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Permit (9) _ n CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00102 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/10/2016 Parcel: 2S112CD05400 Jurisdiction: Tigard Site address: 7947 SW BOND ST Project: Pasc Subdivision: BOND PARK NO.2 Lot: 34 Project Description: Electrical reconnect Contractor: N/A Owner: FLORIAN PASC 360 NE 139TH AVE PORTLAND, OR 97230 PHONE: PHONE: 503-290-8008 FAX: FEES Quantity Description Date Amount Specifics: 1 ea Reconnect Only 02/10/2016 $67.84 1 ea 12%State Surcharge- 02/10/2016 $8.14 Electrical Type of Use: SF Class of Work: OTR Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) This permit is ubject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done i 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. TENTION: Oregon w r it s you to follow the rules adopted by the Oregon Utility Notification Center. hose rules are set forth in OAR 952-0 1-0010 thro gh OAR 952-00 -0090. You ay obtain a copy of the rules or direct questions to OUNC by calling 50 87 or 0.332.2344. Iss ed By: Permittee Signature: 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. 01P Electrical Permit ApplicatiAL' CEIV� FOR OFFICE USE ONLV Received City of Tigard Date/By- d er""' GIDlQZ 13125 SW Hall Blvd.,Tigard,OR 97FEB 10 lt i l Plan Review Related Permit II: MN Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Inspection Line: 503.639.4175 �i'L`1t O, i•'M .A Ready Date/By: turi ® See Page 2 for Internet: www.tigard-or.gov 1.111 lJ 1 V Notified/Method: Supplemental Information TN PE OF T fit'vMWPLAN REVIEW ❑New construction ❑Addition/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. El Demolition El Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. ❑ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 [1 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: El Addition of new motor load of system. I OOHP or more. ❑"A" "E" "1-2""1-3" City/State/ZIP: '.— ❑Six or more residential units. occupancy. / + [_ ❑ AP ❑Hazardous locations.Health-care facilities. [3 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Al- Service or feeder 600 amps or more. [3 Supply voltage for more than /� 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Q1N. I Each Total New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential with above sq.ft. 75.00 _ Limited energy,multi-family residential(with above .ft.) 75.00 _ Renewable Ener [3 See Page 2 OPERTV OWNER C] TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: © 13 c?7# 201 amps to 400 amps 133.56 2 V 401 amps to 600 amps 200.34 2 [ City/State/ZIP: 14PI-3601 amps to 1,000 amps 301.04 2 Phone:( Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or • relocation Owner installation:This installs Ion is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 ❑ APPLICANT ❑ CONTACT PERSON Branch circuits—new,alteration or extensionper 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 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 2 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 CO TR CTOR Pump or irrigation circle 67.84 2 Business name: 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(I hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Supra. Lic.: specifically listed '/:hrmin ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): / Authorized signature: TOTAL PERMIT FEE: 75- 99 This permit application expires if a permit is not obtained within 180 Print name: N PAS Q Date: /© 7/ days after it has been accepted as complete. * Number of inspections allowed per permit. 1:\Building\Permits\ELC_PcrmitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(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 Uescri Tion Qh'. Each Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 5.01 to 15 kva 133.56 ❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 Wind generation systems in excess of 25 kva: ❑ Burglar Alarm 25.0'1 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 F-1 Garage Door Opener* >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 ❑ 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 I charged at an hour] (1 hr min) Inspections for which no fee is 90.00/hr specifically listed(/2 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. 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:\Building\Pe hs\ELC_PcnnitApp_ELR_ERE.doc Rev 06/17/2015