Permit n CITY OF TIGARD ELECTRICAL PERMIT
1,1
I. COMMUNITY DEVELOPMENT Permit#: ELC2015-00490
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/24/2015
Parcel: 2S109DB06000
Jurisdiction: TIGARD
Site address: 13296 SW HAZELCREST WAY
Project: Sequoia Heights,Lot 8 Subdivision: SEQUOIA HEIGHTS Lot: 8
Project Description: Power Line Electric is completing the electrical work under MST2014-00141 and assuming responsibility for the
previous work.
Contractor: POWER LINE ELECTRIC INC Owner: LENNAR NORTHWEST INC
8403 SE SHERRETT ST 15060 SW 133RD AVE
PORTLAND, OR 97266 TIGARD, OR 97224
PHONE: 971-645-3807 PHONE: 360-258-7900
FAX:
FEES
Quantity Description Date Amount
3061 sf Permit Fee-Elect(per 06/24/2015 $338.14
Specifics: dwelling unit)
1 ea Limited Energy 06/24/2015 $75.00
Type of Use: SF 1 ea 12%State Surcharge- 06/24/2015 $49.58
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $462.72
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 Sispy.sf the direct questions to OUNC by calling 503.232.1967 or 1.800.332.2344.
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY VV !!!
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 ()1( t I l I it I I ,I t I ,
Cl of Tigard Received /_ '. Permit No. 1 z _ r Jr
`.1 g Dat:i 4 �i'�v
. i 13125 SW Hall Blvd.,Tigard,OR 97223 t Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 4 f 4 DateB : Other Permit:
I:t t inspection Line: 503.639.4175 Date Ready/By: 0 See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Slr� Supplemental information
TYPE OF WORK _ i?, c) a c1 • PlAN
New construction ❑Addition/alteration/replacement Please check all that apply(submit sets of plans w/items checked below).
❑Service or feeder 400 amps or more ❑Building over three stories.
Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION , exceeds 10,000 amps at 150 volts or ❑Floating buildings.
• less to ground,or exceeds 14,000 ❑Commercial-use agricultural
I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
Multi-family ❑Master builder Other: 0 Fire pump. ❑Installation of 150 KVA or
JOB SIT E INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","1-2","I-3",
Job no.: Job site address: ^�/� ‹,,..1
I00HP or more. occupancy.
,�L�"\� J � C. ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 'C� �^10 ❑Health-care facilities. ❑Supply voltage for more than
` , t+ ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more.
FEE SCHED •
Cross street/directions to job site: Description t71L
j E
I Qty. l Fee. I Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: GSAQ; Lot no.: J� 1,000 sq.ft.or less if
4
Ea.add'1 500 sq.ft.or portion eJ 33.92 1
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family
2
4,■,5\N cp.kQ.<- residential(with above sq.ft.) 75.00
Renewable Energy ❑ See Page 2
j--- S -) !H op j Lit 3 O C' / y _� Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I 0 TENANT 200 amps or less 100.70
201 amps to 400 amps 133.56 2
Name: Z 0/..P / 401 amps to 600 amps 200.34 2
Address: a l 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that i own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease.rent,or exchange.according to ORS 447.449,670,and 701. 401 amps to 599 amps 168.54
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
APPLICANT 1 ❑ CONTACT PERSON A.Fee for branch circuits with
• above service or feeder fee,
7.42
Business name: each branch circuit B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18
Address: branch circuit Each add'l branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84
Phone:( ) Fax: :( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:
Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Vo'. \;,,t,e_'\e Lk e.c. --_ Signal circuit(s)or limited-energy See
�t panel,alteration,or extension. Page 2 2
Address: Ih10-5 <4 I4em 3"� (\ Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr '
City/State/ZIP: 'oC ` o� C;7
Investigation(I hr min) 66.25/hr
Phone:(CM) (,/�5`7,cip Fax:( ) Industrial plant(1 hr min) 78.18/hr
` ` v'v ��" I Inspections for which no fee is
CCB Lic.:a0sRG Electrical Lie.: C \O a Q Suprv.Lic.:5 30 S specifically listed CA hr min) 90.00/hr
Suprv.Electrician signature,required: L I ELECTRICAL'.PERMIT FEES.
iglowillP/� / Subtotal: L�// ? )�
Print name:t4 c a E3 LC3 r et e .4z-i� /te:�Vx'(SQ�y,�� Plan review(25%of permit fee): s"
f State surcharge(12%of permit fee): f7,
Authorized signature: '�.>(t0\ t..i TOTAL PERMIT FEE:
Print name: �`�le�� This permit application expires if a permit is not o red within ISO
Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
I.\nuilding\Permits\ELC_PennitApp_ELR_ERE doe Rev 05/21/2013 440-4615T(1I/05/COM/WER - _ ,_ `7
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
13296 SW HAZELCREST WAY, TIGARD, OR,
97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00490
David Young
Changed contractor for final inspection, contractor takes responsibility for entire
residence.
Violation Summary:
Inspector Contractor