Permit CITY OF TIGARD ELECTRICAL PERMIT
.114 .n Permit#: ELC2015-00474
COMMUNITY DEVELOPMENT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/17/2015
Parcel: 1 S136AA08700
Jurisdiction: Tigard
Site address: 10048 SW 70TH PL
Project: Bridges Subdivision: VENTURA ESTATES Lot: 9
Project Description: (1)branch circuit to connect a/c
Contractor: OWNER Owner: WEST COAST HOME SOLUTIONS LLC
JACEN BRIDGES PO BOX 1969
10048 SW 70TH PL LAKE OSWEGO, OR 97035
TIGARD, OR 97223
PHONE: 323-422-4446 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 06/17/2015 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/17/2015 $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 accor•. ce 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. ATT- • ION: Or-,on la equires you to follow the rules adopted by the Oregon Utility Notification Center. T.•= rues et forth in O•: -
952-001-•610 through OAR 15 .01-a'.• You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1•= • :•6.332.
Issue, By: —• � lX Permittee Signature: "
OWNER INSTALLATION ONLY
The installation is being made on property I own •tom'-'not intended f• --e e olrent.
OWNER'S SIGNATURE /%�i � '� Date: 4/7//5
ONTRACTOR 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 Applicatic>�ILCE1VE1) FOR OFFICE USE 0\I.1'
City of Tigard Date/13 &ma y Permit#: l,.C, /5=66 ,
- • 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 1 7 2015 DateB : Related Permit#:
T I G A R I Inspection Line: 503.639.4175 Ready Date/By: !uric B See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
❑New construction ❑Addition/a teratiotl/replacement Please check all that apply(submit 1 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition DI 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
100 / Ai 70? ❑Addition of new motor load of system.
Job#: Job site address: ( 8' 5/ plate 100HP or more. ❑"A„ "E" "1_2„ "1_3„
City/State/ZIP: / / (� 7? ❑Health-care or more facidents. units. occupancy.
ty i a� [ d r [ 7? ❑Health care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I 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:
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'(500 sq.ft.or portion 33.92 1
Limited energy,residential 75.00 2
(with above sq.ft.)
1/1 A e e--k- C h t ` 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: ,)acp 13 r t`J q e S 200 amps or less 100.70 2
L `n 5 ' r , 0 '' ?I CC Q 201 amps to 400 amps 133.56
Address: V Oa i jf W 17 . 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 1 ;'clod 601 amps to 1,000 amps 301.04 2
Phone:(. x23) Lila 4 if y4, 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,le or exchan g to 7,449,670, 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: ' S 401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension, er panel
A.Fee for branch circuits with
Busi ss name: above service or feeder fee, 7 42 2
each branch circuit
Contact name: B.Fee for branch circuits without 1
service or feeder fee,first
Address: _ branch circuit 56.18 Cad 2
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not includedL
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: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension. g
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(1 hr min) 78.18/hr
Inspections for which no fee is
90.00/lir
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed /s hr min
Suprv.Electrician signature,required: Subtotal: h r
Print name: Date: ❑Plan Review Required(25%of permit fee):
/ %/� State surcharge(12%of permit fee): (a 7
Authorized signature: �� /�c'/ TOTAL PERMIT FEE: �,� . �-
_ This permit application expires if a permit is not obtained within 180
Print name: .�a L,e,4 •,�7 P S Date: 0 (p//7( S • days after it has been accepted as complete.
( Number of inspections allowed per permit.
I:\Building■Permita\ELC_PermitApp_ELR_ERE.doc Rev 04/21 oti 440-4615T(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
Description I Qty. I Each j Total j *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 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)
El Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
El 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 9000/hr
s•-cificall listed %l hr min
COMMERCIAL WORK ONLY:
F l ,. ;
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:
El Audio and Stereo Systems
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
El Instrumentation
El Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
El 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
10048 SW 70TH PL, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00474
David Young
Violation Summary:
Inspector Contractor