Permit p CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00196
13125 SW Hall Blvd.,Ti Date Issued: 04/28/2014
c1,��F and OR 97223 503.718.2439
T[ .C� 9
Parcel: 1S125DB02400
Jurisdiction: Tigard
Site address: 7280 SW TAYLORS FERRY RD
Project: Marquardt Subdivision: BOULEVARD HEIGHTS Lot: 4
Project Description: (1)branch circuit to reconnect furnace
Contractor: CARRICK INC Owner: MARQUARDT,JOHN R&CHERYL R
4875 NW KAHNEETA DR 16165 SW SHELTON ST
PORTLAND, OR 97229 BEAVERTON, OR 97007
PHONE: 503-708-0836 PHONE:
FAX: 503-645-8273
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 04/28/2014 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/28/2014 $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 a 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
days. A NTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those •e are set forth i •AR
952-0 -0010 through OAR 952-0 -009 -You may obtain a co y of the rules or direct questions to OUNC by calling 503.2 '87 or :00.3
Iss ed By: Permittee Signature:
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' ='' F'-7r• _ 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 _,EIVEh FOR OFFICE USE ONLY
City of Tigard Daisy a� G ,v� f 1-Cf '�l QlG
Permit No.:
13125 SW Hall Blvd.,Tigard,OR �� t. g 2014 Plan Review y� / G
I Phone: 503.718.2439 Fax: 503.5•:.1 Date/By: '�Pefm't' !(EL, %/�/'�14`O
TIGARD Inspection Line: 503.639.4175 Date Ready/By- funs: H See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method Supplemental Information
TYpiibill bRX DIVISION PLAN REVIEW
❑New construction ®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 ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of
❑"A" "E" "1-2" "1-3"
Job no.: Job site address:7280 SW Taylors Ferry Rd 100HP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard ❑Health-care facilities. ❑Supply voltage for more than
❑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 tom. 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 4
Ea.add'l 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
Limited energy,multi-family 75.00 2
Reconnect Furnace 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 2
201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to L000 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 ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
7.42 2
Business name:Same as Contractor each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first 1 18
56.18 56. 2
branch circuit
Address: Each add'1 branch circuit 7.42 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:Carrick Inc Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 _ 2
Address:4875 NW Kahneeta Dr Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:Portland OR 97229 Investigation(1 hr min) 66.25/hr
Phone:(503)708-0836 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/hr
CCB Lie.: 120169 Electrical Lic.: 34-439c ' Suprv.Lie.: 22955 1 `� specifically listed('i,hr min)
t` ELECTRICAL PERMIT FEES
Suprv.Electrician signature,r\uired: I Subtotal: 56.18
Print name: Doug Carrie. Date: 4/25/14 Plan review(25%of permit fee):
State surcharge(12%of permit fee): 6.74
Authorized signature: i TOTAL PERMIT FEE: 62.92
Print nam Y .� Date: J This permit application expires if a cc pte is as not obtained within 180
e_�\s�`"y days after it has been accepted as complete.
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 Doortnr. I Qty. I Foe I Total I •
Renewable electrical energy systems:
Check Type of Work Involved: 5 lrva 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
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
❑ 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
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is
90.00/hr
specifically listed(Vi 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 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
❑ 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
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
7280 SW TAYLORS FERRY RD, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
2014-04-29 00:00:00
ELC2014-00196
PASS - No C of O
Violation Summary:
Inspector Contractor