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Permit (15) CITY OF TIGARD ELECTRICAL PERMIT ,, COMMUNITY DEVELOPMENT Permit#: ELC2016-00198 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/15/2016 Parcel: 2S109DA09800 Jurisdiction: Tigard Site address: 15288 SW OAK VALLEY TER Project: Balakrishnan Subdivision: SUMMIT RIDGE NO.2 Lot: 87 Project Description: Electrical reconnect only Contractor: N/A Owner: LESLIE BALAKRISHNAN 2323 SW 19TH AVE PORTLAND, OR 97201 PHONE: 503-227-2624 PHONE FAX: -- FEES Quantity Description Date Amount ~ 1 ea Reconnect Only 03/15/2016 $67.84 Specifics: 1 ea 12%State Surcharge- 03/15/2016 $8.14 Electrical Type of Use: SF Class of Work: OTR Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in ordance ' approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATT TION: Oregon aw requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0 10 through OAR 952- 01-0 /, You may obtain a copy of the rules or direct questions to OUNC by calling 503.232. •87 or 1.$*'.332.�. /- Issued ,/:.. k , L� Permittee Signature: ...���' L�/�%� 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 Applicn��taaaEEjV 1,0R 01.1 1( 1: L S I(Y\l.A City of Tigard Received ` S./l0,t / Pennit 6: Z(.e� Datedi" [lo' 14 ■ 13125 SW Hall Blvd.,Tigard,OR p7323 2- y rr 'Plan Review II Phone: 503.718.2439 Fax: 503.598:1960` p7 n" Dale/B Related Permit#: inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for I I.\R I) Internet: www.tigard-or.gov ai 01 f>lb, RD Notified/Method: Supplemental Information TvPRIMDIVISION . ,. . PLAN REVIEW 0 New construction 0 Addition/alteration/replacemen 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: pQ Wo.N- `(-Q `ra 0Y\ where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. KI-and 2-family dwelling IDCommercial/industrial ElAccessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 1 S,2$g'SW ©Ak if_ii 0 AdditionHof new motor load of system. �/ iy, 100HP or more. ❑"A" "E" "1 2" "1-3" ❑Six or more residential units. occupancy. City/State/ZIP: J r1C�P C' /1 t� v 0Health-care facilities. �ry �,,JJ�6 p�a_70 Recreational vehicle parks. Suite/bldg./apt.#: Project name: ©tel` t0.''p� . 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or snore. 600 volts nominal. Cross street/directions to job site: S��V),✓n i j- f i'ctes�, a FEE SCHEDULE Description I Qty. 1 Each { Total I * New residential single-or multi-family dwelling unit. Subdivision: ,fv, Lot#: Includes attached garage. TTT��� 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add]500 sqft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 t (with above sq.ft.) Z(n S i) IL n 0 MR_ JD cp OW.i2A,r— �....s‘. 1✓1 Q].0 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 ��� . - �� Renewable Energy 0 See Page 2 ,+g PROPERTY OWNER - 0 TENANT Services or feeders installation,alteration,and/or relocation Name: LAS i .z i L L r.,(5i VI a V` 200 amps or less 100.70 2 j 201 amps to 400 amps 133.56 2 Address: a3 a 6W f 9 f4N 4 V 401 amps to 600 amps 200.34 2 City/State/ZIP: 4 0y—.,JJ 1 el t1 j 9 7 ao ! 601 amps to 1,000 amps 301.04 2 Phone:(5 3) ��—), a�.2u Fax:( ) f v /� Over 1,000 amps or volts 552.26 2 i r Temporary services or feeders installation,alteration,and/or Email: IPS l I -, e bc...1 0.k v'i 51'N nA inmal).0� Y\Vrelocation Owner installation:This installation is being made on property at,_Down which is not 200 amps or less 59.36 I intended for sale,lease rent,ore. hange . co - ,g to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: '4 - /� ° -" Date:3)15 jc, 401 amps to 599 amps 168.54 2 i, , ICAN IBranch circuits—new,alteration,or extension,per panel 0 CONTACT PERSON0. A.Fee for branch circuits with Business name: ©LA jam' above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add]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 j /_67.84 ? 2 //4. CONTRACTOR Pump or irrigation circle ` 67.84 2 Business name: J Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. 0 See Page 2 2 Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: 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.ge." Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): g/V Authorized signature: TOTAL PERMIT FEE: 7 5.9 rd j This permit application expires if a permit is not obtained within 180 Print nam ' »" _ Date:3/f5/„OD/c days after it has been accepted as complete. * Number of inspections allowed per permit. I:`BuildingPermits,ELC_PermitApp_ELR_ERE.doe Rev 06172015 440-46151)1105,COMiWEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: Y■� ; *,S,11043,44 Description I QtyEach 1 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: ❑ 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 win) Inspections for which no fee is 90.00/hr specifically listed(/z hr min) C M IE AL WOAK ONLY: - Cfn AL'motif Es Fee for each commercial system: $75.00 Subtotal(Enter on Page t): y * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ C• lock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ M• edical ❑ N• urse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1r Buildings Penults.ELC_PermitApp_ELR_ERE.doe Res 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 15288 SW OAK VALLEY TER, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final PASS - No C of O ELC2016-00198 Herb Stabenow Violation Summary: Inspector Contractor