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Permit (16) CITY OF TIGARD ELECTRICAL PERMIT ' COMMUNITY DEVELOPMENT Permit#: ELC2016-00540 T[GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/05/2016 Parcel: 1 S 125 DA05601 Jurisdiction: Tigard Site address: 6620 SW ALFRED ST Project: SAARINEN Subdivision: KINGS VIEW Lot: 42 Project Description: Upgrade to 200 amp panel and add(1)branch circuit for hot tub. Contractor: PRO CIRCUIT ELECTRIC LLC Owner: SAARINEN,ANNE C PO BOX 3948 9755 SW PEMBROOK ST WILSONVILLE, OR 97070 TIGARD,OR 97224 PHONE: 971-563-8211 PHONE: FAX: 503-266-1349 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 07/05/2016 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 07/05/2016 $12.08 Type of Use: SF Electrical Class of Work: ALT 1 crt Branch Circuits w/Purchase 07/20/2016 $7.42 Service or Feeder Type of Const: 0 ea 12%State Surcharge- 07/20/2016 $0.89 Occupancy Grp: Electrical Total $121.09 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 accord-A - 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. ATTE •N: Oreg.o law 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- - 90 You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 !,87 or 1.800.332.2344. 7.f Issue By: � LQ�..��� Permittee Signature: A .% w 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' 4, ��, /.*-"- Date: '?�a�-b LICENSE NO. 37e 75 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 Application rolz orrici: rs►.ON Ll City of Tigard „�."`:1 11 'y,ived ® C ennit#: (l '. is : ,1� c, D!(o GV ,111 • 13125 SW Hall Blvd.,Tigard,OR 97223 ` Plan Revie = Phone: 503.718.2439 Fax: 503.598.1960mato/Byc Related Permit#: I a L keady Date/By: Juris: la See Page 2 for Inspection Line: 503.639.4175 , T I G A R 1) Internet: www.tigard-or.gov "� d/Method: wad�L M.60 Supplemental Information ❑New construction AlAddition/alteration/rep] tyW Please check all that apply(submit 2 sets of plans w/items checked): &� ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY Ot COIS1* N�, exceeds 10,000 amps at 150 volts or 0 Floating buildings. Si 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or .i R 44.1 'l* / 1 ,ftl�l t ❑Emergency system. larger separately derived attE % 5'- ❑Addition of new motor load of system. lob#:. Job site address: l -y 5 - 100HP or more. ❑"A","E","1-2","1-3", City/State/ZIP: Le rd 0 9 7.x�3 ❑Health-care or mare facties. units. oRcc rection cl — ❑Hfacilities. ❑ ecreational vehicle parks. Suite/bldg./apt.#: I Project name: �'.I�,�4--._ 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: ' U tzt,e�. ..a.. ,. .._ SC II D1� - Description 1 Qty 1` - _ „�Each 1 _Total New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 _ Ea.add'1500 sq.ft.or portion 33.92 1 . 0�,� A� s'-,..0.77711i1., : ., Limited energy, residential 75.00 2) I cs.rJ )' Ua_ e "e-4-_dL , , ,. " v , Li(mwietdhanbvgey,smti-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 ' Pltt),PEI2T O tt ' == . P NA4iT' x Services or feeders installation,alteration,and/or relocation Name: ` .� l�l�J K� �f( ��_��� � 200 amps or less / 100.70 1w.70 2 Address: Cj(p.2.p _6..ua Sf 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: J )- -3 601 amps to 1,000 amps 301.04 2 Phone:( ) b(ct. i c([45 I ) 5(JDj Cl (3 3 -2- Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: a_yl K e_S Q ccc J s( cC ,,_`_`_ 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,lea - rent,or exchan',according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: t,, ,,.- 17_1, e; , a ate:r7k 401 amps to 599 amps 168.54 2 � APPLICANT . i � CON TACT PER$ON Branch circuits-new,alteration,or extension,ger panel L A.Fee for branch circuits with Business name: tliz _ above service or feeder fee, 1 7 42 -7i 2 each branch circuit 4 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder Email: 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: T,,,, are . (G, Sign or outline lighting 67.84 2 Address: pd J fZ/�j / Signal circuit(s)or limited-energy 9 Y v panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP:((f tl�jh tate, 1 Fl Gi 7�� Each additional inspection over allowable in any of the above (J /! Additional inspection(1 hr min) 66.25/hr Phone:(Tv) "--43 . r�f( Fax:( ) Investigation(1 hr min) 90.00/hr Email: ©(t r Citi etCG c�� � �n Industrial plant(1 hr min) 78.18/hr �/ Inspections for which no fee is CCB Lic.: /W 'b 2 Electri al L' . •-• ,.. ( Suprv.Lic.: 451 ) specifically listed(''Ahrmin) 90.00/hr Suprv. Electrician signature,required: lei ELECTRICAL PERMIT FEES �— p Subtotal: t i Print name: ,-c&IAA pt.,,„ Date: 7.-1-3--1 /n ❑Plan Review Required(25%of permit fee): `� State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtai d within 180 Print name: Date: days after it has been accepted as comp te.f 1 y.0.01* Number of inspections allowed per permit. I:Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application FOR OFFICE I SE Oy►.v City ofTigard I e{ived illh `J g S�1..,.r.. a/By: 1�7 'ermit#: Gi l�CilJ (Xt J 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Revie Phone: 503.718.2439 Fax: 503.598.1960 �.�( ate/By: Related Permit#: Inspection Line: 503.639.4175a k'Ready Date/By: Juris: 0 See Page 2 for TIGARn Internet: www.tigard-or.gov � i�d/Method: ��t: Supplemental Information TYPE OF WORK C1 i r �� e t�� PLAN REVIEW tN1 �� �� Please check all that apply(submit 2 sets ofplans w/items checked): 0 New construction �(Addition/alteration/repl3�e _I pp y 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. Xi 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived r S ❑Addition of new motor load of system. Job#: I Job site address: t,62D �y f-- 100HP or more. ❑"A","E","1-z "1-3", / L l7 ❑Six or more residential units. occupancy. City/State/ZIP: rd '- [ �'�� ( 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: ur.I K.,P�r^ 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: Ul<_z, �� FEE SCHEDULE Description I Qty. I Each I Total New residential single-or multi-family dwelling unit. Subdivision: I 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 ` �. � 1�P� (with above sq.ft.) 75.00 2 -4J 114�r"e /79 >��'t'a'LC (1)644- 2- o- . Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 4 44 K c t 4 e 200 amps or less / 100.70 A.V.'7() 2 ,(7 7est_p___40 �� 201 amps to 400 amps 133.56 2 Address: ( 401 amps to 600 amps 200.34 2 City/State/ZIP: C _ 3-13 4.4601 amps to 1,000 amps 301.04 2 Phone:( ) 6(c:( . j c'U tic, I r. : ) 50, 9-(,3 3'6,,c--2_ Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: A_h il c(e.s QCC.C>Ukt-'( _CO,,,.` relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 inten a-a for sale, , - rent,o`xchan•-,acco 'ng to QRS 447 A '',670,and 701. 201 amps to 400 amps 125.08 2 O signator: %,7_.� _ a at ,,, 401 amps to 599 amps 168.54 2 111 APP I �ONTACT 'E' a N Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with : siness name: ,fa - 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: 01-i /e i" !S I L;: ,/, 1 /A/ Each add'l branch circuit 7.42 2 ,/�J / Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) S r e..i' ,each manufactured or modular 67.84 2 Email: dwelling,service and/or feeder ...p. ../C,"� Reconnect only 67.84 2 CONTRACTORPump or irrigation circle 67.84 2 r Business name: T(E) a 1/CL.k.— Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address: panel,alteration,or extension. g City/State/ZIP: Each additional inspection over allowable in any of the above 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 Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('A hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: T2 Y L`e5N Date: 0 Plan Review Required(25%of permit fee): J State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: I tcl This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 2 Check Type of Work Involved: 5 kva or less 1 70 5.01 to 15 kva 13333..56 56 2 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 min) Inspections for which no fee is 90.00/hr specifically listed('A hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): • Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 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 6620 SW ALFRED ST, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final PASS - No C of O ELC2016-00540 Jeff Grove Violation Summary: Inspector Contractor