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Permit
CITY OF TIGARD ELECTRICAL PERMIT n . . • COMMUNITY DEVELOPMENT Permit#: ELC2014-00694 T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/03/2014 Parcel: 25111 CD04000 Jurisdiction: Tigard Site address: 9545 SW BRENTWOOD PL Project: Wenner Subdivision: SUMMERFIELD NO.9 Lot: 529 Project Description: Interior remodel-(1)service and(12)branch circuits. Contractor: LIGHTING ELECTRIC LLC Owner: SHERMA WENNER PO BOX 890 9545 SW BRENTWOOD PL WOODBURN, OR 97071 TIGARD,OR 97224 PHONE: 971-338-8989 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 12/03/2014 $100.70 Specifics: amps or less 12 crt Branch Circuits w/Purchase 12/03/2014 $89.04 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 12/03/2014 $22.77 Electrical Type of Const: Occupancy Grp: Total $212.51 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 - •- •- 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 180 days. • ENTION: Orego law r:•uires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules - e set forth in OAR 952 •11-0010 through OAR 952 r• -009 '•• may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332. =sued By: _/ 50 Perm Signature: r\ • 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' ` 1 / hirWr 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 Applicat CEIVEl) 1 ()1t ()1 I I( I I �1 11\I 1 City of Tigard n(� 3 2014 1 4�© Permit No.: EL Al 'dD apf• 13125 SW Hall Blvd.,Tigard,OR 9'42 Plan Review 11111 a Phone: 503.718.2439 Fax: 503.598.1960 / p(� Date/B : Other Permit: 1 1 `1\1 Inspection Line: 503.639.4175 CITY OF c I(,ARI) Date Ready/By: turfs: H See Page 2 for Internet: www.tigard-or Notified/Method: Supplemental Information BUILDING DIVISION PAN ❑New construction ®Addition/alteration/replacement Please check all that apply(submit a 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 ® 1-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.A ❑Addition of new motor load of ❑"A","E","1-2","1-3", Job no.: Job site address:9545 SW Brentwood Place 100HP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. ❑S Supply voltage nom nal more than ❑Hazardous locations. Suite/bldg./apt.no.: Project name:Wenner ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description I Qty. I Fee. I Total I • 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 New 200amp panel/interior remodel residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation ® PROPERTY OWNER I ❑ TENANT 200 amps or less 1 100.70 /et.7Q 2 201 amps to 400 amps 133.56 2 Name:Sherma Wenner 401 amps to 600 amps 200.34 2 Address:9545 SW Brentwood place 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP:Tigard,OR 97224 Temporary services or feeders installation,alteration,and/or relocation Phone:( ) Fax:( ) - 200 amps or less 59.36 1 Owner installation:This installation is being made on property that I own which is not tot 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 I ® CONTACT PERSON A.Fee for branch circuits with above service or feeder fee, l`�, . 7.42 9.15q 2 Business name:TL Remodel&Construction Inc each branch circuit B.Fee for branch circuits without Contact name:Tim Labunsky service or feeder fee,first 56.18 2 branch circuit Address:PO Box 1996 Each add'l branch circuit 7.42 2 City/State/ZIP: Lake Oswego,OR 97035 Miscellaneous(service or feeder not included) tY g Each manufactured or modular Phone:(503)9842783 Fax: :( ) dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 E-mail:TLRemodel @yahoo.com Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Lighting Electric LLC Signal circuit(s)or limited-energy See panel,alteration,or extension. Page 2 2 Address:PO Box 890 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP:Woodburn,OR 97071 Investigation(1 hr min) 66.25/hr Phone:(971)338-8989 Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 198682 Electrical Lic.: C904 Suprv.Lic.: 3535S specifically listed(%1 hr min) ELECTRICAL PERM TT FEES Suprv.Electrician signature,required: ,' Subtotal: /g 9-7� Print name: John Christensen I Date: 11/24/14 Plan review(25%of permit fee): , State surcharge(12%of permit fee): A7 .77 Authorized signature: KcnS--1-Q iv, 1/LOLN,".IA TOTAL PERMIT FEE: ,51 This permit application expires if a permit is not obtained within 180 Print name: Konstain Lobsyuk Date: 11/24/14 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permi ts\ELC_PennitApp_ELR_ERE.doe Rev 05/21/2013 440-461ST(l1/05/COM/WEB City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9545 SW BRENTWOOD PL, TIGARD, OR, 97224 May 22, 2015 at 9:26:58 AM Record Type: Record ID: Residential - Electrical ELC2014-00694 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Cover changed, opens 90 degrees. Violation Summary: Inspector Contractor