Permit Iy �� CITY OF TIGARD ELECTRICAL PERMIT
li _ ' • COMMUNITY DEVELOPMENT Permit#: ELC2015-00701
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/31/2015
Parcel: 25111 BC03001
Jurisdiction: TIG
Site address: 10440 SW VIEW TERR
Project: DUNKLEE Subdivision: Lot:
Project Description: This permit is for the modification of the electrical previously inspected under MST2004-00269:(9)branch circuits
for kitchen remodel.
Contractor: OWNER Owner: DUNKLEE, JOHN+MARGARET
JOHN DUNKLEE 10440 SW VIEW TERR
10440 SW VIEW TERRACE TIGARD,OR 97224
TIGARD, OR 97224
PHONE: 503-505-0247 PHONE: 503 620-1440
FAX:
FEES
Quantity Description Date Amount
9 crt Branch Circuits wo/Purchase 08/31/2015 $115.54
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/31/2015 $13.86
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $129.40
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 ru opted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may_oblaia.a cop of the rules or irect questions to OUNC by calling 503. 1987 or 1.800.332.2 4.
Issued By: �� Permittee Signature: �,
CCC
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 FOR OFFICE USE ONLY
Received
City of Tigard pertnit
tY g it� Date/By: 3l/I y B'IT- eli: got 5 (o 701
" 13125 SW Hall Blvd.,Tigard,OR 97223 r v Plan Review
_ - Phone: 503.718.2439 Fax: 503.59 G��, Date/By: Related Permit#: 5--9.004.(x,261
Inspection Line: 503.639.4175 VV Ready Date/By: fu r 10 See vPage J2 for ice^ J
TIGAIiI' Internet: www.tigard-or.gov Ready u c Supplemental Information
TYPE OF WORK k\G PLAN REVIEW
❑ New construction ❑Addition/alteration/resplacement 'N Please check all that apply(submit a sets of plans w/items checked):
0 O1' ❑Service or feeder 400 amps or more ❑Building over three stories.
❑ Demolition ❑Other: �` ' where the available fault current
❑Marinas and boatyards.
CATEGORY OF CONSTlit!Y k i 1 c exceeds 10,000 amps at 150 volts or ❑Floating buildings.
nd 2-family dwelling ❑Commercial/indushial .II building
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
a
amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: ❑Eire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: /0 1-/"10 75 1/IEt.r Tit-ACC I00HP or more. ❑"A","E",°l-2","t-3",
City/State/ZIP: T� of-3 D� 7 2 Z ❑Six or more residential units. occupancy.
9 ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: 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 Q1.1%. I Each I tutal 1
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.it.or less 168.54 ( 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
�n ` / (with above sq.ft.) 75.00
'14 (\t-cy E 16`c-tr c_AC // Ic 'C)" l Limited energy,multi-family
residential( ith above sq.ft.) 75.00
w
Renewable Energy ❑ See Page 2
jgr PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: ZQ kA D nk 16= — 200 amps or less 100.70 2
Address: /04t11 O 5-(A)(,✓ 064.,/ /-/ael ACC 201 amps to 400 amps 1 33.56 2
R 401 amps to 600 amps 200.34 2
City/State/ZIP: 7 f9,4rd Q R 601 amps to 1,000 amps 301.04 2
Phone:(503) ,5-05- 02 7 I Fax:( ) Over 1,000 amps or volts 552.26 2
p /� C �/t}�OA s 51-Coot s Temporary services or feeders installation,alteration,and/or
Email: J01�n r V n y , CO n^ 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,i re t,ore nge,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: .C3/5 1/1.)6 401 amps to 599 amps 168.54 2
❑ PLICANT 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 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 1 56.18 S ,1$' 2
branch circuit
City/State/ZIP: Each add'I branch circuit D d
7.42 S,30 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: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy See Page 2 2
Address: ❑ g
panel,alteration,or extension. _
City/State/ZIP: Each additional inspection over allowable in any of the above_
Additional inspection(I 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 Lie.: Electrical Lie.: Suter\. Lie.: specifically listed('L-hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: ! /15: >h
Print name: Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 13L
Authorized signature:
TOTAL PERMIT FEE:�raA,
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.
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
nescriplion Qt). I Each I I oral I "
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
I Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26
Garage Door Opener*
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26
1 1 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:
I Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifleall% listed f'-hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page I):
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
Clock Systems
Data Telecommunication Installation
I I Fire Alarm Installation
I I HVAC
Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
7 Nurse Calls
I Outdoor Landscape Lighting*
I Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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