Permit CITY OF TIGARD ELECTRICAL PERMIT
" ' COMMUNITY DEVELOPMENT Permit#: ELC2016-00161
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2016
Parcel: 2S111AA01500
Jurisdiction: Tigard
Site address: 14445 SW 87TH CT
Project: Spitler Subdivision: GREENSWARD PARK Lot: 23
Project Description: Electrical reconnect only.
Contractor: N/A Owner: DARIAN SPITLER
17914 SW REISNER LN
SHERWOOD, OR 97140
PHONE: 503-730-6361
PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 03/02/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 03/02/2016 $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 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 ore the 180
days. ATTE •1: • •on law •ares you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are se forth in OAR
952-001-00 0 through OAR • -0%1-0090. You•ay obtain a copy of the rules or direct questions to OUNC by calling .1987 or 1.86 t
/Issued %y: — � / _� 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.
Electrical Permit ApplicatioRECEIjjVEP l oR 0141( I ISI OM l
City of Tigard ReceivDate/Bea .2 /2�� Permit#: jj(e�/6—op/62/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
UPI Phone: 503.718.2439 Fax: 503.598.1 Date/B : Related Permit#:
Inspection Line: 503.639.4175 Nf A R 2 n i 6 Ready Date/By: Juris: ® See Page 2 for
1 It.:1 R 1) Internet: www.tigard-or.gov ` j Notified/Method: Supplemental Information
TYPE OF 311i ''OF 1itAK1 PLAAi REVIEW
0 New construction 0 Addition/WAINGCBMfii01N Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
.l-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family 0 Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
1 w ❑Addition of new motor load of system.
L‘\..1Job#: Job site address:, \"1 L\S Sg'7 h� 0— I00HP or more. ❑"A","E '1-2 "1-3",
City/State/ZIP: TJOt V� 02—
f ` ' —Lf ❑Six or more residential units.
0 Health-care facilities. 0occupancy.
Recreational
l vehicle parks.
Suite/bldg./apt.#:
Project name: 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more.
600 volts nominal.
Cross street/directions to job site: SV Gc�S\AKA FEE SCHEDULE
Description I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit.
Subdivision:(: tem CVIS« V a Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'I 500 sqft.or portion 33.92
1
DESCRIPTION OF WORK _
energy,residential
75.00 2
(with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
El PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: QCX v t a r 1`4 1.e-/v" 200 amps or less 100.70 2
Q en � 201 amps to 400 amps 133.56 2
Address: W '' 1 S� Y��S II c/V \ 401 amps to 600 amps 200.34 2
City/State/ZiP: c... \p-)a,YWD 0 a t j./L cl '7 1 y ( 601 amps to 1,000 amps 301.04 2
Phone:(�--'( -1 - Q Lp .3V k Fax:( ) Over 1,000 amps or volts 552.26 2
1^ '^ Temporary services or feeders installation,alteration,and/or
Email: t \ TN �J\r^'Y l S` W - ( bieN Th relocation
Owner installs ion:This installation 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
0
APPLICANT ❑ 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
service or feeder fee,first 56 18
Address: 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
67.84 2
dwelling,service and/or feeder
Email Reconnect only 67.84 7.u/
NTRACTOR 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. 0 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(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.: Suprv. Lie.: specifically listed('/hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal: 6 7..df
Print name: Date: 0 Plan Review Required(25%of permit fee): c___---'
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: 7 S,sb
This permit application expires if a permit is not obtained within 180
Prin elk Date: f (0days after it has been accepted as complete.
* Number of inspections allowed per pennit.
I:Building ,C_PermitApp-ELR_ � )15 441-4615T(1 I,05,COMA WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY; FgE•IICI 1I7IrIi::
Description I QW. I Each I Total 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
❑ 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
2
with OAR 918-309-0040) 552.26
❑ 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:
ri Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr min)
COMMERCIALWORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
ri Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:Building Permits FLU_PermitApp ELR_ERE.doc Ret 06 1 7 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
14445 SW 87TH CT, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00161
Herb Stabenow
Reconnect only
Violation Summary:
Inspector Contractor