Permit CITY OF TIGARD ELECTRICAL PERMIT
111 Permit#: ELC2014-00730
= u COMMUNITY DEVELOPMENT
Date Issued: 12/24/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135CA01902
Jurisdiction: Tigard
Site address: 9600 SW NORTH DAKOTA ST
Project: Gelgelu Subdivision:.HERS ADDITION TO GREENBURG HE Lot: 1
Project Description: (1)branch circuit: removed ceiling fan and installed(4)can lites
Contractor: LIGHTING ELECTRIC LLC Owner: GELGELU, DURETI G
PO BOX 890 ITICHA, WAGARI
WOODBURN, OR 97071 9600 SW NORTH DAKOTA ST
TIGARD, OR 97223
PHONE: 971-338-8989 PHONE: 503 914-7189
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 12/24/2014 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/24/2014 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 hcation Center. Those rules are set forth in OAR
952-001-0010 through 04952-0s -0090. You may obtain a copy of the rules or direct questions to OUNC by calling .232.1987 or 1.800.332.23
Issued By: to Maw air:_ 1LL Permittee Signature: , ' E
•
�t J
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 603.639.4175 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_-""EIVED 1.0R or I I( I. I 'l 0\1.1
City of Tigard DFC 2 4 2014 Dte/Bea /�17/d ""I Permit 4: Eh. / —�o 7 33
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.5 $J Date/B Related Permit#:
Inspection Line: 503.639.4175 j11 Y OF TIGARD Ready Date/By: Juris ® See Page 2 for
`' \I'I' Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE BUILDING DIVISION WORK
PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply(submit/,sets of plans w/items checked):
(1U-, ❑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 snips at 150 volts or ❑Floating buildings.
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 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
/(O(� S W ��/�!� iobl 4✓* ❑100Addition of new motor load of system.
Job#: Job site address: Q IOOHP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: / ai n ❑Six or more residential units. occupancy.
Ty r Q 2 ❑Recreational vehicle parks.
❑Health-care facilities. P
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑supply voltage for more than
L.`I is S- ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less [ 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
( 24-nov1i Caiail, -c'otln -a, re 4 T 0-7 K ci rm., le-tes. Limited energy,multi-family 75.00 2
residential(with above sq.ft.) _
❑ PROPERTY OWNER ❑ TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: l a re 4I G ell.((A 200 amps or less 100.70 2
Address:S/ v ('wvl�r� ((���� 201 amps to 400 amps 133.56 2
s"Rkbtit 401 amps to 600 amps 200.34 2
City/State/ZIP:'i`t fet 1 O( - 67'7 Z21 601 amps to 1,000 amps 301.04 2
Phone:( ) g//(— 7/ I Fax:( ) Over 1,000 amps or volts 552.26 2
!� 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 59.36 1
intended for sale,lease,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
la APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel _
A.Fee for branch circuits with
A(
Business name: s Ca n{I ac4ftn L Lc above service or feeder fee,
7.42 2
�" each branch circuit
Contact name: 110 vlYll s N . S A 9 i re✓ B.Fee for branch circuits without //
Address: service or feeder fee,first 56.18 fit!-/y 2
i 11 5 q-iQ ed, branch circuit
�� ca D R ' 7o Each add'I branch circuit 7.42 2
City/State/ZIP: M� � J./ ) IL 3 S Miscellaneous(service or feeder not included)
Phone:( ) 921//_/?2/ I Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: disc pc 4-i oc3 [r - CO1i1.---% Reconnect only 67.84 2
CONTRACTOR `, Pump or irrigation circle 67.84 2
Business name: L 15hf I h5 t('G.(r t c k LL Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 2 5 37 ie t7ct/n C t e S.7 l ❑ See Page 2 2
g
panel,alteration,or extension.
City/State/ZIP: a� u I-� G)'-y��7 Each additional inspection over allowable in any of the above
I 1 ! ! Additional inspection(I hr min) 66.25/hr
Phone:Ell ( ) 338 _ y32 6 I 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.: /786 g2_ I Electrical Lic.• /0/4 I Suprv.Lic.:3 535 s specifically listed(V2 hr min)
ELECTRICAL PERMIT FEES a•
Suprv.Electrician signature,required: Subtotal: r(p. D
Print name: '- -O) ('I„ "sue v, Date: 12/2c//ley icy ❑Plan Review Required(25%of permit fee):• Y 1 State surcharge(12%of permit fee): eP•?zi
Authorized signature: N at( TOTAL PERMIT FEE: (02)-92^
`� This permit application expires if a permit is not obtained within 180
Print name: 111 �� . A !l e t j Date: (��2 t{/ZC tJ days after it has been accepted as complete.
Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 440-4615T(I 1/05/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 l Qty. Each I TotalRen I
�' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva orless 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:
❑ 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 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over25 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(Y hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
*
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
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\ELC_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
9600 SW NORTH DAKOTA ST, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00730
Jeff Grove
Violation Summary:
Inspector Contractor