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Permit
CITY OF TIGARD ELECTRICAL PERMIT 1111 T I ' COMMUNITY DEVELOPMENT Permit#: ELC2015-00530 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/09/2015 Parcel: 1 S136DD00500 Jurisdiction: Tigard Site address: 11580 SW 67TH AVE Project: LHL Homes Subdivision: WEST PORTLAND HEIGHTS Lot: 12-Jul Project Description: (2)reconnects for furnace and a/c. Contractor: PYRAMID HEATING&COOLING Owner: HARTUNG, RICHARD& 9409 NE COLFAX LESLIE,TIMOTHY J PORTLAND, OR 97220 11580 SW 67TH AVE TIGARD,OR 97223 PHONE: 503-786-9522 PHONE: 503-348-3000 FAX: 503-786-3432 FEES Quantity Description Date Amount 2 ea Reconnect Only 07/09/2015 $135.68 Specifics: 1 ea 12%State Surcharge- 07/09/2015 $16.28 Electrical Type of Use: COM Class of Work: ALT Type of Const: Occupancy Grp: Total $151.96 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 issuan ', ‘r if work is sus•- •r-'r for more the :0 days ATTEN N: Or on law s you to follow the rules adopted by the Oregon Utility Notification •ent- . Thos- es are set f• h in •AR 952-001-001 thro h OAR 52- -009 may obtain a cop of the rules or direct questions to OUNC by calling 503.2 •.1987 or 1.8x.2.2344. i Issued By: Permittee Signature: / I�-, .d Aka..Z 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 INSTALLATI•N ONLY SIGNATURE OF SUPR.ELEC' , 1 / / c�"--- Date: rAm.' 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 Applic&ECEIVEP l (1►z c,► l,c l 1 'I ()NI 1 City of Tigard Received ©�� O -3 ILLII-_ Received 7 Permit 0: C�7 O • 13125 SW Hall Blvd.,Tigard,01 11 223 9 2015 Plan Review : I Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: TIC,A l:l) Inspection Line: 503.639.41CITY OF TIGARD Ready Date/By: lens. 0 See Page 2 for Internet: www.ti gar d-or. ov ' '��' I1lJlON Notified/Method: Supplemental PLAN atvww ❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): El Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION 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 JOB gra INIKIR MAT110N1 AND LA3CAT11ONl ❑Emergency system. larger separately derived Job#: Job site address: 11580 SW 67th ❑Addition of new motor load of system. I OOHP or more. ❑"A„ ..E, ..1-2„ .,1_3. City/State/ZIP:Tigard ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name:LHL office ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qtr. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: 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 DESCRIPTION OF WORK Limited energy,residential Disconnect and reconnect furnace and AC like for like (with above sq.ft.) 75.00 2 Limited energy,multi-family 7500 2 residential(with above sq.ft.) ❑ 1 0 TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name:LHL Homes 200 amps or less 100.70 2 Address: 11580 SW 67h 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:(503)348-3000 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 ❑ APPLICANT i F ❑ C l CT Branch circuits—new,alteration,or extension,per panel t A.Fee for branch circuits with Business name:Pyramid Heating and Coiling above service or feeder fee, 7.42 2 each branch circuit Contact name:Dave Salholm B.Fee for branch circuits without ' Address:9409 NE Colfax St branch circuit feeder fee,first 56.18 2 branch h circuit t City/State/ZIP:Portland,OR 97220 Each add'I branch circuit 7.42 2 Phone:(503)786-9522 Fax: Miscellaneous(service or feeder not included) ( ) ( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email:dsalholm @pyramidheationg.com Reconnect only 2 67.84 2 ACTOR Pump or irrigation circle 67.84 2 Business name:Same Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ Ste 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) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: 59382 Electrical Lic. R113 uprv.Lic.: specifically listed(%hr min) /6�y LEA EISCTRICAL PERMIT FEES Suprv.Electrician signature,required: ( 5 e .r. Subtotal: Print name: Corey Parsons Date: 7/8/15 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: 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. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(II/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RRSIDENTL4L WORK ONLY: IREE SCHEDULE Fee for all residential systems combined: $75.00 Renews i �' i Each 1 Total 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 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ❑ Burglar Alarm Wind generation systems in excess of 25 kva: BUr g 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 ❑ 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(I hr min) Inspections for which no fee is 90.00/hr specifically listed(1/2 hr min) COMMERCIAL WORK ONLY: ELECIDICAL MOW FEES 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: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ ire 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\Pmnits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015