Permit CITY OF TIGARD ELECTRICAL PERMIT
8''- COMMUNITY DEVELOPMENT Permit#: ELC2016 00688
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2016
Parcel: 2S104CB01600
Jurisdiction: Tigard
Site address: 13083 SW ASCENSION DR
Project: DAWOODBHAI Subdivision: HILLSHIRE WOODS Lot: 32
Project Description: (2)branch circuits for can lighting and deck addition.
Contractor: PRECISE ELECTRIC LLC Owner: DAWOODBHAI, YUSUF&INSIYA
13013 NE 91ST CIR 13083 SW ASCENSION DR
VANCOUVER, OR 98682 TIGARD, OR 97223
PHONE: 360-607-1208 PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 2 crt Branch Circuits wo/Purchase 09/12/2016 $63.60
Service or Feeder
1 ea 12%State Surcharge- 09/12/2016 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 may obtain a copy eVacotdirect questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / _—"1 2 ---- 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.
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard Received �] p
. " g - E „!""'' Date/B : —I NAM Permit#: V
13125 SW Hall Blvd.,Tigard,OR 9721 ` .(6:. ^1�
Phone: 503.718.2439 Fax: 503.598.1 6 Plan Review (�
Date/B Related Permit#: /V)57, 1!'___ .I I
TIGARD® Inspection Line: 503.639.4175scg 1 2 Y ReadyDate/By: t for
0, Internet: www tl ard or. ov o I°" B1 See Page 2 for
g g r Notified/Method:
_ g , � Supplemental Information
�J ,�'"itpitt'-i`---�!^� et li .,.#" -,V TYPE.. OF W(. � sm r. `t... 'i -`, m , "_ _ ,'' #` Y
+tet PLAN REVIEWS
ElNew construction ®Addition/alterati3i ` t''' Please check all that a I
pp y(submit 2 sets of plans w g w/items
ve checked):
❑Demolition 0 Other: ❑Service or feeder 400 amps or more ❑Budding over three stories.
where the available fault current 0 Marinas and boatyards.� boat
ards.,4 ATEGORYOCNSTI) IW:�1 "'� a ntexceeds 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
0 Multi-family 0 Master buildamps for all other installations. buildings.
er 0 Other ['Fire pump.
JOB SITE IIVFORMATIoN'AND'�-LO'CATION,ii 0 largerInstalse a of 150 KVA or
�w x �-
� ❑Emergency system. larger separately derived
Job 4: I Job site address: 13083 SW Ascension Dr ❑Addition of new motor load of system.
100HP or more. ❑"q" `F„ °°1.2•• <.1 3„
City/State/ZIP:Tigard,OR 97223 []Six or more residential units. occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.4: , Project name: Useff Patio ❑Hazardous locations. ❑Supply voltage for more than
Cross street/directions to job site:Barrows Rd&Horizon Blvd,S on HiriZon ❑Service or feeder 600 amps or more. 600 volts nominal
-� 'FEE'=sCi�ar�uUL>1° � ��,,. .
Right on Ascension Dr. Descrip6naQty. *
New residential single-or multi-family dwelling unitEach IToral
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
�' `. n 'u= ��DESCRIPTION OFf WORD " Ea.add'1 500 sq.ft.or portion 33.92 1
1° ' . ' Limited energy,residential
8 can lights,2 fans&2 christmas plugs for patio cover (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
0 PROPERTY OWNER : . `7' " ' ` Renewable Ener
! 0 TENANT gY 0 See Page 2
Name:
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
City/State/ZIP: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Phone: ( ) I Fax:
( ) Over 1,000 amps or volts 55226 �
Email: Temporary services or feeders installation,alteration,and/or
y
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
® -APPLfICANT =4 0 CONTACT PERSON vz k, . Branch circuits—new,alteration,or extension,per panel
Business name:Precise Electric LLC A.Fee for branch circuits with
above service or feeder fee,
Contact name:Vadim Vergulyanets
each branch circuit 7.42 2
B.Fee for branch circuits without
Address: 13013 NE 91"Cir service or feeder fee,first 1 56.18
branch circuit 56.18 2
City/State/ZIP:Vancouver,WA 98682 Each add'I branch circuit 1 7.42 7.42 2
Phone:(360)607-1208 Fax: :(360)607-1208 Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: precise.electric.office@gmail.com dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2Fv N _ '_ , CONTACTOR
t20'_ .
6 Pump or irrigation circle 67.84 2
Business name:Precise Electric! LLC Sign or outline lighting 67.84 2
Address: 13013 NE 91"Cir Signal circuit(s)or limited-energy
panel,alteration,or extension. ❑ See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP:Vancouver,WA 98682
Additional inspection(I hr min) 66.25/hr
Phone:(360)607-1208 I Fax:(360)607-1208 hr min Investigation 1
g ( ) 90.00/hr
Email: precise.electric.office@gmail.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: 211112 4 1, electrical Lie.: C1210 7, ' Suprv.Lic.: 6044S /o�i/j specifically listed(%1 hr min) 90.00/hr
Suprv.Electrician signature,required: EL ECTRICAL'PERMIT,FEESS
b
_— —i`7'" Subtotal: W
-.;.Qi'—
Print name: Vadim VergulyanetsI Date: 9/12/16 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 7 6.,3
Authorized signature: TOTAL PERMIT FEE: 7/ ;2,9
This permit application expires if a permit is not obtained within 180
Print name: Vadim Vergulyanets Date: 9/12/16 days after it has beenper peaccepted as complete.
* Number of inspections allowed rmit.
C�BuildingU'ermits�ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(I t/05/COM/WEB