Permit CITY OF TIGARD ELECTRICAL PERMIT
■ COMMUNITY DEVELOPMENT Permit#: ELC2015-00517
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/08/2015
T i(;rlK D g Parcel: 2S110DD90011
Jurisdiction: Tigard
Site address: 10980 SW MEADOWBROOK DR 1
Project: Wolfe Subdivision:SUMMERFIELD BROOKSIDE CONDO Lot: 1
Project Description: (1)branch circuit to move receptacle.
Contractor: NICE ELECTRIC CO Owner: WOLFE, SANDRA L
PO BOX 636 10980 SW MEADOWBROOK DR#1
MCMINNVILLE, OR 97128 TIGARD, OR 97224
PHONE: 503-434-5802 PHONE:
FAX: 503-472-1628
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 07/07/2015 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/07/2015 $6.74
Type of Use: SF Electrical
Class of Work: ALT 1 ea Investigation Fee 07/07/2015 $90.00
Type of Const:
1 ea Investigation 12%State 07/07/2015 $10.80
Surcharge
Occupancy Grp:
Total $163.72
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 obtain a copy• the rules or 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.
2015/JUL/07/TUE 12:59 P, 002
Electrical Permit Applicatio9ECEIVED fOf orriCE rsiiONL\
City o Tigard Received
11111 - f g Date/ !i U
• 13125 SW Hall Blvd.,Tigard,OR 97223 I I I� 7 2015 Date/0 Phone: 503.718.2439 Fax: 503.598.19 Related Permit#:
Inspection Line: 503.639.4I 75 Reedy Date/By: J' , el See Page 2 fbr
TIGARn CITY '1 ArRD Notified/Mothod: 'J�Cv supplemental Information
Internet; www itgard or aov 1 t r
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rr :f. " ^4 ti? �etn 10.':M,4t,: j,t, 7ii 1. i %-: Y °�„14.1L 'fit'^�3!� �� ` �
O New construction IA Addition/alteration/replacement Please check:all that apply(submit a sets of plans w/Rams cheoked)
❑Service or Feeder 400 amps or more ❑Building over three stories.
El Demolition ❑Other: where the available fault curreot ❑Marinas and boatyards.
r
b,?', Zy1 'uiSffgi �4 i Yca4at*a ra o "::l ' ,i . ;'. exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to w or exceeds 14.000 ❑Commeroial-use agnc
0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building ound utturat
amps for all other inatallariotui. buildings.
0 Multi-family ❑Master builder �❑`Other: ❑Fire pump El Installation of 150 KVA or
ppgiw b16 5 d 0 d )a ,.+.r k r ql,r•,j^of ❑Emzrgency system larger separately deriver]
F l+ ❑Additio 1 of new motor load of system.
Job#: Job site address:10980 SW Meadowbrook Dr 1001P or more. ❑"A', 'E °1-4 °l s
❑Six or more residential units. ocoupancy.
City/State/ZIP:Tigard OR 97224 ❑Health-care facilities. El Recreational vehicle parks.
Suite/bldg./apt.#:Unit 1 Project name:Square Deal-Move Recept 0 Hazardous locations. in Supply voltage ibr mare than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross strcet/direetions to job site _. j Rgrotitmoll y 1 B
Dem-lotion "'• Qty. Loch Total ,` ,
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.
Tax map/parcel#:(Y) R1209472 R.or less 168.54 4
Ea.add':500 sq.ft.or portion 33.92 i
.rk a ti s t. .. :, .t,S a v�.� Mth:4a._ Limited energy,residential 75.00 2
Move Receptacle (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.) -
Renewable Energy 0 See Page 2
' ftI ttkgE - 4:rat Ki1 :y '. L: of ;c ', 9' Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less I 100.70 2
201 amps to 400 amps 133.56 2
Address:
401 amps to 600 amps I 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 snips 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 I 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 hips to 400 amps _ 125.08 2
Owner signature: Date: 401 amps to 599 amps ' 168.54 2
w 71,.rr , ,l-,..xc>— Branch circuits—new,alteration,or extension,per panel
...4,,,„441,4,..,,,,::,,:.;,ii,.,,xo.:® , v 1 ,-.. r. ,,: ": , *,1 �- 4 • A.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 1 56.18 56.18 2
Address: branch circuit
City/State/ZIP: _Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
itkt„L'..1'0‘1,:,--'+t-3 g Sii:'r 7 aai+ m' O1 +�yC Q 't-' Irv,;' i ,.:;_ef/ .f.: 't r- . Pump or urination circle 67.84 2
Business came:Nice Electric Co Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address:BO Box 636 panel,alteration,or extension- El Sec Page 2 2
City/State/ZIP:McMinnvlle OR 97128-0636 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.21 hr
Phone:(503)434-5802 Fax:(503)472-1628 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:infogir..nice-es.conit Inspections for which no fee is
CCB Lie.: 2061 I Electrical Lie.: 36-9C Suprv.Lic.: 4829S ' specifically listed('A hr nain)_ 90-001 hr
Ti. t131? i
Supry.Electrician signature,required: Subtotal: ' 56-18 '
-
Print name: Men,Zook . Date: 7/7/2015 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 6.74
Authorized signature: TOTAL PERMIT FEE: 62.92
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\r'wmit?\ELC_PermltApp_ELR ERE des Rev 06/17'2015 440-46157(lt/05/COM/WEB ` l C V (�J
/63,72
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
10980 SW MEADOWBROOK DR 1, TIGARD,
OR, 97224
Residential - Electrical
199 Electrical final
FAIL
ELC2015-00517
David Young
Not ready for final, recepticals and face plates not installed.
Violation Summary:
Inspector Contractor
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
10980 SW MEADOWBROOK DR 1, TIGARD,
OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00517
David Young
Violation Summary:
Inspector Contractor