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Permit (22) CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT Permit#: ELC2016 00304 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/13/2016 T I c.A u Dg Parcel: 2S112BCO2500 Jurisdiction: Tigard Site address: 14710 SW 84TH CT Project: Gibb-Parth Subdivision: HAMBACH PARK Lot: 9 Project Description: (3)branch circuits for bathroom remodel. Contractor: BARLOW ELECTRIC INCORPORATED Owner: PARTH, UWE M&CHARLENE M 21977 SW MANDAN CT 14710 SW 84TH CT TUALATIN, OR 97062 TIGARD, OR 97224 PHONE: 503-753-3290 PHONE: FAX: FEES Quantity Description Date Amount 3 crt Branch Circuits wo/Purchase 04/13/2016 $71.02 Specifics: Service or Feeder 1 ea 12%State Surcharge- 04/13/2016 $8.52 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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. Y obtain a copy oitherules or direct questions to OUNC by calling 503.232.1987 or 1.800.33 4. Issued By: L (c ......----)-- 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' t ��- Date: LICENSE NO. Call 603.639.4175 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 �t1 l UR 0111(.1 1 SI ()yI.v City of Tigard `� 11�� Received Date/B I3 IiirliMMIggiMi 13125 SW Hall Blvd.,Tigard,OR 9 ^ l6 Plan Review ': I . Phone: 503.718.2439 Fax: 50 d {,O Date/B : Related Permit 6:00 �/ id,(4 Inspection Line: 503.639.4175 J ll�� 1, ReadyDate/By: ® See Page 2 for 111,.11:1) Internet: www.tigard-or.gov PQ`' „\GVe'�`V Notified/Method: Supplemental Information TYPE OF WOR` O �l PLAN REVIEW ❑New construction Addition/alterat�h7r�tnent 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: Q) where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground.or exceeds 14,000 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of ISO KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: `/ Job site address: 0 Addition of new motor load of system. �(,lp -`�6o14�(,L3 9h.J it-e- ." CrCT 10011P or more. ❑"A" "E" "1-2" "I-i' City/State/ZIP: -11,6 fMip (S(Z-- ❑Six or more residential units. occupancy. ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: ( Project hame: 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: FEE SCHEDULE Description I Qtr. 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 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy residential 7.5.00 2 � y�� (with above sq.ft.) c�`�� -1-• �'^ !'�^ � ''y C' l�tJ S , Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: 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 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 _ 2 401 to 599 amps signature: Date: amps 168.54 2 Jar APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name:' 4N-Q_(,�,�,..i 'I�Lie&TWA G 1 N above service or feeder fee, 7 42 � each branch circuit Contact name: (,-((A. t.- `)/"w "`' B.Fee for branch circuits without Address: service or feeder lee,first e 56.18 ,, it 2 branch circuit City/State/ZIP: Col V p-i.(,lc DV— . -'3 3 5 Each add'I branch circuit 2 7.42 /cf '4 2 / Miscellaneous(service or feeder not included) Phone: (<17C5 )'1-5---3 - 3') Ct O Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Signlighting or outline li 67.84 2 '--2 L, CM. L ( U C g g Signal circuit(s)or limited-energy Address: o ' to-2 Z S o fi ❑ See Page 2 2 1 panel,alteration,or extension. City/State/ZIP: G(yZU R l�t 5 ©fL Each additional inspection over allowable in any of the above t Additional inspection(I hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr Email: E. T.,t11EYL i .,l„G ,..✓ Industrialspecosplfrnt whichhr mo) 78.18/hr Inspections for no fee is 90.00/hr CCB Lie.: (11 2-S-1) Electrical Lie.: C- 2(o Suprv. Lic.: 9, .5 specifically listed(/ hr min)ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: � Subtotal: "7/.61 Print name: 'e - 7 '(�st� -0M-14-1".•-/ Date: * 0 0 Plan Review Required(25%of pennit fee): ((( State surcharge(12%of permit fee): tr., 5)... Authorized signature: TOTAL PERMIT FEE: ' , / This permit application expires if a permit is not obtained within 180 Print name: 1'_ Date: ,,`(-// �U days after it has been accepted as complete. �— ( C * Number of inspections allowed per permit. I:Building Permits E1.C_PermitApp_ELR_ERE.doc Rer 06 17 2015 440-46151(11 05 COM WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: 'RESWE I I L WOR ONLY: Description Fee for all residential s 3'stems combined: $75.00 Qt). I Each Total rt Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 2 n A• udio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: n B• urglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 n G• arage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n 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 charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically listed('h hr min) COMMERCIAL'W+bRK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal ter Page 1): * Number of inspections allowed perr p permitt. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems n Landscape Irrigation Control* n Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I.Building Permits LI( Penna App EER ERE.do,. Rev 06 I'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 14710 SW 84TH CT, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2016-00304 Jeff Grove Violation Summary: Inspector Contractor