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Permit CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2014-00338 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/19/2014 TIGARD Parcel: 1 S134DA01800 Jurisdiction: Tigard Site address: 10757 SW NORTH DAKOTA ST Project: TASTO Subdivision: NORTHERN PINE Lot: 6 Project Description: Temporary service for New SF. Contractor: OWNER Owner: TASTO, RUSSELL J&NICOLE K 1401 E 8TH ST NEWBERG, OR 97132 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Temp Services or Feeders- 06/19/2014 $59.36 Specifics: 200 amps or less 1 ea 12%State Surcharge- 06/19/2014 $7.12 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total S66.48 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 0 y352- 0 0. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: • Ui�" Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on prop-• I own which is not intended f. sale ease or rent. OWNER'S SIGNATURE /Aili''/ ♦ 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 Applicatio> j CEIV P FOR OFFICE USE ONLY City of Tigard Received ae 6 /9 / "v Permit qtC�(+�/y 00.�3t� III • 13125 SW Hall Blvd.,Tigard,OR 97221I' Plan Review = Phone: 503.718.2439 Fax: 503.598.19 ND 19 2014 Date/B : Related Permit vitsr. ,y evo/9 Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for TI G A R D Internet: www.tigard-or.gov CITY OF TI q ARD Notified/Method: Supplemental Information TYPE O A PLAN REVIEW A New construction ❑Addition/alteraticement Please check all that apply(submit 2 sets of plans w/items checked): ❑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. gi 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural 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 Job#: Job site address: `I�7, 7 s\„1 i b�\,o-\-� St, ❑Addition of new motor load of system. I OOHP or more. ❑"A" "E","1-2","1-3", City/State/ZIP: r� OR QI'?Zn ❑Six or more residential units. occupancy. ty ❑Recreational vehicle s. Ai ❑Health-care facilities. P Suite/bldg./apt.#: (Project name: To, . R�•s t�t,�Ge ❑Hazardous locations. ❑Supply voltage for more than S 600 volts nominal. 1 Q ❑Service or feeder 600 amps or CH. Cross street/directions to job site: © ,l '� FEE SCHEDULE Description I Qty. I Each 1 Total I New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1• DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) - -7-Q V■r` 1 0‘'N'v\ *4•I‘j --)k 1\J tCe Limited energy,multi-family 75.00 2 C residential(with above sq.ft.) Renewable Energy _ ❑ See Page 2 ill PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: v 5 5t\1 To,S 1,,,ly,� 200 amps or less i 100.70 2 Address: 1 08`75 SW N Uokq s� 201 amps to 400 amps 133.56 2 v 401 amps to 600 amps 200.34 2 City/State/ZIP:'7 c7.t'Q 17.)P V Z 7... amps to 1,000 amps 301.04 2 Phone:(j) 3 by)Z Fax:( ) Over 1,000 amps or volts 552.26 2 U SStl) , V.V h.�. lev*A\a V S Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less I 59.36 l intended for sale,leas rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ❑ APPLICANT CONTACT PE ON Branch circuits-new,alteration,or extension,per panel I 1:1 CONTACT A.Fee for branch circuits with Business name: above service or feeder fee, 7 42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy ' ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 66.25/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%:hr min) _ ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 59,3� Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 2, /02-- Authorized signature: TOTAL PERMIT FEE: (Si', yA2 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. 1:\BuildingTenni ts\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 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 Description Qty. I Each I Total I * Fee for all residential systems combined: $75.00 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 Wind generation systems in excess of 25 kva: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* 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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%r hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page I): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ 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 I:\Building\Permits\f:LC_PermitApp_ELR_ERE.doe Rev 04/21/2014 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 10757 SW NORTH DAKOTA ST, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final PASS - No C of O July 7, 2015 at 1:29:13 PM ELC2014-00338 David Young Violation Summary: Inspector Contractor