Permit CITY OF TIGARD ELECTRICAL PERMIT
NI r COMMUNITY DEVELOPMENT Permit#: ELC2015-00378
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/19/2015
Parcel: 2S103CA01600
Jurisdiction: Tigard
Site address: 13410 SW HOWARD DR
Project: JOHNSON Subdivision: WOODCREST Lot: 5
Project Description: (6)branch circuits for remodel.
Contractor: NEC ELECTRIC Owner: JOHNSON, CHERYL R
1508 NE 194TH ST 13410 SW HOWARD DR
RIDGEFIELD,WA 98642 TIGARD, OR 97223
PHONE: 360-798-2819 PHONE:
FAX: 360-807-0752
FEES
Quantity Description Date Amount
6 Crt Branch Circuits wo/Purchase 05/19/2015 $93.28
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/19/2015 $11.19
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 Cente Those gulps are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtai the rules or direct questions to OUNC by calling 503.232.19 or .8951t.,352' 44.
Issued By: y� 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 I OR I11 1 11 1 I til 11v1 1
IIIII City o f Tigard Date By: S"/l"7 15-. ,- -'Permit#: ��ao 15"-,01 ).,
13125 SW Hall Blvd.,Tigard,OR 97223 `' Plan Review
Phone: 503.718.2439 Fax: 503.598.19 (1 E V ED Date/By: Related Permit#: /06,1,7„20/5"-_ wi ,
Inspection Line: 503.639.4175 t. Ready Date/By: furls: ® See Page 2 for
I I i• \I:I) Internet: www.tigard-or.gov O\13 Notified/Method: Supplemental Information
it�� rat Please check all that apply(submit j sets of plans w/items checked):
0 New construction Addition/alterationttiafi
r S1O1`t ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: G oV 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
❑Multi-family Master builder Other: amps for all other installations. buildings.
y ❑ ❑ ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:f 3 / 0 „J� ]r l OOHP or more. ❑"A",°E',°l-2 "l-s',
City/State/ZIP: ;.1..(3-_ J ❑Six or more residential units. occupancy.
ty L 4�[ Q ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Prdject name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or,more. 600 volts nominal.
Cross street/directions to job site: / / � �, J� �
/ Description Qty. Each 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
•Limited energy,residential
(with above sq.ft.) 75.00 2
rn I Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 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:( ) 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
Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: y`- C l -�- ;C- above service or feeder fee,
` ` r each branch circuit 7.42 2
Contact name: G- 1 w� - B.Fee for branch circuits without
service or feeder fee,first i
Address: branch circuit / 56.18 57 ji 2
City/State/ZIP: ( c.0 t.f l Each add',branch circuit j 7.42 377,/(J 2
V ( 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 2
Pump or irrigation circle 67.84 2
Business name' 4. c-/a c 4 1-,�' Sign or outline lighting 67.84 2
T Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension. g
City/State/ZIP: . ) y,� 3 Each additional inspection over allowable in any of the above
C/�^ti C B.—CA Additional inspection(1 hr min) 66.25/hr
Phone:3r 7/) 2 .l 7 _ -/p?7 Fax:( ) Investigation(1 hr min) 66.25/hr
Email: !! .7/'i'b? /0��//4 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic./q53 1 i Electrical Lic.: U 60 Suprv.Lic.4 6;7_5 specifically listed Vz hr min
Suprv.Electrician signature,required: �J`-' 4/1(?//..�� Th4'Ic,r-- Subtotal: •
Print name: /'7 / //1/10,--v-,_ �— / Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):yi t 1. 7 Authorized signature: TOTAL PERMIT FEE: t1 `1 This permit application expires if a permit is not o ined within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
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•
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
systems combined: $75.00) Description I Qty. I Each I Total
Fee for all residential s
y Renewable electrical energy systems:
Check Type of Work Involved: s kvaorless 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
s xcificall listed %2 hr min)
COMMERCIAL WORK ONLY:
CAL 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
I:\Building\Permits\ELC_PennitApp_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
13410 SW HOWARD DR, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
July 1, 2015 at 10:20:48 AM
ELC2015-00378
David Young
Corrections complete.
Violation Summary:
Inspector Contractor