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Permit CITY OF TIGARD ELECTRICAL PERMIT s' COMMUNITY DEVELOPMENT Permit#: ELC2015 00344 T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2015 Parcel: 2S 104DC00700 Jurisdiction: Tigard Site address: 13652 SW BENCHVIEW PL Project: WELLS Subdivision: BENCHVIEW ESTATES Lot: 7 Project Description: Altering(1)branch circuit. Contractor: OWNER Owner: WELLS, BRENT J &JODIE JODIE WELLS 13652 SW BENCHVIEW PL 13652 SW BENCHVIEW PL TIGARD,OR 97223 TIGARD, OR 97223 PHONE: 479-372-2600 PHONE: FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 05/11/2015 $56.18 Specifics:, Service or Feeder 1 ea 12%State Surcharge- 05/11/2015 $6.74 Type of Use: Electrical Class of Work: 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 Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of e ru= •r direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: _� � Permittee Signature: 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 ONLti' - City of Tigard Received 71 • 13125 SW Hall Blvd.,Tigard,OR 97223 `' D Plan Review / �� Phone: 503.718.2439 Fax: 503.598 �`V Date/13 : Related Permit#: ' , O`S _ Inspection Line: 503.639.4175 Q Ready Date/By: HI See Page 2 for I I(,A R D Internet: www.tigard-or.gov , ` 20�, Notified/Method: ILMEIll Supplemental Information ❑New construction ❑Addition/alterati elte 'CIO Please check all that apply(submit 1 sets of plans w/items checked): G` \ `N� ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: ``� where the available fault current ❑Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 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 , ❑Emergency system. larger separately derived Job#: Job site address: /] ''5 4 p) ❑Addition 0H moew motor load of system. 2 S W � 'V■¢W 100HP or more. ❑"A" "E" "1-2" "I-3" / ❑Six or more residential units. occupancy. City/State/ZIP: 7 d vi v n ?-7 2�3 ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: 3 I Project name: f/IS ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: Description Qty. Each Total • New residential single-or multi-family dwelling unit. Subdivision: I 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 Limited energy,residential ` I i (with above sq.ft.) 75.00 2 !W 0 b'S 1At S w: '('t t° d� ��J uc 5 rL Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ' Services or feeders installation,alteration,and/or relocation Name: oc4;e e 115 200 amps or less 100.70 2 Address: I -3(D S 2 S W 13 u�cli u, tv, 0 J 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: i,\C a u) () t( ?2 2 ] 601 amps to 1,000 amps 301.04 . 2 Phone:('1-i el ) 3 7 2 - 2 co 0 d I Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: �J1 J i e 1�S rJC �!{"f i/1�Q/t't r 0vet 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: 5 ' I/^/S 401 amps to 599 amps 168.54 2 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 _L� 2 Address: 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 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 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:( ) Fax:( ) Investigation(1 hr min) 66.25/hr Email: Industrial plant(I hr min) 78.18/hr _ _ Inspections for which no fee is 90.00/lir CCB Lic.: Electrical Lic.: Suprv.Lic.: s,'cificall listed %f hr min Suprv.Electrician signature,required: Subtotal: � .11 Print name: Date: ❑Plan Review Required(25%of permit fee): _ State surcharge(12%of permit fee): . Cp. '71 Authorized signature: TOTAL PERMIT FEE: 602-9,2. 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:\Buildine\Permits\ELC_Pe nuwpp_ELR_ERE.doe Rev 04/21/2014 440-4615T(1 troy/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY I`i i 4;t ,)l 1• Destri Fee for all residential systems combined: $75.00 Renewable �� o y Renewable electrical energy systems: Check Type of Work Involved: s kva or less 100.70 _© 5.01 to 15 kva 133.56 _© ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 _© Wind l eneration s stems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva - 301.04 _© a 50.01 to 100 kva 552.26 Garage Door Opener* _© ❑ g p >100 kva(fee in accordance ■ 552.26 _© with OAR 91 5-309-0040 El Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 _© El Vacuum Systems* >100 kva—no additional charge - 0.0 _© Each additional ins.ection over allowable in an of the above: ❑ Other. Each additional inspection is ■ 66.25/hr —� char ed at an hour! 1 hr min Inspections for which no fee is ■ 90.00/hr _. si cificall listed 4 hr min y , 5 i 3 I x'• Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: El Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation El Fire Alarm Installation El HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* ❑ Medical El 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_PertnitApp_ELR_ERE.doe Rev 04/21/2014