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Permit
�It�} tt CITY OF TIGARD ELECTRICAL PERMIT ji '''g r. COMMUNITY DEVELOPMENT Permit#: ELC2015-00886 A .f e At,' 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439 Date Issued' 11/03/2015 T1 R5. Parcel: 1S135DC07900 Jurisdiction: Tigard Site address: 11635 SW 90TH AVE Project Jung Subdivision: TIGARDVILLE PARK Lot. 7 Project Description: Install overhead meter socket and new service panel Contractor: OWNER Owner: JUNG, PETER R LIVING TRUST PETER R JUNG PO BOX 230331 11635 SW 90TH AVE TIGARD, OR 97223 TIGARD, OR 97223 PHONE 503-880-1110 PHONE 503-880-1110 FAX FEES Quantity Description Date Amount 1 ea Services or Feeders-200 11/03/2015 $100 70 Specifics: amps or less 1 ea 12%State Surcharge- 11/03/2015 $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 accordance th 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 r uires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR 952- 01-0010 through OAR 952- -009 may obtain a copy of the rules or direct questions to OUNC by calling 503 231987 or 1 800 332 2344 Is ued By: K Lf�'�f' JC Permittee Signature: • " OWNER INSTALLATION ONLY The installation is being made on pro!dpr .ac y I own which is not intended for sale,lease or rent OWNER'S SIGNATURE Date: ///05/5 TRACTOR 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 Applica : zt. - z��Y " N ' t��I] erIVE FOR OFFICE U.SE ONLi - r Received City of Tigard Date/B if 3 AIM Permit N I[,C6P6i s-cO g e r` `4 13125 SW Hall Blvd,Tigard,OR 97223 �_. l i&` Plan Review . ,,,I1,,,',. Phone 503.718 2439 Fax: 503.5 Q 0 Date/[3 Related Permit N { ��` 32015 *.:r, Inspection Line. 503.639.4175 Ready Date/By Juiis. ® See Page 2 for• TIGARD - v, Internet: www.tigard-or.gov T' Notified/Method Supplemental Information Uafr ��,A �.y TYP if ,, `~ PLAN REVIEW ❑ New construction ❑Addittalryef 8 /Felp gn N Please check all that apply(submit 2 sets of plans w/items checked) ❑ Demolition ❑Other: ❑Service or feeder 400 amps or more ❑13uilding over three stories where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings El I-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: ❑Addition of new motor load of system t 16 3. S,14/.go ti 10011P or more ❑"A „13 `i_2 l_3 ; �)' ❑Six or more residential units occupancy. City/State/ZIP: •'I ilctr d� ©tie—{ 711 3 ❑l lea lth-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 Qt■. 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'l 500 sq ft or portion 33 92 1 DESCRIPTION OF WORK Limited energy,residential (With above sq ft) 75.00 101,5I—a((t((14 04"2-C—k d (en e I Sock e---j- greQ kereQr Limited energy,multifamily J residential(with above sq ft.) 75.00 2 Renewable Energy ❑ See Page 2 PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name' Pee_- ,Y►R 3 iA,5 200 amps or less ' 100.70 2 Address: I1 635 Si qQ,��. /� 201 amps to 400 amps 13356 2 t/e° 401 amps to 600 amps 200 34 2 City/State/ZIP: "f' at-d r Or. e'71.13 601 amps to 1,000 amps 301 04 2 Phone:(j 03) g d a_ i i 10 Fax:( ) Ovei 1,000 amps 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 59 36 1 intended for sale,lea. ,rent,or exchange,acco ding to ORS 447,449,670,and 701. 201 amps to 400 amps 125 08 2 t>,,, au' . .--)g._0,10i6' 401 amps to 599 amps 168.54 2 ❑ APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fcc for branch en cults with Business name: above service or feeder fee, each branch circuit 7 42 2 Contact name: 13 Fee for branch circuits without Address: service or feeder fee,first branch circuit 56 18 2 City/State/ZIP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone: ( ) Fax: :( ) Each manufactured of modular 67 84 2 Email: dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 6v vi e r Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy panel,alteration,or extension ❑ See Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(I hi min) 66 25/hr Phone:( ) Fax. ( ) Investigation(1 hr min) 90 00/hr Email: Industrial plant(1 hr min) 78 18/hi Inspections for which no fee is 90 00/In CCB Lie.: Electrical Lie.: Suprv. Lie.: specifically listed('/hi min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: '57o -(I ADD, Print name: Date: ❑Plan Review Required(25%of permit fee): 1 State surcharge(12%ofpernntlee) Co- '7•L(4° Authorized signature: TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 181) Print name: Date: days after it has been accepted as complete. .7///49.....7 Ci * Number of inspections allowed per permit . IARmldingAPei nuts VELC_Pei maApp_ELR_ERE doc Res 06/172015 440-46151(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: FEE SCHEDULE Fee for all residential systems combined: $75.00 Description Q,y. Each Total y 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: n Burglar Alarm 25 01 to 50 kva 301.04 2 50.01 to 100 kva 552 26 2 n Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n H• eating, 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—noadditional charge 0.0 3 Each additional inspection over allowable in any of the above: ❑ Other: Each additional inspection is 66.25/hr chat ged at an hourly(I hr mm) Inspections for which no fee is 90.00/hi specifically listed('A hr mm) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Pagel) (SEE OAR 918-309-000 0 * Number of inspections allowed per permit Check Type of Work Involved: Ti A• udio and Stereo Systems n Boiler Controls n Clock Systems n D• ata Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* Medical n Nurse Calls U Outdoor Landscape Lighting* Ti Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all •other installations I\Bmld mg\Permits\ELC_P.mn App ELR_E-RE doe 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 11635 SW 90TH AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final PASS - No C of O ELC2015-00886 Jeff Grove 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 11635 SW 90TH AVE, TIGARD, OR, 97223 Residential - Electrical 115 Electrical service PASS ELC2015-00886 Jeff Grove Violation Summary: Inspector Contractor