Permit CITY OF TIGARD ELECTRICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: ELC2014-00430
IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/04/2014
Parcel: 2S103CA02300
Jurisdiction: Tigard
Site address: 11880 SW JAMES CT
Project: Sverid Subdivision: TRAVPORT PARK Lot: 3
Project Description: Panel upgrade
Contractor: LIGHTHOUSE ELECTRIC LLC Owner: SVERID, DARLINE M LIVING TRUST
10778 SW CLEAR ST 11880 SW JAMES ST
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503-582-9600 PHONE:
FAX: 503-612-6558
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 08/04/2014 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 08/04/2014 $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 in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in Gordan 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 160
days. AT ENTION: Oreg law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001- 010 through OAR 95 001 9�JpI. ye�y may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 orr1800.3322233444
C3.8 �
Issue y: \ r " — mot' Permittee Signature: ^ / ! l t�
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: $/G//g/-
LICENSE NO. 057
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 ApplicaticRECEIVEP FOR OFFICE t'si:ONLY
City of Tigard Received g q mom Permit No.:(Fhl�`CX`7'(9t7
Date/B
't 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
Phone: 503.718.2439 Fax: 503.598. G 4 2 U 14 Date/B : Other Permit:
IITII I
Inspection Line: 503.639.4175 Date Ready/By: Juris: El See Page 2 for
TIGARD Internet: www.tigard-or.gov CITY OFTIGARD Notified/Method: Supplemental Information
TYPE 11111N9ING,DIVISION PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction Addition/alteration/replacement ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Ot er: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
Multi-family 0 Master builder 0 Other:
❑Fire pump. ❑Installation of 75 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",
100HP or more. occupancy.
Job no.: Job site address: / I WO 50. Jt/m.S 0.4-. ❑Six or more residential units. ❑Recreational vehicle parks.
��
----,.,i-L ❑Health-care facilities. ❑Supply voltage for more than
City/State/ZIP: I/ ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.n0.: Project name: ❑Service or feeder 600 amps or more.
4',..... FEE SCHEDULE
Cross street/directions to job site: Description 14y. I Fee. I Total 1
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 sq.ft.)
Limited energy,multi-family 7500 2
n /,I �� Q residential(with above so,,ft.)
/J(lip U(� up Services or feeders installation,alteration,and/or relocation
// 200 amps or less ! 100.70 /fit•10 2
❑ PROPERTY OWNER ' ❑ TENANT 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Name: 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP: relocation
Phone:( ) Fax:( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation:This installation is being made on property that I own which is not 401 amps to 599 amps 168.54 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
above service or feeder fee, 7 42 2
❑ APPLICANT ❑ CONTACT PERSON each branch circuit
Business name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Contact name: branch circuit
Each add'I branch circuit 7.42 2
Address: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84 2
City/State/ZIP: dwelling,service and/or feeder
Reconnect only 67.84 2
Phone:( ) Fax: :( ) Pump or irrigation circle 67.84 2
E-mail: Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
. panel,alteration,or extension. Page 2 2
/
Business name: ( �(
` � : e(` n Each additional inspection over allowable in any of the above
Address: (/' —1 D S 0/4 a/' S � Additional inspection(l hr min) 66.25/hr
+ Investigation(1 hr min) 66.25/hr
City/State/ZIP: - O e 9--lab 0 Industrial plant(1 hr min) 78.18/hr
q Fax: Inspections for which no fee is 90.00/hr
Phone:Fj ) �' Z— / Q� ( cpl z f9 5 5 specifically listed(Az hr min)
CCB Lic.: (5�8� Electrical Lic.:3 570 Suprv.Lic.: 306 fS ,} - ELECTRICAL PERMIT`FEES '.
Subtotal: /eV• 7e
Suprv.Electrician signature,r• Plan review(25%of permit fee): —�
Print name: Q i I7/!/ $ [, 1ILt Date: g, 7 1 State surcharge(12%of permit fee): /A 4.'
-7 TOTAL PERMIT FEE: !l 3 . 7`'
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
1:\Building\Permits1ELC-PermitApp.doc 07/01/10 440-4615T(II/05/COM/WEB
Location:
Record Type:
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Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11880 SW JAMES CT, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00430
Herb Stabenow
Violation Summary:
Inspector Contractor