Permit CITY OF TIGARD ELECTRICAL PERMIT
`�I • ' - COMMUNITY DEVELOPMENT Permit#: ELC201600246
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/30/2016
Parcel: 1 S135AA05500
Jurisdiction: Tigard
Site address: 10277 SW 87TH AVE
Project: OneWest Bank Subdivision: MAPLE RIDGE ESTATES Lot: 10
Project Description: Electrical reconnect only
Contractor: N/A Owner: ONEWEST BANK
BY FINANCIAL FREEDOM ACQUISITION
2603 MAIN ST STE 300
IRVINE, CA 92614
PHONE PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 1 ea Reconnect Only 03/30/2016 $67.84
1 ea 12%State Surcharge- 03/30/2016 $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 more the 180
days. A TION: on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-0 -0010 through OAR .S -O90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Iss ed By: / let/tit/VI r Permittee Signature: Q—Q
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 PermitAppli '�"'"��'1E�� FOR OFFICE USE ONLY
n
City of Tigard Date/B : Permit#:EL /(,-{ /
w 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax 504 96� Received
9 2 16 CraMMI
Date/B : Related Permit#:
TIGARD p Y Date/By. Tuns See Page 2 for
Inspection Line: 503 639 4175 Read
Internet www ugard or gov I \9 Notified/Method: Supplemental Information
1 4 �I u a Q ^> '' a x#y o d I, -. , 5 r i�+N :,fix
rI'i: f ,ak 3�re_ ' .,:TYP,, i r_9 I "�' ,//.'.fi��d�t,T ',. "'. a :i "' :WI •
:t.E m •, 2 k W .:. .�
E New construction ❑Adcl IUII/1 ''• tip/ t S/RDN Please check all that apply(submit'2 sets of plans w/items checked):
❑Service or feeder 400 amps or more 0 Building over three stories
11 Demolition ❑Other:
where the available fault current ❑Marinas and boatyards.
;/;.:44::.' { CATEGORVOF CONSTRUCTION 1'. 'l; exceeds 10,000 amps at 150 volts or 0 Hooting buildings.
® I-and 2-fool l dless to ground,or exceeds 14,000 0 Commercial-use agricultural
ywel l In g ❑Commercial/industrial ❑Accessory building
amps for all other installations. buildings.
❑ Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
' ',1.:I• I 1.-'!'' •' JOB SITE INFORMATION'A�TD`LOCATION .,:;,,,,,,,I.,,10; ❑Emergency system largerseparately derived
dd
Job#: Job site address: 10277 SW 87th Avenue ❑A IO0HP HP or moreo of ormotor load of system.
. ❑"A" "E" "I-2" "1-3"
City/Stale/GIP:"Tigard,OR 97223 ❑Six or more residential units. occupancy.
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: , ,: ',1, FEE::SCHEDULE 1 1;;:`• IV:ltZl,
Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Maple Ridge Estates Lot 4: Includes attached garage.
1,000 sq.ft.or less 168 54 4
Tax ma
p parcel 4:
Ea.add'I 500 sq.H.or portion 33.92 1
DESCRIPTION OF WORK'
Limited energy,residential 75.00 2
Electrical reconnect (with above sq.ft.)
Lintited energy,multi-family 75.00 2
residential(with above sq.ft.) _
t7i. Renewable Energy ❑ See Page 2
' 0,PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:OneWest Bank Mortgage,CIT Bank,N.A. 200 amps or less 100.70 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 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 55226 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 I
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-c new,alteration,or extension,per panel
A.Fee for branch circuits uvih
Business name: Principal Brokers Realty above service or feeder fee,
7.42 2
each branch circuit
Contact name: Francine Best for Steve Snyder B.Fee for branch circuits without
service or feeder fee,first
Address: 15770 Moonlight Drive branch circuit 56.18 2
City/State/ZIP: Caldwell,II) 83607 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(208)369-6256 Fax: :(866)840-1369 Each manufactured or modular 67 84
dwelling,service and/or feeder 2
Email: fran@bestagentassist.com Reconnect only 1 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
Each additional inspection over allowable in any of the above
City/State/ZIP:
Additional inspection(1 hr min) 66.25/hr
Phone: ( ) Fax:( ) Investigation(I 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('/:lir min)
,� I Et,ECTRICAI;,PtRMIT r`FEES t tIIIIIIIIIII III
Suprv.Electrician signature,required: Subtotal $67 84
Print name: I Date: 0 Plan Review Required(25%of permit fee):
Y &14--
This
`[ State surcharge(12%of permit fee): $8 14
Authorized signature: I—{^a� 8C'b t TOTAL PERMIT FEE: $75.98
This permit application expires if a permit is not obtained within ISO
Print name: Francine Best Date: 3-29-2016 (lays after it has been accepted as complete,
* Number of inspections allowed per permit.
i kBinkiingA Pernf,ELC_PennooiAp1c FI R_ERE doe Re,06/17'2015 4.1W615T(I I//15/COLb10EB
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
10277 SW 87TH AVE, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00246
Jeff Grove
Violation Summary:
Inspector Contractor