Loading...
Permit CITY OF TIGARD ELECTRICAL PERMIT 511 s COMMUNITY DEVELOPMENT 1 t Permit#: ELC2014 00030 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 �� Date Issued: 01/22/2014 Parcel: 2S 111 C 800200 Jurisdiction: Tigard Site address: 14915 SW 103RD AVE Project: KEENEY Subdivision: DEL MONTE SUBDIVISION Lot: 1 Project Description: Installing(4)branch circuits.2/27/14:Corrected project description and reprinted permit. Contractor: OWNER Owner: KEENEY, CHARLES&ROXANNE CHARLES KEENEY 14915 SW 103RD AVE 14915 SW 103RD AVE TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 503-913-2959 PHONE: FAX: FEES Quantity Description Date Amount 4 crt Branch Circuits wo/Purchase 01/22/2014 $78.44 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/22/2014 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800 332.2344. 0 1 Issued By: Permittee Signature: ,,Zyri-. 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. _ CITY OF TIGARD ELECTRICAL PERMIT lig C • COMMUNITY DEVELOPMENT Permit U: ELC2014-00030 Date Issued: 01/22/2014 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CB00200 Jurisdiction: Tigard Site address: 14915 SW 103RD AVE Project: KEENEY Subdivision: DEL MONTE SUBDIVISION Lot: 1 Project Description: Gas line for range Contractor: OWNER Owner: KEENEY, CHARLES& ROXANNE CHARLES KEENEY 14915 SW 103RD AVE 14915 SW 103RD AVE TIGARD, OR 97224 TIGARD, OR 97224 PHONE 503-913-2959 PHONE FAX: FEES Quantity Description Date Amount 4 crt Branch Circuits wo/Purchase 01/22/2014 578 44 Specifics: Service or Feeder 1 ea 12%State Surcharge- 01/22/2014 $9 41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total 587 85 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 • . .sate--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 AT NTION. Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those r -- are s forth in OAR 952-001-•010 through OAR 952-001- Y may obtain a copy of the rules or direct questions to OUNC by calling 503 232. 987 or 1 80• - 2344 Issue. =y: ' Permittee Signature: i OWN = -TALLATION ONLY The installation is being made on property I ow which is not int-••-• • sale.lease or rent OWNER'S SIGNATURE ,A /Date: � 7 116,— tt 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 FOR OFFICE USE ONLY City of Tigard ��� Received e ( .t,1 Vii. Permit No.: ��`4 • 'r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review I Phone: 503.718.2439 Fax: 503.5 V DateB : Other Permit: .`+IL(— _ '8 f 1 c;+R ) Inspection Line: 503.639.4175 4 Date Ready/By: r dg s� ® See Page 2 for Internet: www.tigard-or.gov %%1% � Notified/Method: �L Supplemental Information TYPE OF WORK�p.� �NV PLAN REVIEW ❑New construction old Please check all that apply(submit sets of plans w/items checked below) ``ll`"' l�� ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition 0 Other: CSC \G� where the available fault current ❑Marinas and boatyards. CATEGORY OF CONST1 exceeds 10,000 amps at 150 volts or ❑Floating buildings. less to ground,or exceeds 14,000 ❑Commercial-use agricultural (Ell-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 new system. larger E",separately 1- ",derived system. ❑Addition of new motor land of ❑"A",`B","1-2","1-3", Job no.: Job site address: 100HP or more. occupancy. Q ['Six or more residential units. ❑Recreational vehicle parks. Clay/StaIP,/ZIP:� / f� ^� ❑Health-care facilities. ❑Supply voltage for more than 1 ( J L �� S�C�� ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: \e_.,... C A__,,,y_11 ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description 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 I Tax map/parcel no.: Limited energy,residential 75.00 2 DESCRIPTION OF WORK (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation � ,, PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 1_`-_ 201 amps to 400 amps 133.56 2 Name: ��A 'C—\ ` cu.., 401 amps to 600 amps 200.34 _ 2 Address: \ ` C) tit �f 601 amps to 1.000 amps 301.04 2 1 p �1 Over 1,000 amps or volts 552.26 2 1 ` � City/State/ZI —)Z— Temporary services or feeders installation,alteration,and/or Phone:( ) ) relocation 200 amps or less 59.36 1 Owner installation:This installati e. ' . • • ::e e on property that I own which is not 201 amps to 400 amps 125.08 2 intended for sale,lease ',1 t, t cording to O' 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Li 4 �4,`_ Date: 1/ dck Branch circuits—new,alteration,or extension,per panel ❑ APPLICANT ❑ 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 1 branch circuit 56,18 I y 2 Address: Each add'1 branch circuit 3 7.42 2.).?.0 - 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 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 90.00/hr CCB Lie.: Electrical Lie.: Suprv.Lic.: specifically listed(%hr min) - ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: 7r.`l t1 Plan review(25%of permit fee): Print name: Date: State surcharge(12%of permit fee): q•11/ Authorized signature: TOTAL PERMIT FEE: '7. fss`-- 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 tBuildinglPermitstELC_PamitApp ELR_ERE.doc Rev 05/21/2013 440-4615T(11/051COM/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 l Qty. 1 Fee I iotaa • 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 ElAlarm Wind generation systems in excess of25 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 OAR 918-309-0040) ❑ Heating, Ventilation and Air Conditioning System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 7 Vacuum Systems* >IOOkva—noadditionalcharge 0.0 3 ❑ Each additional inspection 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 90.00/hr specifically listed(%]hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system 575.00 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. ❑ Boiler Controls El Clock Systems [1 Data Telecommunication Installation ❑ Fire Alarm Installation [� HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* ❑ Medical El Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 11Building'Permii,'ELC_PermitApp_ELR_ERE.doc Rev 05121/2013 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing per mits. Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not submit this statement.This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date I will inform my general contractor that a II subcontractors who work on the structure must be licensed with the Construction Contractors Board. 0 I will be performing work on property I own, a residence that I reside in, or a residence that I w ill reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this horn eowner statement is true and accurate. it_ 0 )9 .,ec 4_, Print Name of Permit Applicant Signature of Permit -pplicant Date Permit#: f-mad/`7'-000)e-; Address: /III'/5 $Z-' /0 art Issued by: -/ Date: ViA 2�`I_ _ \IIPtl-i: This Copy for Permit Offices