Permit CITY OF TIGARD ELECTRICAL PERMIT
, f,: " COMMUNITY DEVELOPMENT Permit#: ELC2014-00604
TIGrARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/21/2014
Parcel: 2S111AD17100
Jurisdiction: Tigard
Site address: 9058 SW WESTLUND CT
Project: Fannie Mae c/o Melvin 0 Broadous Subdivision: MALLARD LAKES Lot: 37
Project Description: Electrical reconnect only
Contractor: NOT REQUIRED Owner: FANNIE MAE C/O MELVIN 0 BROADOUS
PO BOX 4627
PORTLAND, OR 97208
PHONE: PHONE: 503-680-6293
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 10/21/2014 $67.84
Specifics:
1 ea 12%State Surcharge- 10/21/2014 $8.14
Electrical
Type of Use: SF
Class of Work: OTR
Type of Const:
Occupancy Grp:
Total $75.98
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. ATTENTIO • -:,• law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001 rough OAR 952 01-r;°i Y.- •ay obtain a copy of the rules or direct questions to OUNC by calling 5S3 2 1387 or 1.800.332.2344
Issue By: yp, 1 Perm thee Signature: � 1 irt- _
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.
Melvin Broadous Realtor 5034955052 P- 1
Electrical Permit Appli Y' C ��a FOR:OFFICE,USE ONLY
City of Tigard �iJ Received
•. 13125 SW Hall Blvd..Tigard,OR 97223
Dateil3y: �� /V Pcnnit No.:e ���-ool�K
30T 0 2014 plan Review
Phone: 503.7�s,.?439 Fax: 50 19 Datc:B�: Other Permit.
TIGARD Inspection Line.- 503.639.4175 Date RradyBy: Juris: Ed See Page 2 for
Internet: www'.tigard-or.gov C OF TIGARD Notitied/Method: Supplemental Information
TyCITY
w+ gg�u (m PLAN REVIEW
-- Y.p, ��g�y��IQ p�, Please check all that apply(submit 2 sets of plans writems checked below):
New construction - I Add?' 17Y2?[t[[���` to /r Tacemedt
_ _y p _ Service or feeder 400 amps or more I Building over three stories.
i Demolition Other: where the available fault current Marinas and boatyards.
CATEGORY OF CONSTRUCTION • exceeds 10,000 amps at 150 volts or i__I Floating buildings.
less to ground,or exceeds 14,000 ' -!Commercial-use agricultural
I-and 2-family dwelling I 1 Commercial/industrial i. !Accessory building amps for all other installations. buildings
—I Multi-famil ; i I -Fire pump. -I Installation of 150 KVA or
Y Master builder Other. Emergency system. larger separately derived system.
� t; y.y'
JOB SITE INFORMATION AND LOCATION ;-_i Addition of new motor load of
I
-— -- -- -- — -- _ _ I OOH P or more. occupancy.
Job n0.: Six or stare residential units. ___,Recreational vehicle parks.
REO# 1_140B6Q - f health-cafe facilities Supply voltage for store than
City/State/ZIP:
Loan# 1704031798 Hazardous locations 600 volts nominal.
--State/bldg./apL Service or feeder 600
1 9058 SW Westlund CT. amps or more.
ss sUit FEE SCHEDULE
C1ro eeVd
Tigard, Oregon 97224
Description I Qty. I Fee. I Total I"
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: I 168.54 _
lax map/parcel no.: Ea.add'I 500 sq.(t.or portion 33.92 I
DESCRIPTION OF' WORK Limited energy,residential
(with above sq.ft.)
75.00
Limited energy,multi-family 75.00 2`n �CT d 1 U � residential(with above sq.ft.)
Renewable Energy IP See Page 2
Services or feeders installation,alteration,and/or relocation
lK PROPERTY OWNER 1 TENANT 200 amps or less 100.70 2
Name: -F0.nn7e_ / h a2. [lo M Ul/,riri, , D` Q raLkCk 7lA5 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
Address: p, D I?1 /4 /_2 601 amps to 1,000 amps 301.04 2
City/State/ZIP: �ora�^D( �Ql) O Over 1,000 amps or volts 5522(, 2
III t I 0 Temporary services or feeders installation,alteration,and/or
Phone:603 ) 6r6o- 67-613 Fax:( ) relocation
Owner installation:This installation is bang made on property that I own which is not 200 amps or less 59.36 I1
intended for sale,lease,rent,or ex.ta/•e,acc•:ding t. ORS 447,449,670,and 701/. 201 amps 10 400 amps I25.o3
/ 'd/3-O lY 401 amps to 599 amps 165.54 2
Owner signature '!�_- /, __I Date: / Branch circuits—new,alteration,or extension,per panel
APPLICANT A CONTACT PERSON A.Fec for branch circuits a iih r
above service or feeder fee,
Business name: Q. each branch circuit ;' '
a
B.Fee for branch circuits tritour
Contact name: service or feeder fee,first
Address: branch circuit 56.18 2
Each add'I branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included) _
Each manufactured or modular
Phone:( 7 ) 6(6o—6 - Fax: :( 4,q dwelling,service and/or feeder 67.84
7p � " � ��� e Reconnect only 67.84 ,
E-mail:MgLJ(✓1 Lr,'v 17)' DUS Go
�Q'V �K' + WI Pump or irrigation circle 67.84 -)
CONTRACTOR Sign or outline lighting 67.84 2
Business lame: Signal circuit(s)or limited-energy See
_panel,alteration,or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr I
City/State/ZIP:
investigation(I hr min) 66.25,hr
'
Phone:( ) Fax:( ) Industrial plant(1 hr mitt) 78.181 hr
Inspections for which no fee is 90.00/hr -
CCB Lie.: Electrical Lie.: Suprv. Lic.: specifically listed('L•hr min) _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal: 67'+ -
Print name: Date: Plan review(25%of permit tree):
/ • State surcharge(12%of permit fee): 1 (43, ( '
Authorized signature: f &loey/
TOTAL.PERMIT FEE: 1
//,.t This permit application expires if n permit is not obtair d within 1800
Print name: Melvin 0. Broadous, PC , Date: �rJ/��/J clays after it has been accepted as complete.
" Number of inspections allowed per permit.
I\Building\PerniitstELC_PermirApp_ELR_ERE.doc Rev 05:21,2013 440.461 5T(I 1;05iCOMPa'En
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
9058 SW WESTLUND CT, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00604
Jeff Grove
Violation Summary:
Inspector Contractor