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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2015-00160 Date Issued: 03/16/2015 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135AA70109 Jurisdiction: Tigard Site address: 8888 SW ELENA LN Project: DEPARTMENT OF HOUSING&URBAN DEVELOPME Subdivision:TOWNHOMES AT WASHINGTON SQL Lot: 09 Project Description: Reconnect only. Contractor: Owner: DEPARTMENT OF HOUSING& URBAN DEVELOPMENT 7105 CORPORATE DR PLANO,TX 75024 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 03/16/2015 $67.84 Specifics: 1 ea 12%State Surcharge- 03/16/2015 $8.14 Electrical Type of Use: COM 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 •' more the 180 days. ATTENTION: Oregon law requires you to follow th- - adopted by the Oregon Utility Notification Center. Thoser rules are -et forth ' •AR 952-001-0010 through OAR 952-001-0090. You ma obtain a copy• •_rules o •irect questions to OUNC by calling 503. . 987 or .8 .34.234.. Issued By: f1 —s Permittee Signature: 987 • / 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 FOR OFFICE USE ONLY up, City of Tigard �O Received • 13125 SW Hall Blvd.,Tigard,OR 97 Ge`� Plan RevtewJ/'�` JS Permit#: �(�La� �,..��{ D g +`` Related Permit#: Phone: 503.718.2439 Fax: 503.598. 43 Date/By: Inspection Line: 503.639.4175 0o 1 t " Ready Date/By: Juris: ® See Page 2 for T I G A R D Internet: www.tigard-or.gov t�Pp l ^n� Notified/Method: Supplemental Information E.OF WORK _;, • 11rr�. X5�� PLAN "maw ❑New construction [ : ddit'on/alteratio �. Please check all that apply(submit I sets of plans w/items checked): • b ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition er:t1 v0 0 n NI c_TE E. 1 WS Ate r101,? where the available fault current ❑Marinas and boatyards. CATER OV CONOMJCIION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling ommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural 4I J amps for all other installations. buildings. ❑Multi-family ❑Master builder ❑Other: aI a 0 pump.b V t �- p p 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address: 0 0 0 0 rf'` 0. 1 I , ❑Addition 0H of new motor load of system. in 100HP or more. ❑«A„ «E» <`1-2" "1-3» City/State/ZIP: Q ❑Six or more residential units. occupancy. ty l q t�t�-d d 14 - I, �'3 ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: 1 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 5 W ©p, i ....,1 1°oA 1 r> , FEE SOMME tt Description I Qty. I Each I Total . 8-1-c- h c c- -1[ 13/V� • New residential single-or multi-family dwelling unit. Subdivision: (o v h.e c l—eA -f o W v' IAD VI e 5 Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK. . Limited energy,residential 75.00 2 `1I { -Q V 1 N�Sp:°G O II\ 50 Q(�E ('u ' 1-ur0 (7Y) SV vi G-Q (with ne gysq.ft.) Limited energy,multi-family f O r `VI �C- on \,.__ „1 ! S I L-e 1O I residential(with above sq.ft.) 75.00 2 i' C1S11vr t fJ t T Renewable Energy ❑ See Page 2 • Q PROPERTY OWNER I . 0 TENANT Services or feeders installation,alteration,and/or relocation Name: V, ` kd e'-.i' -e J 0„e��v1 k 200 amps or less 100.70 2 Address: r13 (3 3 50 5iy�0 y-e t 201 amps to 400 amps 133.56 2 o N' �,'f" 401 amps to 600 amps 200.34 2 City/State/ZIP: {— 1 9 aAcl C0 P-e- W 601 amps to 1,000 amps 301.04 2 Phone:(50'3) l(7 \ ., to 39 0 I Fax:( ) Over 1,000 amps or volts 552.26 2 . t Temporary services or feeders installation,alteration,and/or Email: al,IJ U I n( -e AA l) C1 IM WO ' CO relocation Owner installation:This installation is bein 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. �. © CONTACT.PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: �4/ele_ AS abd - above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) I Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only / 67.84 67 ry 2 CONTRACTOR Pump or irrigation circle 67.84 / 2 Business name: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy ❑ See Page 2 2 panel,alteration,or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) I Fax:( ) Investigation(1 hr min) 66.25/hr Email: Industrial plant(l hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: I Electrical Lic.: I Suprv.Lie.: specifically listed(1/2 hr min) ' ELECTRICAL PERM T FEES Suprv.Electrician signature,required: Subtotal: C7-711 Print name: Date: ❑Plan Review Required(25%of permit fee): _ /� State surcharge(12%of permit fee): $ 1 Authorized si•• re: ��e 4G£J / TOTAL PERMIT FEE: 75 .16 I�����i This permit application expires if permit is not obtained within 180•Print n• e' Date: /!J( days after it has been accepted as complete r., " Number of inspections allowed per permit. I:\Building\P- its LC_PermitApp_ELR_ERE.doc Rev 04/21/2014 4'•14615T(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 Description I Qry. Total I F.en I rot I =_ y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n 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 n 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('/2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 i 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 n 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 8888 SW ELENA LN, TIGARD, OR, 97223 Commercial - Electrical 199 Electrical final PASS - No C of O ELC2015-00160 Herb Stabenow Violation Summary: Inspector Contractor