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Permit (24) INCITY OF TIGARD ELECTRICAL PERMIT a . '. COMMUNITY DEVELOPMENT Permit#: ELC2016-00192 T E G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/14/2016 Parcel: 2S110DB91081 Jurisdiction: Tigard Site address: 15371 SW 114TH CT 108 Project: Bank of America Subdivision:rAINS AT SUMMERFIELD CONDO-PH/ Lot: 108 Project Description: Reconnect only. Contractor: Owner: BANK OF AMERICA BY REVERSE MORTGAGE SOLUTIONS INC 2727 SPRING CREEK DR SPRING,TX 77373 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 03/14/2016 $67.84 Specifics: 1 ea 12%State Surcharge- 03/14/2016 $8.14 Electrical Type of Use: SFA 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 more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy o les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued 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. Electrical Permit Application ® FOR OF TICE I SF (1N1.1 Received (� City of Tigard (�� ',� Date/By: 3 1 MO Permit#: 16-001 41 13125 SW Hall Blvd.,Tigard,OR 9 Plan Review Related Permit#: Phone: 503.718.2439 Fax: 503.59 1960 141p16 Date/By: Inspection Line: 503.639.4175 MAR Ready Date/By: Juris: 0 See Page 2 for Internet: www.tigard-or.gov ," �� ,e.P�0 Notified/Method: . Supplemental Information l3 v TYPE OF WO inn-N1 Gov, PLAN REVIEW ❑New construction 0 Addition/alters �l�� ;�119>r hent Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition 1• 0 Service or feeder 400 amps or more 0 Building over three stories. ®Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ®Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Additionof Job#: Job site address: 15371 SW 114th Ct#108 100HP Hor moew motor load of system. more. ❑"A","E","1-2","1-3", City/State/ZIP:Tigard OR ❑Six or more residential units. occupancy. ty ger ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 108 Project name:Bank of America 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:East on 114th FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision:Fountains at Summerfield Condo Lot#: 108 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#:R1471534 Ea add'1 500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) Reconnect Electric Services Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ® PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Bank of America(Foreclosure Property) 200 amps or less 100.70 2 Address: ,_7 3-10C� �� 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: tpi'Vxi 77 373 601 amps to 1,000 amps 301.04 2 Phone:( ) I 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 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 extension, r er panel A.Fee for branch circuits with Business name:Oregon Realty above service or feeder fee, 7.42 2 each branch circuit Contact name:Bryan Durk B.Fee for branch circuits without Address:8552 SW Apple Wayservice or feederfee,first 56.18 2 PP branch circuit • City/State/ZIP:Portland OR 97225 Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)913-2488 Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: bryankd@mac.com Reconnect only X 67.84 67.84 2 CONTRACTOR 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(I 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 Lic.: Electrical Lie.: Suprv.Lic.: specifically listed('/3 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 67.84 Print name: Date: 0 Plan Review Required(25%of permit fee): 8.14 ' State surcharge(12%of permit fee): Authorized signature TOTAL PERMIT FEE: 75.98 This permit application expires if a permit is not obtained within 180 Print name: I' l/f ae l c/YL Date: /,�� days after it has been accepted as complete. 6 � * Number of inspections allowed per permit. I.\Building\Permits\ELC_PennitApp.ItLR_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 Description I Qty. 1 Each I Total 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: El Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 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* >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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(%4 hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page l): * Number of inspections 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 I:\Building\Permits\ELC_PemtitApp_ELR_ERE.doc 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 15371 SW 114TH CT 108, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2016-00192 Herb Stabenow Violation Summary: Inspector Contractor