Permit (23) CITY OF TIGARD ELECTRICAL PERMIT
1114 a. COMMUNITY DEVELOPMENT Permit#: ELC2016-00449
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/31/2016
T I c, a.z g Parcel: 2S104BA06700
Jurisdiction: Tigard
Site address: 13919 SW NORTHVIEW DR
Project: Rager Subdivision: CASTLE HILL NO.2 Lot: 100
Project Description: Alteration of(1)branch circuit for installation of 6 can lights.
Contractor: ELECTRICAL CONCEPTS LLC Owner: RAGER, GAIL A
4676 COMMERCIAL ST SE#205 13919 SW NORTHVIEW DR
SALEM, OR 97302 TIGARD, OR 97223
PHONE:
PHONE: 503-856-4060
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 05/31/2016 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/31/2016 $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 don accordan = with appr.ved 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: Ore•. - r,qui -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952 01-0010 thr.ugh OAR 9''-001-r0•r ou may obtain a cpy of the rules or direct questions to OUNC by callin 0'32132.1987 or 1.800.33 44.
r .l
Is ued By: � Permittee Signatur ''J 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: �/
J
LICENSE NO. 027 �S
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.
Rece
City of Tigard Date/By: 5�3i l( (D _Permit# '
: 4-,e-2 /t�001490 1111 0 13125 SW Hall Blvd., 8. �+ M l.-!Tigard,OR ( (1/ t1 PlanReview
I Phone: 503.718.2439 Fax: 503. Date/By: Related Permit#:
Inspection Line: 503.639.4175 Ready Date/By: Avis. 0 See Page2 for
i I`' v R I) Internet: www.tigard-or.gov MAY 3 1 2016 Notified/Method:
Supplemental Information
LAN REVIEW
TYPE OF RD Please check all that apply((submit sets of plans w/items checked):
❑New construction [D, ditiotl t a3 fOnl
DemolitionOther: 1`
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ 0 where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
'Cand 2-family dwelling 0 Commercial/industrial El Accessory buildingamps less to ground,or exceeds 14,000 ❑commercial-use agricultural
gs.
❑Multi-family 0 Master builder 0 Other: 0uor allotherinstallstioos. Inbustallation
pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Q ❑Addition of new motor load of system.
Job#: Job site address:
I3I3 s h/O('4 j44/t ' r- I00HP or more. ❑"A "E""1-2","1.3"
Ci /State/ZIP: '/_ 13?! 9 Q Six or more residential units. y
City ` �� I Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: V Project name: 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: 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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
C/� (with above sq.ft.)
o C.O.n /`� b I vt / �.�1 Limited energy,multi-family 75.00 2
`J residential(with above sq.ft.)
��ItOPERTY OWNER ❑ ,�T Renewable Energy 0 See Page 2
C'6"1-4-'.
r1 Services or feeders installation,alteration,and/or relocation
Name: '1 6"t 1 200 amps or less 100.70 2
Address: iv l 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 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
LICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:r rzec_t_si.‘o % an✓,J rix ••:.+ above service or feeder fee,
7.42 2
each branch circuit
Contact name: SAr.‘1_i 2 ?�,�•,L B.Fee for branch circuits without
S- t b n service or feeder fee,first ` 56.18 Ie 2
A i
Address: f"P --..0 branch circuit 3�
City/State/ZIP: -7:::0.(.4.1) /tel - .y Each add'l branch circuit 7.42 2
e` Miscellaneous(service or feeder not included)
Phone:(53-4) Fax: :( ) Each manufactured or modular
S ✓5�+� � 67.84 2
dwelling,service and/or feeder
Email: Cf,Cry._ " l'hi i ( . (y i-.. Reconnect only 67.84 2
C NettCTOR Pump or irrigation circle 67.84 2
Business name:Electrical Concepts lle Sign or outline lighting 67.84 2
Address:4676 Commercial St SE#205 Signal s)or extension. 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Salem, Oregon 97302 Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:(503)856-4060 Fax:( ) Investigation(1 hr min) 90.0W hr
Email:electricallee@aol.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: 176169 Electrical Lic.: C-325 Suprv.rv.Lic.: 2755S specifically listed(%hr min)
�} ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: !/_ ,L < Subtotal: 5!,.18
Print name: Dickie Comstock Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): (o,7 tf
Authorized signs TOTAL PERMIT FEE: 6,a.9),
This permit application expires Ka permit is not obtained within 180
Print name: L Date: days atter it has been accepted as complete.
• Number of inspections allowed per permit.
l:\Building\Permits\ELC_Permit LR_ERE.doc Rev 06/17/2015 440-46151(1I/05/COM/WEB
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
13919 SW NORTHVIEW DR, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00449
David Young
Violation Summary:
Inspector Contractor