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Permit (17) CITY OF TIGARD ELECTRICAL PERMIT '-> COMMUNITY DEVELOPMENT Permit#: ELC2016-00577 T[GAR 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2016 Parcel: 2S112BD90331 Jurisdiction: Tigard Site address: 14655 SW 76TH AVE 33 Project: Timbercrest Condos,Unit 33 Subdivision: TIMBERCREST CONDO Lot: 33 Project Description: Electrical reconnect for unit#33 Contractor: N/A Owner: CLAPA, BENJAMIN 17008 SE DUNHILL LOOP DAMASCUS, OR 97089 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 07/20/2016 $67.84 Specifics: 1 ea 12%State Surcharge- 07/20/2016 $8.14 Electrical Type of Use: MF 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. ATTENTI•,. = -••n law requires you to follow the rules adopted by the Oregon Utility Notification Ce ter. Those rules are set forth in OAR 952-001-001! rough OAR 9 001-' Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19:7 or 1.810.332.2344. Issued :y: L, /1"/ . . teidaiii1. ' Permittee Signature: ;.._4 OWNER INSTALLATION ONLY 'Ilk 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 Permit Applica r FOR 01 I I( F. I I. ON l.'s r- F Received City of Tigard DateB : 7M/6,/ /6Q iffej Permit#: e O/ -66 5-77 IIa 13125 SW Hall Blvd.,Tigard,OR 97 2 0 2 016 Plan Review 2 Phone: 503.718.2439 Fax: 503.598. DateB : Related Permit#: Inspection Line: 503.639.4175 .�.-_ .„r Ready Date/By: Juris: H See Page 2 for T i G A R D Internet: www.tigard-or.gov Ur i T ' £ 1 J4tr+t3 Notified/Method: Supplemental Information 0 New construction 0 Addition/alteration/replacement, Please check all that apply(submit a sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 1:1 Demolition Z • er: " . v3 where the available fault current 0 Marinas and boatyards. Naaw . A, !Y t t ,.,Ob at. ',ii r.I.t tt> . . . wFexceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑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 b . r ,? , " ; t 1 41 ,g t � , 'I t L ' ❑Emergency system. larger separately derived Job#: Job site address: / // 'Sc.) ❑Addition of new motor load of system. _ /y(��� 7 . 100HP or more. ❑"A» "E» "l-2»"l-3» City/State/ZIP: jl Ct ❑Six or more residential units. occupancy. ty b IC 9 7 Z2-g 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: 53 (Project name: .#33 et�®ylh e 4- ❑Hazardous locations. 0 600vlolts nominal.more than ❑Sernce or feeder 600 amps or more. Cross street/directions to job site: or^ h:: S 4� `j 6J I t tt ` �J M D/ p / Description I Qty. Each I Total I * 704 Ale.- Iee- C&`e moi'7- fI1!t d 5' New residential single-or multi-family dwelling unit. Subdivision: ` Lot#: L p Includes attached garage. .�e�-c trey./... G�ti a�a �f �-- Tax map/parcel#: ,e 2/yS 3a� 1,000 sq.ft.or less 168.54 4 Ea.add'!500 sq.ft.or portion 33.92 1 a :''i% ,a a" a _' 6) $8>.4a 11 .,..,. .. ,a .. . NI �.'. .,.,,. Limited energy,residential 75.00 2 r-- [ (with above sq.ft.) _ � �- ©�lyli �� �"l �e�-//GG1 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Ene 0 See Page 2 t. *44,_i, ,��r��t. � l.. g t .ra _t ***ktttk . Services or feeders installation,alteration,and/or relocation Name: e, s` S° ' C CI r 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: f 7-C%r✓ � .t A hu'll fi' 401 amps to 600 amps 200.34 2 City/State/ZIP: Lk. 5> t /\ e"7-"C-4.r 7 601 amps to 1,000amps 301.04 2 Phone:(91 ) g 4„,vrg Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email:. O,c '. ,4relocation Owner ins 1 titin:This instillation i : 'i ade on prope that I own which is not 200 amps or less 59.36 1 intended for lese,re exc le :,cor• ng to •'. ,47,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: .,/ Date: en ''j M /4, 401 amps to 599 amps 168.54 2 Branch circuits-new,alteration,or extension,per panel �' . =� ,.�_ tA �u A.Fee for branch circuits wdth Business n. . 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: Each add'!branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email Reconnect only i 67.84 6 ,Ity 2 ' a 1 } i , �. .` '., Pump or irrigation circle 67.84 2 Business name: l Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address: panel,alteration or extension. City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(I hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(I hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv.Lie.: specifically listed('/:hr mmj Suprv.Electrician signature,required: Subtotal: e7-gy Print name: Date: 0 Plan Review Required(25%of permit fee): ...<---- .y,- State surcharge(12%of permit fee): g./y Authorized signature: s TOTAL PERMIT FEE: 45-, eiR This permit application expires if a permit is not obtained within 180 Print name: sem.OP t pp_EDate: /�/ days after it has been accepted as complete. l * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermiLR_ �?'f�RE.doc Rev 06/1$12015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: '� al��� x s �x �,_,l,-:r�.'•Fs'�� .. ._ � �,�t_ ,.�..��u; '�,� .d` a�'1. x.�. ..i,.uz� ., � � . ,a ,.�` .c e.; m_ Fee for all residential systems combined: $75.00 Ren ewa systems:ems 7 E"e C T°�I 3' 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* >l00 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(14 hr mm) x ';l�A ■�A 1, ,�� ... � M��a _� ,.. ,� -.��....>-...,�. ; C �� � ,",aa ,:_.,e.,,-`,,.r .,, ., �,.�.. .,.� .,,..,,Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls O Clock Systems ❑ Data Telecommunication Installation O Fire Alarm Installation ❑ HVAC O Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* O Medical O Nurse Calls O Outdoor Landscape Lighting* ❑ Protective Signaling O Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC PermitApp ELR_ERE.doc Rev 06/17/2015