Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permits: ELC2016-00040
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/20/2016
Parcel: 2S110AB03200
Jurisdiction: Tigard
Site address: 14285 SW 114TH AVE
Project: Watkins Subdivision: COLE'S ACRES Lot: 15
Project Description: Add(2)branch circuits
Contractor: OWNER Owner: WATKINS, PETER&MAGGIE
PETER&MAGGIE WATKINS 14285 SW 114TH AVE
14285 SW 114TH AVE TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-957-8472 PHONE: 503-957-8472
FAX
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 01/20/2016 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/20/2016 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total S71.23
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specially Codes and all other applicable law. All work will
be done in �O��ith approved plans. This permit will expire k work is not started within 180 days of issuance, or if work is suspended for more the 180
days. AT NTION: Oregdt I quires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-00L010..thrJough OAR 95 001-09 You may obtain a copy of the rules or direct questions to OUNC by calli 503 87 0 1 00.332.2344/f21_.d� Permittee Signature: _ f�ci P v v
OWNER INSTALLATION ONLY
The installatbn is being rustle on property I wn hic t ended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4176 by 7:00 a.m.for the next available inspection date.
This perk 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 IBNIBB
EIVEh Received Q M
City of Tigard Dale/0 : O V Permit £ 1!a 0M a
i• 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date tic: Related Permit e:
Inspection Line: 503.639.4175 �(�U 2 0 2016 Ready Dale By: Jars: ® See Page 2 for
Internet: www.tigardor.gov Notified Method: Supplemental Information
PLAN REVIEW
❑New construction Addlfit)n/atteretionheplacement 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<utrem ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
1-and 2-family dwelling ❑Con)mercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations. buildings.
Multi-family ❑ Master builder El Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
Job#: Job Site address: �r� 'rJ.i., �t ,,, ❑Addition ofmw motor load of system.
J92S SW'j7' 4 r1YC IOOHP or mom. ❑"A , E , 1.2,•,"I-Y,
Cit /State/ZIP: ❑Six or more residential units. occupancy.
y Tt a.d O!t `3 7 2 Z y [3Healthcare facilities. C]Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Haeardous locations. 0 Supply collage for more vArA mhothan
�J _��. , ❑Service or feeder 600 strips or more. 600 bs nominal.
Cross street/directions tojob site: 1. +0 Jay _ 4V Z' FEE SCHEDULE
Description 1 21, 1 Jaen 1 ram[
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.H.or less 168.54 4
Tax map parcel ft: Ea.add'I 500 sq.0or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Add/ a by _ p 5 lavish above .11. 75.00 2
TCLC b4h(h .Cv.�eL �YILC.0 C !t'GC.L7J Limited energy,multi-family 75.00 2
residential with above .a.) -
❑ Renewable Energy ❑ See Pa e 2
PROPERTY OWNER TENANT L Services orfeeders installation,alteration and/or relocation
Name: Pe—kr RnC� Iva q/9- Wig4-k Ir 200 amps or less 1 100.70 1 2
Address: Nags 'S VV 11L Q 201 amps to 400 amps 133.56 2
401 amps to 600 amps 2(10.34 2
City/State/ZIP: TI OR q 72-zq 601 amps to 1,000 amps 301.04 2
Phone:(50�j) '7 7—btl72. Fax:( ) Over 1,000 amps of cops 552.26 2
L ^ Temporary services or feeders installation,alteration,and/or
Email: Loa_i i e/ `cr art. cum relocation
Owner installation:Thi allation is being made on property that 1 own which is not 200 amps or less 59.36 1
intended for sale le h nge,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: eF�n Date: Y?! 201& 401 amps to 599 ampa 168.54 2
❑ APPLICANT ❑ CONTACT PERSON Branch circuits—new alteration or extension,per panel
A.Ice for branch circuits will,
Business name: above service or feeder fee, 7.42 2
each branch circuit
Contact name: B.Fee for branch circuits withota C
Address: service or feeder fee,first 56.18 5(v, 8 2
branch circuit (F
City/State/ZIP: Each add'I branch circuit 7.42 } 2
Miscellaneous service or feeder not included
Phone:( ) Fax: : ( ) Each manufactured or modular
doellin ,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuigs)or Iimiledcnergy
panel,alteration or extension. [I See Page 2
City/State/ZIP: Each additional Inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/for
Phone:( ) Fax:( ) Investigation(I In min) ?2 21E
Email: Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv. Lic.: scilically listed(' hrmin)
ELECTRICAL PERMIT FEES
Sup".Electrician signature,required: Subtotal:
Print time: Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of peril fee): 7•
Authorized signature:
U^ O x/)0 2 0 R W TOTAL PERMIT FEE: .a3
p This permit application expires if a permit is not abtai ed within ISO
Print name: 1\'t 1 OL k_1 Y6 Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
Ii MildintPermits.ELC_P.uApp EIA ERE.doc Ree 06/17/2015 440-4615T(11/05,COAUWEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESID �11i.WORK ONLYW
Fee for all residential systems combined: $75.00 u,er tloa e.sh ,.t.t
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
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑
50.01 to 100 kva 552.26 2 Garage Door Opener* >I00 kva(fee in accordance 552.26 2
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
❑ Vacuum Systems* 1100 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 I
charged at an hour) (1 hr min)
Inspections for which no fee is 90 OU hr
specificallylisted(%hr min)
COMMERCIAL WORK ONLY: Af eERmEr FEES
Fee for each commercial system: $75.00 snbtt,tai(Enter on Page I c
• Number-of impections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
L auilamp Permits ELC PmokA,,UX LRE.doc Rev 06IM015
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
14285 SW 114TH AVE, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00040
Chip Barnett
Violation Summary:
Inspector Contractor