Permit CITY OF TIGARD ELECTRICAL PERMIT
_ COMMUNITY DEVELOPMENT Permit#: ELC2014 00731
I G A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/29/2014
-�
Parcel: 2S 103D D00423
Jurisdiction: Tigard
Site address: 10915 SW FAIRHAVEN WAY
Project: PHIPPS Subdivision: FAIRHAVEN COURT Lot: 10
Project Description: Repairing(3)branch circuits due to tree damage.
Contractor: WEBER ELECTRIC INC Owner: PHIPPS LIVING TRUST
7007 SW ROBBINS RD 10915 SW FAIRHAVEN WAY
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503-819-7380 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 12/29/2014 $71.02
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 12/29/2014 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow th ted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may$ tai�saccv-oLtbe ru t questions to OUNC by calling 503.232.1987 or 1.800.332.2344
Issued By: Vii..._ - _ Permittee Signature:
es a
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.
Electrical Permit Application �1 1 in O l 1 I( I 1 '.1 O\11
City of Tigard ace wi Datee/B : a 1 ik 0 Permit#: — _OiLi—otD-
13125 SW Hall Blvd.,Tigard,OR 97223at(w / Plan Review
I 11 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 �A Ready Date/By: �
y: � 9: 0 See Page 2 for
1 1 I. \1,1) Internet: www.tigard-or.gov , C1 2 9 20 't Notified/Method: --'4:1‹j Supplemental Information
TYPE OF WORK iGAg° PLAN REVIEW
❑New construction (�IAddition/alteration/repik �1t Please check all that apply(submit 1 sets of plans w/items checked):
MING DIVIO ` ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTR exceeds 10,000 amps at 150 volts or ❑Floating buildings.
g_1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑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
- --- -- ❑Addition of new motor load of system.
Job#: Job site address: /095-S' ) FG irj ver-t G�b.y I00HP or more. ❑"A "E","1-2","l-3",
Cl /State/ZIP: ❑Six or more residential units. occupancy.
n l c S e.... 9 7 223 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑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: Lot#: Includes attached garage. _
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential _
_ (with above sq.ft.) 75.00 2
r e Q a r- 3 C-t.S C L.J.-a s cl U e- To Limited energy,multi-family
Ti--e a sl r t fC� G r+,G�cy Q,� residential(with above sq.ft.) ; 75.00 2
9 .... Renewable Energy ❑ See Page 2
Ef-PROPERTY OWNER Services or feeders installation,alteration,and/or relocation
Name: /912 /
/3/0 S 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) 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
❑ APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit _
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 56,12 2
Address: branch circuit .
City/State/ZIP: Each add'l branch circuit _ Z 7.42 (y ,g4 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
e � Qr ���¢r��r'tL1 LnC —
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: -7,� >, 7 SC-3 / ...,6 ,t r,$ / panel,alteration,or extension. g
City/State/ZIP: �� C Each additional inspection over allowable in any of the above
/Le ,_c,..:1-,r-� , 2 ( 70 4i.s Z Additional inspection(1 hr min) 66.25/hr
Phone:( tr,`o}� 2 i 9 - 7 3,y0 Fax:( ) q5 Investigation(1 hr min) 66.25/hr
,/ C Industrial plant(1 hr min) 78.18/hr
Email: ,e b e r e �r;\c_1 e .S r^a.<- • co Inspections for which no fee is
CCB Lic.: ectrical Lic.: Suprv.Lic.: specifically listed(%2 hr min) �/hr
Al'99 0$7 39-�I9 2 C p d 28 S ELECTRICAL PERMIT FEES •
Suprv.Electrician signature,required: Subtotal: 7/,0 2..
Print name: /1i e., J e a,- Date:/Z-ay_i¢ ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): ',4 2
Authorized signature: TOTAL PERMIT FEE: 79, 66 9
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.
1:\BuildinglPermita\ELC_PermitApp_ELR_ERE.doe Rev 04/21/2014 4404615T(11/05/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 Renewable
Description ► Q . Each l Total 1
)' Rene electrical energy systems:
Check Type of Work Involved: 5 kva or less 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 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 66.25/hr
charged at an hourly(1 hr min) _
Inspections for which no fee is 90.00/hr
specifically listed(%:hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y ' Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
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
1:\Building\Permits\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
10915 SW FAIRHAVEN WAY, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2014-00731
Jeff Grove
Violation Summary:
Inspector Contractor