Permit CITY OF TIGARD ELECTRICAL PERMIT
Ill s. COMMUNITY DEVELOPMENT Permit#: ELC2014-00301
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/05/2014
Parcel: 2S111CD04600
Jurisdiction: Tigard
Site address: 15970 SW BRENTWOOD CT
Project: Gattuccio Subdivision: SUMMERFIELD NO.9 Lot: 505
Project Description: Install new panel and branch circuits for interior remodel.
Contractor: LIGHTING ELECTRIC LLC Owner: GATTUCCIO, ROSEANN
PO BOX 890 15970 SW BRENTWOOD CT
WOODBURN,OR 97071 TIGARD,OR 97224
PHONE: 971-338-8989 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 06/05/2014 $100.70
Specifics:, amps or less
8 crt Branch Circuits w/Purchase 06/05/2014 $59.36
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 06/05/2014 $19.21
Electrical
Type of Const:
Occupancy Grp:
Total $179.27
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 -00 960. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 1.800.332.23
Issued 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' 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 1 t 1 I Z ()I l i t I I 'NI ()\I 1
City of Tigard aCC1•`: u/ / 4i. Permit No �'oZQ/g 4031
13125 SW Hall Blvd.,Tigard,OR 97223 _
Phone: 503.718.2439 Fax: 503.598.1960 �. : Other Permit
i I, \f:I, Inspection Line: 503.639.4175 ,._. Date Ready/By: FM B See Page 2 for
Internet www.tigard-or.gov c ; !' Notified/Method:
= ' Sl Information
TYPE OF WORK PLAN REVIEW
❑New construction ddition/alteration/replacernent Please that apply(submit 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.
1-and 2-family dwelling less to ground,or exceeds 14,000 ❑Commercial-use agricultural
y g ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fun 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.: Job site address: 100HP or more. occupancy.
I �5 Sea �ee,ni w�� ��• ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: T‘ ,), / 011ny ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: V ❑Service or feeder 600 amps or more. -
Cross street/directions to job site: Q 1 (Ar FEE SCHEDULE
J 1���1��1J`^Nl \Yl�� Description I Qty. I Fee. I Total I V
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq.ft.or less 168.54 4
Tax map/parcel no.: Ea.add'1500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft)
Limited energy,multi-family 7500 2
— -h}C-ebt t fe ..>att\ L!kPtil residential(with above sq.R)
Services or feeders installationalteration,and/or relocation
91 PROPERTY OWNER I ❑ TENANT 200 amps or less 1 100.70 2
�?
201 amps to 400 amps 133.56 2
Name:
Roc t o,fir\ G4t'I r c►17 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2 Address: 15170 W Akf tf Lao0i C.i.
• Over 1,000 amps or volts 552.26 2
City/State/ZIP: Ti 3qr/ O q72.2_9 Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation I/
--200 amps or less 59.36 I
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps / 4 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 stops 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,perpanel
A.Fee for branch circuits with
❑ APPLICANT I CONTACT PERSON above service or feeder fee, 17 7.42 2
Business name: Q,, each branch circuit
T L '`�w�r�G B.Fee for branch circuits without
Contact name: Tl VNA Lab 1J►,�ck.� service c r�fee,first
56.18 2
Address: QO 6x ` I.i Each add'l branch circuit 7.42 2
City/State/ZIP: �VV (�-, Miscellaneous(service or feeder not included)1 a(,,Q to,etp/ Q 1(2 Each manufactured or modular 67.84 2
Phone:(55e8 ) 9 8 . 273.g3 6 431 Fax::( ) dwelling,service and/or feeder
nn-- 1 Reconnect only 67.84 2
E-mail: TL_t' bMD k 0 7400&W\ Pump or irrigation circle 67.84 2
I CONTRACTOR Sign or outline lighting 67.84 2
Business name: Lr..: �C c---r L (i Signal circuit(s)or limited-energy See
'K /P C.! T r L ` panel,alteration,or extension. Page 2 2
Address: I,0 g 0 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 6625/hr
City/State/ZIP: titjmtxt!4`, C, I ai 7 1 Investigation(1 hr min) 6625/In
Phone:(Cr 7() 3 Y. ct Fax:( ) Industrial plant(1 hr min) 78.18/hr
C CB Lic.:lei la icZ Electrical Li C coil I Suprv. 3 S3 5 5 ens for which no min)
90.00/hr
Su rv.Lic.: specifically listed f,hr min
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: It.4 abri 3 in Subtotal:
Plan review(25%of permit fee):
Print name: ci O lin C ii I M ` . .j t/ State surcharge(12%of permit fee): /9.v2-/
Authorized signature: ,- TOTAL PERMIT FEE: /7/G► 7
Print name / // + . Date / t This permit application expires if a permit is sot obtained within 180
14145 imp! in [U b u 5 yviZ_ I_ ' D . r•l l days after it bas been accepted as complete.
/ • Number of inspections allowed per permit.
I:%Buildinir1PermitsELC_Pem itApp ELR ERE.doc Rev 05/21/2013 4 0-4615T(t 105/COMIWEB
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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
15970 SW BRENTWOOD CT, TIGARD, OR,
97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00301
Jeff Grove
Violation Summary:
Inspector Contractor