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Permit (80) iii �,,� CITY OF TIGARD ELECTRICAL PERMIT 1l .•'° COMMUNITY DEVELOPMENT f Permit#: ELC2016 00627 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2016 Parcel: 2S 111 CA02600 Jurisdiction: Tigard Site address: 15452 SW SUMMERFIELD LN Project: RUPP Subdivision: SUMMERFIELD NO.7 Lot: 373 Project Description: Panel replacement and(7)branch circuits for kitchen remodel. Contractor: BUCKAROO ELECTRIC Owner: RUPP, NORMAN N FAMILY TRUST 31601 S WRIGHT RD ROBINSON, PATRICIA B MOLALLA, OR 97038 15452 SW SUMMERFIELD LN TIGARD, OR 97224 PHONE: 503-880-6326 PHONE: FAX: 503-829-5207 FEES Quantity Description Date Amount Specifics: 1 ea Services or Feeders-200 08/11/2016 $100.70 amps or less 7 crt Branch Circuits w/Purchase 08/11/2016 $51.94 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 08/11/2016 $18.32 Type of Const: Electrical Occupancy Grp: Total $170.96 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. You ma obtain a cop efthe. les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: 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' 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. Aug 10 16,11:34p Buckaroo Electric LLC 503-829-5207 p.1 Electrical Permit APPliceitt EIVEDFOR OFFICE 1cE I SE ONE e City of Tigard Received ` Da 111 n 13125 SW Hall Blvd.,Tigard,012.59a01 0 20'16 i i Phone: 503.718.2439 Fax: Ptan Review Inspection Line: 503.639.4175 r�, Ready RelatedPerm;tit: TI G,�t2 DIMIIII Internet: www.tigard or.gov t f Ready Date/By: Ef Sec Page 2 for CITY OF �� ®� Nolified/Metbod: SapplementalInformtalon T tL' PLAN REVIEW D New construction Addition/alteration/replacement Please check all that apply orit 2 sets of plans ing checked): 0 Demolition Other: 0 Service or feeder 400 amps more ❑Bwlding over three stories. wCATEGORY OF CONSTRUCTION ham the available fault current ❑Marinas and boatyards. exceeds 10,000 amps at 150 volts or ❑Floating buiklia . ti-- JOB 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural Mulri-famil3' ❑Master builder [�p�ei: amps for all other installations. buildings. SITE INFORMATION AND LOCATION ❑Firepump. El(=Dilation teI5d rivAor ❑Emergency system. larger separately derived Job#: Job site address: '` 5 /�� ❑Addition of new motor load of system. Sc S1hMMtrc1e.1a L71, l0011Pormore. ❑"A,.,..E,."1`,..<1-3,• CitylState/Ztl': "�-^`�a r O 14. qp ❑Six or more residential units. occupancy. Suit//tat / t#: * ❑Healthcare facilities. 0 Recreational vehicle parks. g•ap I Project name: Hazardous locations. 0 Supply voltage for more than CiOSS street/directions to job site: l rt r �� 1]❑Service or feeder 600 amps or more. 600 volts nominal. l FEE SCHEDULE Description I Qty. I Each I Total I • New residential single-or multi-family dwelling unit. Subdivision: I Lot 4: Includes attached garage. Tax trip/parcel#: 1,000 sq.ft.or less 168.54 4 DESCRIPTION OF WORK Fa.add'I 500 sq.ft.or portion 33.92 1 Limited energy,residential ,` , ,,\ CQ 1• Pawl { aan (with above sq.fl.)• 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0See Page 2 0 PROPERTY OWNER I 0 TENANT Name Services or feeders installation,alteration,and/or relocation 20D amps or less , 100.70 i 0,1 6 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 I 601 amps to 1,000 amps 301.04 2- Phone:( ) Fax:( ) Over 1,000 amps or volts 55226 2 Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 i 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 ❑ APPLICANT © CONTACT PERSON Branch circuits-new,alteration,or extension,per jranel Business name: A.Fee for branch circuits with above service or feeder fee, 1 Contact name: each branch circuit 1 7.42 51 G94i 2 B.Fee for branch circuits without Address: service or feeder fee,first branch circuit 56.18 2 City/State/ZIP: Each add'I branch circuit 742 I 2 Phone:( ) Fax::( ) Miscellaneous(service or feeder not included) Each manufacture[or modular Email: dwelling,service and/or feeder 67.84 ( 2 CONTRACTOR Reconnect only 67.84 I 2 Pump or irrigation circle 67.84 2 Business name: 1 a n 1/ roo �Q J j(„ f i_ 6, Sign or outline lighting 67.84 ! r(/�fJt� �t� h 2 Address: �j / l Q r Signal circuit(s)or limited-energy `3 1+a"0, 1 `�- J�r i g - panel,alteration,or extension. 0 See Page 2 I 2 City/State/ZIP: `vie/a //4 , �JQ,/� 970 3 Each additional inspection over allowsMe in any of the above Phone:(�63) g�U—, 3z I Fax:((i- ) _ Additional inspection(I hr min) 66.25/hr + � d IQInvestigation(1 hr min) 90.00/hr Email:GUtC.iled0.r(1t)_+ IG�1FAAl COM - Industrial plant(1 hr min) 78-18/hr CCB Lie.: S"L J� I Inspections for which no fee is <l SO Electrical Lie.:,(,�31d 14,,Suprv.Lic.39 5 ./ S' specifically listed(i4 hr min) 90.00/hr Suprv.Electrician signature,required: , L J / ELECTRICAL PERMIT' FEES t� �' Subtotal: Print name. V 4-ni - i >j'^j�. G Li f 17ate:�.. �O_�� Q Plan Review Required(25°!°of permit fee): State surcharge(12%of permit fee): 11,3 ti Authorized signature: TOTAL PERMIT FEE: 170 0}u i Print name: 1 Date: I 'This imp application expires if a permit is not obtain within ISO i days after It has leen accepted as complete. 1:tIIuildlnalt'vrautelPl:C_A@rmltApp GLR t R6,doc Rev 06lITROIS * Number of inspections allowed per permit. 440.461$T(l 1/OSKJOM/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 15452 SW SUMMERFIELD LN, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O October 28, 2016 at 12:51:10 PM ELC2016-00627 Jeff Grove Violation Summary: Inspector Contractor