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Permit (44) CITY OF TIGARD ELECTRICAL PERMIT • COMMUNITY DEVELOPMENT Permit#: ELC2016-00296 T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2016 Parcel: 2S103AA03700 Jurisdiction: Tigard Site address: 12300 SW 106TH DR Project: NEWTON Subdivision: CLYDESDALE Lot: 17 Project Description: (1)branch circuit for outside light wall switch. Contractor: WEST SIDE ELECTRIC CO INC Owner: NEWTON, ELIZABETH ANN FAMILY TRU 1834 SE 8TH AVE BY NEWTON, ELIZABETH ANN TR PORTLAND, OR 97214 12300 SW 106TH DR TIGARD, OR 97223 PHONE: 503-231-1548 PHONE: FAX: 503-736-0677 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 04/18/2016 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 04/18/2016 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 i cordance 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. ENTION: Oregon',law eq ires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-00 -0010 through OAR 952' 1-009. o may obtain a cop of the rules or direct questions to OUNC by callin .1987 or 1.800.332.234 . / L / Issu d By: k ♦ Permittee Signatur ;'��/�G�--�_ 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. 04-15-16;09:48 ;From:West Side Electric To: 5035981960 ; 5032319987 # 2/ 2 l;l 1 Y Ur i I1(aARD PAGE 02/82 Electrical Permit Application G G� 1 ,)1t 111 111 i t (P11 1 City of Tigard Pearnlf tp1 �/��o/b-ao�.� 13125 SW Ha1181vd„Tigatd.OR I 0b�fy :. _ , 9Phone; 903.718.2439 Fa7t; 503,598,1 Rvlatod Permitil; 1 1' htipcetinn Unc: 503.639.4175 � w1i:w::` 1>,tranet: WwW.dytard arl�c+v 'k �, �Y 4kiliiiy Sec Pima8tor �,Y :' „ :i. �_r�g�_y�y� $tip iomaaMi Informatlen 01` P Teottstntotipn ... .7 7.-).1 L 4.�.r. „w•-.',-..•r3;ii. 'Iw •.:%wCL"v,,,:ti;:y ,w. r,l.`w ,I..+'1), '.. '? ' ,'f dditiort/aitcration/rep R Mope ohook all that apply(nubtn tams of plans w/taint chocked); , ❑Demolition 0 Other: i I insow1ao oramp s' � , .• .."" cxi fader or more Ci Mufidlnp Oyertiro!nler ia, whom he inronablle AIM,currant El WHOM and oonnowdo,�; ' Ga+ 'a»r'' rti � .�7" :I'''"ti.r;"77. -:77« �t' 1 muds 10,000 amp*at 15P valb or ©Firming WW1= .4 1-turd 2-family dwelling 0 Commercial/Industrial • ccesaoty building lea to ground or uxeecdt:14,000 q t^omrtareln sur o thr all mho*trotailatkma, l"`q'a O>zriaalturnl 0 Multi-famil ❑Muster builder • 0 her: Cl'hn !into ntio 'Y. ��'�;`�.=e�x;;;�--"';.,;.:.:�:�.'..�_'� ' ' -"�-_-..r,�"....�.,-..�.,,.,..,_.._T� rump, �I►trmlladonoris0kvner ;:6«;,,! P�!li?:1tA",r�,gd:a AmorFanoy"'In' larger nottnratcty thrivenJob#: Job sten oddre I j ©0 Addition craw motor loan of FOWL r'^ TOOWP or mem O"A"."Z","1.2« «1,a«, J J Z I n Six or more maiden int alta. MOM* Ciry/Stato/TIP; D Nanith.e,ero wlidm. 1:1 Rootptlonni wPhiete pngleA, 5nite/41dg./apt #: Pro�« name; III 1 Iidnrnaloue roontfona. D Supply minis)for more than Cross streer/c iroctiotla to job sten: /. LA ?Gy, D Service or lrxdcr non amps to mora. 600 vole nominal. 11 n CR% Awn 1 Subdivision: New realdential angle..or multifamily dwelling unit Lot N: Includes attached gringo, Tax map/para.]#; I,000 Rq.rt.or lase ' �� I I 168.34 4 ;, s ��. �� :�, ,; . . .,_ .,,. �,, FSI,min 500 s ft or imrtion ,w, 4,,•,�.1,Fi: ;:?,;7 ,;75,.+.,4,oz�.d'c,7,.r a:r;„1; .rij,,Q,N1,..Z:t�?�' E.a -1".:�� tt id ; r r�AQ33.9 I. , 'LimitedotWr ,,tasidcrttfal . ./ I ' a I ; /L .1 / y SWilh oloteyi,(1.) �S.00 z a . e 'Amitcd tenon e.multi fl,mily _—"”` d_�Mall—Willit .24 / i I I _ residential{with odyn;4 tl.) 7$.Op 2 ,� r 4�„i yy..�.aa a: w,'J'::�+,�'+` ^or;w' ."" r,,., �^ r . ,n Renewable En 0 Nemo; r ��� �.r�L'i✓L!i■J�� f I u" 9orvi�t or&edam---ptllntionouteratMn and/pr relocation • 200 altos or lana 100,7n 1 2 Address: f..j_‘ 6W , 1' II 201=nom Wimps 133.56 ."—"�� 40 t aa to 690 VIVO 200.34 zCity/Stare/ZIP; �l 0 ) 0431 mono Eh I,000 amps 101,042 Mono;(6 ) ? g.... 3 , I Fax:( ) I Ovcr 1,900 ta'rgaR QT Y�IlR 552,20^ Email: 0A, Al ` ' 14I ,• an- III Temporary tiorvlcCtsor hodoraiguallatlon,alt ni ion,and/or Owpler installation:This testa otian ie bcfrt Ata.ea ans rorocaeian intended fbr sale.leoac,rcpt.or exchange,,according to ORS447J 40,t,7n,and 701 not 2n amps or I��"" 59.36 �� Owner signature: _ MOW io 400 amps 121.08 2 f„ I Into: 401 amps to 399 own 161144 "r'iy�^f "?iadr�'.•�1.a:�,''w,.�:�»�,is .��: „�,r•,.`s:� ^"'.y'^^ir.—.Y 'r",-'- .,� q •131'Aneh�i1'Cn 'BuSin ',,,f,c ta. ,i »; '!..,�ifg-t, .tiL=:T,' :�.".r::•.;�.`�'t,!'.:.:'ti/..;i;.'.�.t!t i ,w I. : 119N'�:Hepatins,nroxtansion,pCrpanel a name: I A.Pea thr breach circuitO wirh above service Or%dor tbo, 7,d2 2 Contact name: I I ranch circuit Ads �-� fj. ta0 for hranch ChCn IS urll!►n,q b I� sorvioo or feeder ice.f1rs1 brant drool. } 56.18 564 2 City/Stttto/ZIP: _ Each sdd'I brnneh Circuit 742 2 I Phan ( ) - Misedtanaoup(sorvice or tender not included) Fax::( ) I Each manuiheinredormodular 1 email: ( -” etwclllnr...__2o and/or Fccdor 67.84 2 • ---K• S: '•-- Reconncon 67� 2+;NyP; r:';��:M■r: a:rir; N.; 's '1_} L4__- ;hteXM 7ti- ' rt"iy"" . Pgmp or celo 67.84 2Business name: A A' f / C_. 1 �i s .1 �1tn or outifna xghdnR 67.84 _ 2 Addre”: 5 L,1 s` —, SiStteiCilNll.ptotRv orlimitct t ;• I I panel,teleost br nritcnnion_ El Po 2 2 City/Scatc/2IF: / - Each.aaleb„t►c Inspection ow Allowable In or the above a �� A,I I I ��un�I Phone; ) AddhNpnol Inspection(1 hr min • ~” 1 Fax; &,'U' I hr ) b6.2$I hr` 1 )r t`�:a ! investigation(1 hr min) 90.00JhT menti: Cj 1/, 4,('l ! r. it - - . 71T1 C.1 C:.1/VV l lndwdrial dant 1 hr min) 78^ 1-� CCB LiC.: ��► s r_anOPcaticna fbr which no ibc la • "� ;its Electrical Lie.: j-/ _ Suprl, �' . ',knit J,..(Prrlllrmin 90,00/hr Electra .L C� '';.4r M .., ry .,7 _. ... _ I Supry Electrician signature, trod: tti >1„,:. ,r z -•..N..;q A'ar.,. Print nano: ��.r� � � r� Subtotal: �� b.r y� WMZaill DPW!Review Required(2596 of p.m... foe): 11 Ciea._,...a.. e,ee. f..-.�_ I $Za. 9 Electrical Permit Application C) 1.0R OI, Ic LI til: oNi.l Received City of Tigard �` Date/B : Ari i r Permit#: a�� I y , IN Ill 13125 SW Hall Blvd.,Tigard,OR 97224 „,/ ,%\CO ��// Related Permit#: Phone: 503.718.2439 Fax: 503.598.1 1.. - Inspection Line: 503.639.4175 � �P� : �rate/By: Juris: ® See Page 2 for I I� %RP ^ .[ �, Internet: www.tigard-or.gov 1^ Cr `� `1\'� ted/Method: faG. Supplemental Information i'-N . PE OF WORK. `,x 1,0O� PLAN REVIEW 0 New construction ddition/alteration/rep ly Please check all that apply(submit 2 sets of plans w/items checked): El Demolition El Other: V e$$ 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRIJ TION 70Lexceeds 10,000 amps at 150 volts or 0 Floating buildings. and 2-family dwelling ElCommercial/industrial ❑Accessory buildingless to ground,or exceeds 14.000 ❑Commercial-use agricultural amps for all other installations. buildings. Multi-family El Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION Emergency system. larger separately epara[elY derived ❑Addition of new motor load of system. Job#: Job site address: Z�� VV /i0---/v), w � ,e`' 100P or more. ❑"A","E","1-2","I-3", City/State/ZiP: 3 0 Six or more residential units. occupancy.���-d1 u �� 9 7z Z ❑Recreational vehicle parks. ❑Health-care facilities. Suite/bldg./apt.#: / Prof ct 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: via l j bi / /j FEE SCHEDULE "V v Description I Qty. I Each I Total I New residential single-or multi-family dwelling unit. Subdivision: 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 Limited energy,residential 75.00 2 /� ( �j/ , 1/J (with above sq.ft.) (M dr(4 1/071 2?, ` �� rJ aid/11, Limited energy,multi-family 75.00 2 //12t/{;42 3ji _ 1j{ ( residential(with above sq.fl.) vL 14/ick (/ Renewable Energy ❑ See Page 2 .: PROPERTYO R I []WANT Services or feeders installation,alteration,and/or relocation Name: jt � ' N� 7J7 I 200 amps or less 100.70 2 �l 111 201 amps to 400 amps 133.56 2 Address:/2,.. 66 Gw /0 !/�i/(/fi2 ` �`•C�� 401 amps to 600 amps 200.34 City/State/ZIP: 9� Q�j� ( �� (2-z_3 601 amps to 1,000 amps 301.04 /�� 5vj 2 Phone:(9 V2)) 6� / 9 / Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:-/-74, -)Q__,-2 .(l.-e, (ciyvt�S�,r.r relocation Owner installation:This inst'ration is being made on property that I own which is not 200 amps or less 59.36 ) 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 ' CI CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 1 56.18 56,4 2 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 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: l 5 tel _. yhiC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: 15'31.1 SECoAve,Qanel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: •, / P �tJEach additional inspection over allowable in any of the above Qr / +aX47 I v+— �. 7 )y Additional inspection(1 hr min) 66.25/hr Phone:c )3) 3 J i 5 4'8 Fax:153 ) -j3&.r77 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 Lic.: / 330(Q Electrical Lic.:06--/3,$ Suprv. Lie'.: specifically listed('A hr min) ELECTRICAL PERMIT FEES �-, Suprv. Electrician signature,required: Subtotal: 56. f T �, Print name: Date: 0 Plan Review Required(25%of permit fee): / State surcharge(12%of permit fee):.4fv•7 TOTAL PERMIT FEE:'14 Authorized s' natt`e: 4 �' _ This permit application expires if a permit is not obtained within 180 Print nam Z j i / I f Date: 7/////b days after it has been accepted as complete. * Number of inspections allowed per permit. I:Building Permits ELC'_Pe itApp ELR_ERE.doe Rex 06 17-, 5 440-4615T( COM WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: ✓',: �. w �,n' ,:. ' S � # -:'tl r s' :f3 ,...43.?.'.,,m'�eat'';nr dk.w € .u:""°„ a 2 t . � t 'r'"ui u`.l w, -v 4 .rY. Fee for all residential systems combined: $75.00 Description QEach Tntet 1µt" �' 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 with OAR 918-309-0040) 552.26 2 ❑ 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('/z hr min) COMMERCIAL WORK ONLY: • >E>lrrx><cn><.-rEx>v�rr FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page I): * 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 1:Building Permits PLC PennitApp ELR_ERE.doe Rec 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 12300 SW 106TH DR, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final PASS - No C of O ELC2016-00296 Chip Barnett Violation Summary: Inspector Contractor