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Permit q CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00039 Dale Issued: 01/20/2016 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 25101 DB00705 Jurisdiction: Tigard Site address: 7475 SW VARNS ST Project: Miller Subdivision: ROLLING HILLS Lot: 5 Project Description: New 150A main breaker panel and(3)branch circuits. Contractor: METRO ELECTRIC INC Owner: MILLER, ROBERT CLARENCE 3860 SE FELTON AVE DOROTHY NELL TROUTDALE, OR 97060 7475 SW VARNS TIGARD, OR 97223 PHONE: 503-666-2159 PHONE. FAX, FEES Quantity Description Date Amount 1 ea Services or Feeders-200 01/20/2016 $100.70 Specifics: amps or less 3 crt Branch Circuits w/Purchase 01/20/2016 $22.26 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 01/20/2016 $14.76 Electrical Type of Const: Occupancy Grp: Total $137.72 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 - cpproved 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. TENTION'. Oregoor anc iIn alaw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1-0010 though OAR 95 -001-0 ger Y ay obtain a copy of the rules or direct questions to OUNC Dy rolling 503 232 1987 or 1.800.332.2344. I ued By: Permittee Signature: x _ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rem. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' G Date: 11R-0116 LICENSE NO. p Y 7 S 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 thejob site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit A licat' �r�� City of Tigard L 1 WleBea ��p Pe mil n: �Lesbt0—coo 9 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Rey:ie pae/ w Related Permit NPhone503.718.2439 Fax: 503.59J.4qVVOD By Inspection Line: 503.639.4175 O Ready _ Date By: �nru= ® &e Page 2 for Internet: www.tigard-or.gov Nmified Methtd: Supplemental Information TYPE l rPLAN:REVIEW E]New construction ;ftAdditi Please check all that apply(submit 2 sets ofplans w,acnis checked): ❑ ❑Sen ice or feeder 400 amps or more E]Building over three stories. Demolition E]Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑Floating buildings. I-and 2-family dwelling ❑Commercial/industrial []Accessory building less to ground or exceeds 14.000 ❑Commemorfuse agricultural amps for all other installations. buildings. E] Multi-family ❑ Master builder E]Other: ❑Fire pump. ❑Installation of 150 RVA or JOB SITE INFORMATION AND LOCATION ❑Lmergency system larger separately derived ❑Add itLon ofnewmotor load of system Job#: Job site address -)S- 6L.D gl 10011E or more ❑-A.. ..F.. ..l;.. 1-3' ❑Six omnore residential unit,_ occupancy. City/State/ZIP: v-d ❑Ilealth-care fLohnes. ❑Recreational vehicle parks. ❑Ila/wdous locations_ ❑Supph mhage for morn,than Suiteibldg./apt. #: Project name: LL - ❑Service or feeder 600 amps or more 600 volts nnnunal. Cross street/directions tojob site: FEE SCHEDULE Descri tion I OM I FrisA I Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 til.It.or less 168.54 4 Tax map/parcel#: Ea.add l 500 sq.Itor gonion 3392 I DESCRIPTION OF WORK Limiled energy,residential (with above sq,t1f 75110 2 r7.s \ Limited energy,multi-famih 7s 00 residential is,ith above s -it - Reactable Ener ❑ See Pa c 2 ❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 100,10 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 30104 Phone:( ) Fax: ( ) Over 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 IM 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps Owner signature: Date: 401 amps to 599 amps branch 2 ❑ APPLICANT ❑ CONTACT PERSON Branch circuits-nee,alteration or extension per panel A.Fee Ibr branch circuits o irk Business name: abocc service or feeder fee. T42 af2r o each branch circuit Or ae Contact name: B.Fee for branch circuits u ohms service or feeder fee,first 56.18 O Address: circuit - City/State/ZIP: Each add l branch circuit Miscellaneous service or feeder not included Phone: ( ) Fax: : ( ) Each manufactured or modular 6784 dwelling,service and/or feeder - Email: Reconnect only ta 2 CONTRACTOR Pump or irrigation circle 2 Business name: ' 1L ]�E�D &L�TI�I� Sign or outline lighting _ Address: Signal circuil(s)or limited-enemy' g /�� panel,alteration,or extension. ❑ See Pae 2 Each additional inspection over allowable in any ofthe above City/State/ZIP: �e- Additional inspection(I hr min) 66.21 hr Phone:(-'W7 )666-Z 1 S Cr, Fax: ( ) Investigation(I hr min) 90.00/hr Email:/ Industrial plant(I hr min) 78.1 S/hr 's, go lrvc�. Ji,-• JiliG Inspections forwhich no fee is CCB Lie.: S Electrical Lic.: Supt-v. Lic.: s cificall y listed t::hr min) 90.001 hr ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal: 9,oZ• Q Print name: Date: ❑Plan Review Required(25%of permit Cee): State surcharge(12%ofpennit fee): l[.(•'7(d Authorized signature: TOTAL PERMIT FEE: 7y. 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 allow ed per permit. (.Buildinu Pcrmhs 01 C PermitApp 14.R ERF.doc Rc�tib 1-]OH 4411461ST(11 lig COV wFD Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: iLaw Fee for all residential systems combined $75.00 iTIA t r ne ne rma Ut e.m _r T.I. yRenewable 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 2 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva 301.00 50.01 to 100 kva 552.^_6 2 F-1 Garage Door Opener* >I00 kr-a(fee in accordance 55-.-6 2 with OAR 916-309-0040) ❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kea over 25 7,42 3 ❑ Vacuum Systems* >100kca—no additional charge o.o 3 Each additional inspection over allowable in anv of the above: ❑ Other: Each additional inspection iv 66.^-S'hr 1 char•cd at an hour,(1 hr min) Inspections for which no tce is 90.00/hr smitically listed PL hr min) COa'�urs,a�RC��©RK ONLY: - - -. CAL PERMIT FEES •)rr. Subtotal(Enter on Page l): Fee for each commercial system: $75.00 Nuniher of inspections Subloallowed l(Entero (SEE OAR 918-309-0000) per perjoil 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 I nuildine Pconiu 1-1 C Perinll'ki, I I R I KI dnc Rcc 06 1-2111;