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Permit t n CITY OF TIGARD ELECTRICAL PERMIT • I COMMUNITY DEVELOPMENT Permit#: ELC2015 00591 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/30/2015 Parcel: 2S102BCO2800 Jurisdiction: Tigard Site address: 12905 SW WATKINS AVE Project: MCCULLOCH Subdivision: ROSE TERRACE Lot: 4 Project Description: Replacing(1)200 amp service. Contractor: CHEROKEE ELECTRIC CO Owner: MCCULLOCH, GRANT H&SHIRLEY A J 13019 SW BRADLEY LN LIVING TRUST TIGARD, OR 97224 12905 SW WATKINS AVE TIGARD, OR 97223 PHONE: 503-209-9039 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 07/30/2015 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 07/30/2015 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 Ce r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma •• . a copy direct questions to OUNC by calling 503.23 or 1.800.332.23 Issued By: � _ - - rmittee Signature: - .00"1"- 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 1-OIZ 01•11( 1: I tii 0\l.1 City of Tigard Received : • 13125 SW Hall Blvd.,Tigard,OR 97223 DDate/13 : MIST" — . e Plan Review Phone: 503.718.2439 Fax: 503.598.1960 \\I Date/B : Related Permit#: T c, i Inspection Line: 503.639.4175 �� , Ready Date/By: 61 See Page 2 for Internet: www.tigard-or.gov `1%11 Supplemental Information _L_ APP TYPE OF WORK,\.CO \ ,�,0.IA Please check all PLAN REVIEW ❑New construction ®Addltion/alteration/repl e�ipean\J\ l that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: \�`� �(.%� ❑Service or feeder 400 amps or more ❑Building over three stories. �l \r1 _ where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSIegjigicON 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 SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived Job#: Job site address:/�q s` .j(4) W - I€z./N 5 ❑ 00HP Addition of new motor load of system. © a 4 ` 100HP or more. 'A" "E>• "1-2" "1-3" ❑Six or more residential units. occupancy. City/State/ZIP: 77y. e ©,Q I7 3 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: G nt iticx.,`'/I,4 L ❑Hazardous locations. ❑Supply voltage for more than t°` °1 ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: p c i- ( J 4 .+ 5-f; FEE SCHEDULE Description I Qty. 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'1500 sq. or portion 33.92 1 ft. DESCRIPTION OF WORK Limited energy,residential Chet,9 / (with above sq.ft.) 75.00 2 t� Se!'tl i L� Limited energy,multi-family residential(with above sq.ft) 75.00 2 ❑ PROPERTY OWNER ❑ TENANT Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation Name: 200 amps or less / 100.70 /a),7 { 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:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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 0 APPLICANT 1 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel clef,1- _ A.Fee for branch circuits with Business name: •cam Ef l_f r i"� above service or feeder fee, 7.42 2 each branch circuit Contact name: RV 64, 5 c rt Vile-1— B.Fee for branch circuits without Address: service or feeder fee,first !-3°(c 5c) B fey C... branch circuit 56.18 2 City/State/ZIP: T:7„,,,e_ Cg_ ??.2-2-`( Each add'!branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(5-03) j 7_ 9.037 Fax: :( ) Each manufactured or modular Email: dwelling,service and/or feeder 67.84 2 Sur i v N.e-("ro t&Q a&t. eo w` Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Cet,e4ro Le.c_ F7,-/-r-(�C—.. Sign or outline lighting 67.84 2 Address:/jot ' Si� B,--a.421 panela circuit(s) or extension.limited-energy b � panel,alteration, ❑ See Page 2 2 City/State/ZIP: ` ('R p? z Li Each additional inspection over allowable in any of the above q Gi r / Additional inspection(1 hr min) 66.25/hr Phone:(5-03) 2,0 t1_ 703? Fax:( ) Investigation(1 hr min) 90.00/hr Email: I Industrial plant(1 hr min) 78.18/hr ne-rra Inspections for which no fee is 90.00/hr CCB Lic.:3S6 v-i Electrical Lie.: _/27L Suprv. Lic.: e l 6 5 specifically listed(v:hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: t(/ Subtotal: I C.t)•/0 Print name: R9,„ • sir V n eir Date: 7_30 —/s ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): /1. 0$ Authorized signature: TOTAL PERMIT FEE: //c ,�+`� 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. 1:1Buldding\PermitstELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB 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 12905 SW WATKINS AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal FAIL ELC2015-00591 Herb Stabenow Nobody there-contractor will reschedule 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 12905 SW WATKINS AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00591 David Young Violation Summary: Inspector Contractor