sale, lease or rent. F�E OWNER'S SIGNATU, !✓ = // Date: J Y. L .3 0 r;.-0 I 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 ` , � IOItOr1.1( 1 l ,,I 0.1.\ \`► Received City of Tigard DateB : f �� Permit No.: -2- _ _ _ y • 'I 13125 SW Hall Blvd., Tigard, OR c Plan Review • Phone: 503.718.2439 Fax: 503. q / O '�Q1 Date/By: Other Permit: i `h I Inspection Line: 503.639.4175 ` 3 Date Ready/By: Juris: ® See Page 2 for Internet: www.tigard-or.gov 1S)-C" ^� � ` GPRO Notified/Method: (. Supplemental Information TYPE OF WO ' V "NW PLAN REVIEW 003 Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction El Addition/alterat t��ent ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition 181 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 ❑ 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 ", "1 -2 ", "1 -3 ", Job no.: ob site address: ) 7�p.� c 100HP or more. occupancy. lQ J 1 C_ ❑ occupancy. arks. { Six or mo residential units. p City/State /ZIP: I (�ap 0 (A) 9 O 1 4 L . ( a //�� ❑ Health care facilities. 0 Supply voltage for more than t U ❑Hazardous locations. 600 volts nominal. Suite/bldg. /apt no.: Project name: v 1 . ❑ Service or feeder 600 amps or more. 111 FEE SCHEDULE Cross street/directions to job site: Description I Qtr. I Fee. I Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 168.54 4 Ea. add' 1 500 sq. ft. or portion 33.92 1 Tax map /parcel no.: Limited energy, residential DESCRIPTION OF WORK (with above sq. ft.) 75.00 2 1 Limited energy, multi - family 75.00 2 it CO 11h �t� \ 0 v, ` \.] residential (with above sq. ft.) 1 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: Mt c� n. r y 1 1 ,n „. 401 amps to 600 amps 200.34 2 Address: ' *,6 v s 9 041” n 601 amps to 1,000 amps 301.04 2 fir 1,000 amps or volts 552.26 2 City/State /ZIP: -v 1 r f AI 22 Temporary services or feeders installation, alteration, and/or Phone: (5 0 -9 _ (_ .3 r ( : ( ) relocation `� 200 amps or less 59.36 1 Owner installa ' n: This installation is being made n property that I own which is not 201 amps to 400 amps 125.08 2 intended for sti lease, ren - xch: , according ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2 Owner si a ture� Date: 1,p 13 Branch circuits - new, alteration, or extension, per panel ❑ APP I ❑CONTACT PERSON A. Fee for branch circuits with above service or feeder fee, 7.42 2 Business n each branch circuit ( B. Fee for branch circuits without Contact name: ( - - service or feeder fee, that 56.18 branch circuit Address: Each add'l branch circuit 7.42 r [ 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 Z2 fil 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 (1 hr min) 66.25/ hr City/State /ZIP: Investigation (1 hr min) 66.25/ hr Phone: ( ) I Fax: ( ) Industrial plant (1 hr min) 78.18/ hr Inspections for which no fee is CCB Lic.: ,./ Electrical Lic.: I Suprv. Lic.: specifically listed (Y2 hr min) 90,00 / hr ELECTRICAL PERMIT FEES _ Suprv. Electrician signature, r: t uired: Subtotal: ` ( p 7.1- Print name: I Date: Plan review (25% of permit fee): — State surcharge (12% of permit fee): r, /y Authorized sign... � TOTAL PERMIT FEE: -75 f •`s • This permit application expires if a permit is not obtained within 180 Prin _��rtt - Date: j, f 1 days after it has been accepted as complete. 'MEOW" • Number of inspections allowed per permit. I: 1Building\ Pamirs\ELC_PennitApp_ELR_ERE.doc Rev 05 /21/2013 440.4615T(I1/05 /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 Qtv. 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 2 111 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 1=1 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 LI Vacuum Systems* >100 kva— no additional charge 0.0 3 Each additional inspection over allowable in any of the above: 1 1 1 Other: Each additional inspection is charged at an hourly (1 hr min) 66.25/ hr I Inspections for which no fee is 90.00/ hr specifically listed (' /] 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 it 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 El Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical El Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1 :\ Buildin Permi ts\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 10200 SW 90TH AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal 2013-12-31 00:00:00 ELC2013-00755 FAIL Nobody on site at 12:20 phone number will not accept incoming calls??? Left written copy on site Violation Summary: Inspector Contractor