Permit 14 CITY OF TIGARD ELECTRICAL PERMIT
111111 ' COMMUNITY DEVELOPMENT Permit#: ELC2014-00532
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2014
Parcel: 25111 BD00312
Jurisdiction: Tigard
Site address: 9940 SW PEMBROOK ST
Project: McCarthy Subdivision: PEMBROOK HEIGHTS Lot: 2
Project Description: Repair(5)branch circuits and add(1)branch c ircuit for bath outlet.
Contractor: WEBER ELECTRIC INC Owner: MCCARTHY, MICHAEL D&JENNIFER E
7007 SW ROBBINS RD 9940 SW PEMBROOK ST
TUALATIN, OR 97062 TIGARD, OR 97224
PHONE: 503-819-7380 PHONE:
FAX:
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo/Purchase 09/18/2014 $93.28
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/18/2014 $11.19
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 i cordance wi 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. ENTION: Oregon aw -q es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 1-0010 through OAR 952 '11-0090. •u may obtain j•py of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I ued 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. 4/lr �/5
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 USE ONLY
�.� , Received
City of Tigard -- � D FOR OFFICE DateB : ��
Permit No.: �3 .
" 13125 SW Hall Blvd.,Tigard,OR 97223S Plan Review li
I e. Phone: 503.718.2439 Fax: 503.598.1960 RD 18 L_! - Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 .,._CITY rf Date Ready/By: Juris: ra See Page 2 for
Internet: www.tigard-or.gov V l 1i�.�(,j) 1 Notified/Method: Supplemental Information
TYPE OF Wn N I NS PLAN REVIEW
❑New construct ion ,i.Addition/alteration/replacement Please check all that apply(submit J,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
R1-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 ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","I-2","I-3",
q Perin or more. occupancy.
Job#: Job site address: !q, 51,..) 1-PI'+n brook 51-- ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: Ti t:.-. 9 7 Z q ❑Health-care facilities. ❑Supply voltage for more than
r 1 ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.#: Project name: ❑Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot#: 1,000 sq.ft.or less 168.54 4
Ea.add'1 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
c.1, 1--s' �T nn Limited energy,multi-family
75.00 2
A re r/PGp . r 5 L-J ,, r X cier` residential(with above sq.ft)
—7-- Renewable Energy ❑ See Page 2
Nee-) c`CT FPr 60. l.. O(,✓v[ - Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ❑ TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name: Pi CC 401 amps to 600 amps _ 200.34 2
Address: 601 amps to 1,000 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 Tess 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: each branch circuit
B.Fee for branch circuits without
Contact name: service or feeder fee,first
branch circuit 1 56.18rj6 t/ 2
Address: Each add'I branch circuit 5 7.42 3?,/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
a ¢i �(q��h�C Tne_ panel,alteration,or extension. Page 2 2
Address: 70c.7 J (06 nA ifick Each additional inspection over allowable in any of the above
City/State/ZIP: �� Additional inspection(1 hr min) 66.25/hr•
/ V G�e..(a r, o2 7, Z — Investigation(I hr min) 66.25/hr
•
Phone:($3) ( ! RD Fax:( -)----- Industrial plant(1 hr min) . 78.18/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: Inspections for which no fee is 90.00/hr
�I y o r 7 yet-94 2C p ¢p L�r S specifically listed(A hr min)
Suprv.Electrician signature,required: L ELECTRICAL PERMIT FEES
Subtotal: ?3,'ig
Print name: PI / ) r Date: 7_/s (4 Plan review(25%of permit fee):
!��/ State surcharge(12%of permit fee): // , f 7
Authorized signature: TOTAL PERMIT FEE: /�. 4 7
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.\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 04/21/2014 440.4615T(II/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
Fee for all residential systems combined ... $75.00 Description I Qty. I Each I Total I
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
El 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
❑ Heating,Ventilation and Air Conditioning OAR 918-309-0040)
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(I hr min) 66.25/hr
Inspections for which no fee is 90.00/hr
specifically listed(%3 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
El HVAC
El Instrumentation
El Intercom and Paging Systems
n Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building\Perini ts\ELC_PermitApp_ELR_ERE.doc 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
9940 SW PEMBROOK ST, TIGARD, OR, 97224
Residential - Electrical
120 Electrical rough-in
FAIL
ELC2014-00532
Herb Stabenow
Personal property on site-an adult has to be present at the re-inspection
Violation Summary:
Inspector Contractor