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Permit 114 a CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2015-00684 13125 SW Hall Blvd..Tigard OR 97223 503.718.2439 Date Issued: 08/25/2015 TIC.+1 li 1) g Parcel: 2S110AB03000 Jurisdiction: Tigard Site address: 14325 SW 114TH AVE Project: Schumock Subdivision: COLE'S ACRES Lot: 14 Project Description: Reground house due to water service replacement. Contractor: OWNER Owner: RANDY& CLAIRE SCHUMOCK RANDY&CLAIRE SCHUMOCK 14325 SW 114TH AVE 14325 SW 114TH AVE TIGARD. OR 97224 TIGARD, OR 97224 PHONE: 503-781-9409 PHONE: 503-781-9409 FAX. FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 08/25/2015 $56 18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 08/25/2015 S6 74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty .de. and all other ••pl .•- law All work will be done in ac ncc-.mith approved plans This permit will expire if work is not started within 180 days of i- ua e, or if7work is sus.. ded for more th /180 days. AT TION: Oregon aw -•uires you to follow the rules adopted by the Oregon Utility Notit.f,on i enter. Those rul- are set forth /OAR 952-00 -0010 through OAR 952-:,•1-009*. may obtain a copy of the rules or direct questions to OUNC by calling, ■ .".1 ;7' '1.8s "y Iss ed By: �\ �� ct�E'L� ) Permittee Signature: 1 , �_ ' "R INSTALLATION ONLY ' The installation is being made on property g p p y ',• hich is �tend:,for�•-,lease or rent ,, �/ / 0� /� OWNER'S SIGNATURE I !JI A. / 41/116 Date: P 0S 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 Applicat CE ‘,/ED FOR OFFICE USE ONLY 2015 Received /�/ y C125 of Tigard ?UG 2 5 Date/B : i o-, / Permit CF�o�'/5- ; 't 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review ^ • Phone: 503.718.2439 Fax: 503.5X Date/B : Related Permit H: at694/S-� g Inspection Line: 503.639.4175 i . -;.--'i� pee m Ready Date/By: kris ® See Page 2 for TI G A R D Internet: www.ti and-or. ov 1! ❑i N!( -,t`�,!')1 w g g �( !_ _ _ Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW ❑New construction dditon/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 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings. ffi and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 0 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#: I Job site address: j t7/3 ZS—sgui /17� ❑Addition of new motor load of system. 100HP or more. ❑"A" "E" "l-2" "I-3" City/State/ZIP: �4�r / Q� e(71-Z'{ ❑Six or more residential units. occupancy. etr OK. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I 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: c urLc_ FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: l/1 AA©(Q f 1„d�l'1701A I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK i Limited energy,residential 75.00 6-�L�1S l0-•fi (with above sq.ft.) Limited energy,multi-family 75.00 _ residential(with above sq.ft.) A Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER 1 ❑�,T,ENNANT Services or feeders installation,alteration,and/or relocation Name: . a !�fa (l SX�t/l ut�( bbl 200 amps or less 100.70 2 ' "lf 201 amps to 400 amps 133.56 2 Address: .MAQ . 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:(37)3) -re( _Oi if-of I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: S s �� (' S (wa C'erV Temporary services or feeders installation,alteration,and/or � / relocation Owner installatio stallat'in is be Tl ade oriproperty that I own which is not 200 amps or less 59.36 I intended for sale,lea- t,o• - cha teI :,/ordin tt,,�1RS 447,449,670,and 701. 201 amps 10 400 amps 125.08 Owner signature: / / '"/ ."�`l� Date: 401 amps to 599 amps 168.54 ❑ APP ICANT / I ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first f 56. 18 5./o b 2 ranch circuit City/State/ZIP: Each add'I branch circuit 7.42 Miscellaneous(service or feeder not included) Phone:( ) Fax: : ( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: /')L3 f{2- Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. ❑ See Page 2 2 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 CCB Lie.: I Electrical Lie.: Suprv. Lie.: specifically listed(''/hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: 5('./? Print name: Date: ❑Plan Review Required(25%of permit fee): 4,6' State surcharge(12%of permit fee): le,7(7 Authorized signature: TOTAL PERMIT FEE: tea,,9.„1„ 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440.4615x(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: AIME FEE SCHEDULE Fee for all residential systems combined: $75.00 Renewable Qt,. Ea�1, Total y Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 5.01 to 15 kva 133.56 2 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.04 n Garage Door Opener* 50.01 to 100 kva 552.26 >100 kva(fee in accordance 552.26 with OAR 918-309-0040) Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n 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 charged at an hourly(I hr min) Inspections for which no fee is 90,00/hr specilicall∎ listed(:.hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMITS Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems Boiler Controls 7 Clock Systems n Data Telecommunication Installation U Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems I I Landscape Irrigation Control* Medical Nurse Calls Outdoor Landscape Lighting* n Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PennitApp_ELR_ERE.doc Rev 06/17/2015 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 14325 SW 114TH AVE, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final PASS - No C of O ELC2015-00684 David Young 2 ground rods installed. Violation Summary: Inspector Contractor