Permit II q CITY OF TIGARD
I 4 ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT • Permit#: ELC2014-00018
TIGARD 13125 SW Hall Blvd.. Tigard OR 97223 503 718.2439 q7441,4/ Date Issued: 01/13/2014
Parcel: 1S134DB12600
Jurisdiction: TIGARD
Site address: 11285 SW FOREST LN
Project: Home Investment Services Subdivision: 2008-038 PARTITION PLAT Lot: 1
Project Description: (7)branch circuits for remodel. 1/22/14. Reprinted to add(1)panel and(5)more branch circuits.
Contractor: CASCADE ELECTRIC Owner: HOME INVESTMENT SERVICES LLC
15035 NE OREGON ST BY BRADEN, JOHN N
PORTLAND. OR 97230 1102 N SPRINGBROOK RD STE 113
NEWBERG. OR 97132
PHONE. 503-998-1301 PHONE
FAX: 503-764-9172
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 01/13/2014 $100.70
Specifics: amps or less
12 crt Branch Circuits w/Purchase 01/22/2014 $89.04
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 01/22/2014 $22 7
Electrical
Type of Const:
Occupancy Grp:
Total S212 51
Required Items and Reports(Conditions) i
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 i• -ccordance • approved plans This permit will expire if work is not started within 160 days of issuance, or if work is suspended for more the 180
days. • TENTION: Oregon law r••• • • you to follow the rules adopted by the Oregon Utility Notification Center. Thos- ules are set forth in OAR
952-00 -0010 thro •h OAR 952-00 ,r90. obtain a copy of the rules or direct questions to OUNC by calling 503 232 1987 or 1 y.0 i 344
4/ , / k
Issue. :y: ! ii Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale.lease or re't
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 %.i Iwv
� FOR OFFICE USE ONLY
Received
City of Tigard q c�ti0\N Date/By: l J�AA/ Permit No.: E o�j/it"tX,i j
i 13125 SW Hall Blvd.,Tigard,OR 97223\NN P Plan Review /
Phone: 503.718.2439 Fax: 503.598.196W- G t■I Date/By: Other Permit:
Inspection Line: 503.639.4175 +f �j'1l lQl Date ReadyBy: Luria: ® See Page 2 for
Internet: www.tigard-or.gov (`�i\7 W4 1 Notified/Method: Supplemental Information
TYPE OF WQ( % ' PLAN REVIEW
❑New construction El 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 stories.
❑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 ['Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder El 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","I-2","I-3",
/ I I00HP or more. occupancy.
/
Job no.: Job site address: / p?65 ski 7_,-bt �7c Lam/ ❑Six or more residential units ❑Recreational vehicle parks
City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: /trj ,,_42. T '`y rJ�„ �/. ❑Service or feeder 600 amps or more
L1J .i�Y ��� FEE SCHEDULE
Cross street/directions to job site: S--e-ez/c–eS Description I Qn• 1 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'I 500 sq.ft.or portion 33.92 I
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 7500 2
C4,./1 (c-) C1 j� -rs �/) �C! residential(with above sq.ft.)
�l"t (J 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 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) 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: C a )c c1_c(-Q,_. C- 1 each branch circuit
B.Fee for branch circuits without
Contact name: rykt, \.e 4' A 1.`p A.5 cA service or feeder fee,first
branch circuit 56.18 2
Address: 1 s 4935-- ft)& ()I e9�y1 Each add'I branch circuit 7.42 2
City/State/ZIP: f OAT 062 lC71 Z 3 C] Each manufactured(service u aeeder not included)
Each manufactured or modular 67.84 2
Phone:(5O ) l ct 46 —13 J 1 Fax: :(593 ) 7 (,,t/_9 ii Z 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: (,,rte-)Cc.C( 2 1.e- L Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: 1 j U 3 S rU , o (-.2q 0, , 'g 4 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: 4,.rr9 f M Investigation(1 hr min) 66.25/hr .
Phone:( ) i/, Li Fax:( r– Industrial plant(1 hr min) 78.18/hr .
LC Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical ' . Suprv.Lic.: specifically listed('/t hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,r it • Subtotal: _
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I.\Building\Permits\E1.C_PmnitApp_ELR_ERE.doc Rev 05/21/2011 440-4615T(11/05/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 Descripti0n 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
CI 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 66.25/hr
charged at an hourly(I hr mm)
Inspections for which no fee is 90.001 hr
specifically listed('/2 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 alter 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
1:1BuildinigermitslELC_PmnitApp_ELR_ERE.doe Rev 05/21/2013
INv
OF TIGARD ELECTRICAL PERMIT
8 COMMUNITY DEVELOPMENT Permit#: ELC2014-00018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01!1312014
Parcel: 15134DB 12600
Jurisdiction: TIGARD
Site address: 11285 SW FOREST LN
Project: Home Investment Services Subdivision: 2008-038 PARTITION PLAT Lot: 1
Project Description: (7)branch circuits for remodel
Contractor: CASCADE ELECTRIC Owner: HOME INVESTMENT SERVICES LLC
15035 NE OREGON ST BY BRADEN, JOHN N
PORTLAND,OR 97230 1102 N SPRINGBROOK RD, STE 113
NEWBERG, OR 97132
PHONE: 503-998-1301 PHONE:
FAX: 503-764-9172
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo/Purchase 01/1312014 $100.70
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/13!2014 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112 78
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained on the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in -. •. .ith 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. • NTION: Orego law -•• =s you to follow the rules adopted by the Oregon Utility Notification Center. Tho.- rules are set forth in •AR
952-0' -0010 through OAR 952-1 0090.•may obtain a copy of the rules or direct questions to OUNC by calling!503.232.1987 o f8r'.3 2.2344 f /
Is.ued By: 4. /e..L /LIE�lLL _ ' Penn ittee Signature: c
OWNER INSTALLATION ONLY
The installabon is being made on properttyy�/,II own which is on _•for sale.I- - or ren J �i
OWNER'S SIGNATURE C' i 1- / ' Date: /1/4 7
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 Applicati0 I FOR OFFICE IISE ONLY
ill City of Tigard i ��� Received ( f Permit No.:fit, UJ -(mil
Date/By: ` �v� a
L3125 SW Hall Blvd.,Tigard OR 9722 1 3 2014 Plan Review
Phone: 503.718.2439 Fax: 503.598. Ilate/By: Other Permit:
Date Ready/By:
Inspection Line: are 503.639.4175 GIB,OF TIGA�D 'fied/Method: Juria 0 kmmt.l Information
Internet: ►nvw.tigard-or.gav Pp
TYPE 0014011QING D1VISiOV pLAN REVIEW
❑New construction O Addition/alteration/replacement Please check all that apply(submit j sets of plans w/items eheeked below):
❑Service or feeder 400 amps or more ❑Building over three stories.
C]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
V[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 ❑Addition of system. larger separately derived system.
❑Addition of new motor load of ❑"A" "6" "1-2" "1-3"
Job no.: Job site address: I OOH?or more. occupancy.
' ry r ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: r--1'~"pk t 0 it i to( 5 &to i P r ❑Health-care facilities. ❑Supply voltage for more than
❑I lazardous 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: Beacrtoiloa I Qty. 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'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.:
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above so.ft.) .
( "' Limited energy,mold-family
per. 06. 0-p- �Ov��j{� residential(with above sq.ft.) 75.00 2
Renewable Energy _ ❑ See Page 2
Services or feeders installationLalteratlon,and/or relocation
❑ PROPERTY OWNER I Q TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2-
Name: tkores,e ",0 Gh'4- ' Q.,/".4'i CC-5 401 amps to 600 amps 200.34 2
t _ + - 601 amps to 1,000 amps 301.04 2
Address: 1 , �v7-� 5 I►.,x. R.a O r� �i7't'e� ps ps .
-1-1-.14 t Over 1,000 amps or volts 552.26 2
City/State/ZIP: 0 i 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 123.08 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
18 APPLICANT I ❑ CONTACT PERSON A Fee for branch circuits with
el above service or feeder fee, 7 42 2
Business name: QtS Ca.t1 Q 1 "j e.,+ each branch circuit
B.Fee for branch circuits without
Contact name: ki-11 e ,)(,(,$(.)-, service or feeder fee,first ' 56.18 544 e• 2
branch circuit
Address: ( D$5 L)L 0 r e9 i y\ deo-V , Each add'/branch circuit CO 7.42 '444-5 2 2
City/State/ZIP: par c YN-,4 v 12 91 z..3 ii Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
Phone: ) °, 9 cif-- t 3 0 I Fax::(503)1 bq —cf)-71, dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR ' Sign or outline lighting 67.84
Business name: ( c,cc. roe .,,Q t c Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: 1 5 0 35 /,1€ 6{e9,..„, 44, Each additional inspection over allowable in any of the above
City/State/ZIP: Q of t .yCJt a. 11230 Investigation gati inspection(1 (I hr min) 66.25/hr
Investigation(]hr mm) 66.251 hr
Phone:6 )9`l$--;3 a I Fax:6°3 y7 4y-4 17 'Z,- Industrial plant(1 hr min) - 78.181 hr
Inspections for which no fee is 90.401 hr
CCB Lic.: ((t blf(r , I Electrical Lic.: (+ 61 Suprv.Lic.: 10/42 5 specifically listed(Vs hr mm)
Suprv_Electric an si tame,required: 71,I'y /a/,bee . � PERMTI' FEES .
Subtotal: 1 QQ a`1 0
Print name: l Plan review(25%of permit fee):YV�yC• 11 �t Date: 1 113 : 1
�l�,' (7/FL State surcharge(12%of permit fee): /X-rig
Authorized signature:-1')- TOTAL PERMIT FEE: 1/�,. .7e.
Print name: � //�"! �, J u S Date: J I This permit application expires if a permit is not obtained within ISO
l r f 3, (� days after it has been accepted as complete.
• Number of inspections allowed per permit
r'Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 0$/2112013 4444613T(11/05/COM/WFB
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 Q4. 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
n 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
Ti Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
[1] 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(1 hr mm) 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 ISO
❑ Audio and Stereo Systems days after it has been accepted as complete.
' Number of inspections allowed per permit
❑ Boiler Controls
7 Clock Systems
I I Data Telecommunication Installation
7 Fire Alarm Installation
❑ HVAC
I Instrumentation
n intercom and Paging Systems
❑ Landscape Irrigation Control*
7 M• edical
❑ Nurse Calls
❑ O• utdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:1BuildingSPermitsSELC PermitApp_ELR_ERE.doc Rev 05f21r2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11285 SW FOREST LN, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00018
Herb Stabenow
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10865 SW WALNUT ST, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00184
Chip Barnett
Violation Summary:
Inspector Contractor