Permit p CITY OF TIGARD ELECTRICAL PERMIT
1111 3 - COMMUNITY DEVELOPMENT Permit#: ELC2015-00630
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/10!2015
T-
Parcel: 2S111AD10100
Jurisdiction: Tigard
Site address: 8720 SW REILING ST
Project: Thompson Subdivision: SCHECKLA PARK ESTATES Lot: 58
Project Description: (2)branch circuits for new heat pump.
Contractor: NORMANDIN ELECTRIC Owner: THOMPSON, SHAWNA& RYAN
51086 NW CLAPSHAW HILL RD 8720 SW REILING ST
FOREST GROVE,OR 97116 PORTLAND, OR 97224
P
PHONE: 503-679-8643
PHONE: 503-357-5380
FAX: 503-357-4878
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 08/10/2015 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/10/2015 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 - ordance wi -pproved 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. A NTION: Oregon la• r-.uires you to follow the rules adopted by the Oregon Utility Note . on Center. Those rules are set forth in OAR
952-00 -0010 throu,h OAR 952-0, 00•' ou may obtain a copy of the rules or direct questions to OUNC by .1987 or 1.800.332.2344. '
Iss ed By: if, 0 j Permittee Signat :• oll. "' 1 4� 0, r '
'
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' _1• . �- • �� S[
,. ".t l(Gam_. Date: /
LICENSE NO. Z S-g J
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 Applicapfg C E I VE D FOR OFFICE I S I:ON I.1
City of Tigard Received• DateBy: b �/S , ' ) Pcenut ��L-�/y�.� 56)
1111
13125 SW Hall Blvd.,Tigard,OR 97 G 1 0 2015 Plan Review J
e Phone: 503.718.2439 Fax: 503.59 .1 60 ,g. Related Permit#:
1 1 c.A R l] Inspection Line: 503.639.4175 CITY OF TIGARD RAY Date/By: juns: ® See Page 2 for
Internet: www.tigard-or.gov -, rt; 1 t ... Notfied/Method:
Supplemental DP:',Y.:,, L,N51UN
TYPE OF WORK PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w!items checked):
❑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.
Ff 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:
❑Fue PAP 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATI ❑Emergency system. larger separately derived
Job 4: Job site address: ,), 1 ' ,(1 ❑Addition of new motor load of system.
7Z S�+J��' P//�/1l-f V7 I00HP or more ❑"A. :•E. "t-2""1-3"
City/State/ZIP: 17q4,---d G el 7Z J ❑Six or more residties. units occupancy.
Q / ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.4: 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: FEE SCHEDULE
Description I Qty. I Each 1 Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Lot 4: Includes attached garage.
Tax map/parcel 4: 1,000 sq.ft_or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
GL+ pk e'1"1 ����(,� Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
❑ TENANT Renewable Energy ❑ See Page 2
PROPERTY OWNER Services or feeders installation,alteration,and/or relocation
Name: y4/l 14.,...1;41.01),61_, � .?,��d 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/StalelZlP: 601 amps to 1,000 amps 301.04 2
Phone:( 543 Zj / 844,3 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
❑ APPLICANT ❑ CONTACT PERSON I Branch circuits—new,alteration,or extension,per panel
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
Address: branch circuit 56.18 . 2
City/State/ZIP: Each add'I branch circuit I 7.42 '44 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
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: �'�/'��tnele/L� GG7�j�L Sign or outline lighting 67.84 2
Address' /� t�/�, } Signal circuit(s)or limited energy ❑ See Page 2 2
(J J//,L.) (a 7Q4,� X 4/ panel,alteration,or extension.
City/State/ZIP: / ' /- h /� /,/�� Each additional inspection over allowable in any of the above
_ `/{1/7r '7' Additional inspection(1 hr mini 66.25/hr
Phone:(��/,3.3 7,..5,-. S) I Fax:(Jp J57-4�7y" Investigation(1 hr min) 90.00/hr
Email: !'`m niciy 5, C 6��/ c 1-i Industrial plant(1 hr min) 78.181 hr
Inspections for which no fee is
CCB Lic.:Z,�%y)r l Electrical Lic. -25E C Supry.Lie.;3 'J specifically listed(A hr min) �/hr
Suprv.Electrician signature, J ELECTRICAL PERMIT FEES
gnature,required: / �_
J Subtotal:
Print ram•: , i t " A Date: �5i� 0 Review Required(25%of permit fee):
State surcharge(12%of permit fee): 7
Authorized signature: TOTAL PERMIT FEE: 7/.
.4.3.
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.
',Building\Permits\ELC_PermitApp_ELR_ERE.doe Res 06/17/2015 440-4615T(11705.COM/'sVEB
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
8720 SW REILING ST, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00630
Jeff Grove
Violation Summary:
Inspector Contractor