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Permit (39) CITY OF TIGARD ELECTRICAL PERMIT ,1111 COMMUNITY DEVELOPMENT Permit#: ELC2016-00873 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/10/2016 T['dAR` g Parcel: 2S111DB13800 Jurisdiction: Tigard Site address: 15085 SW DAWN CT Project: BLANCHARD Subdivision: LAUNALYNDA PARK Lot: 3 Project Description: (4)branch circuits for kitchen remodel. Contractor: PORTER ELECTRIC INC Owner: BLANCHARD, GREGORY L&SANDRA M 7320 NE ST JOHNS RD 15085 SW DAWN CT VANCOUVER,WA 98665 TIGARD, OR 97224 PHONE: 360-574-1366 PHONE: FAX: 360-573-3723 FEES Quantity Description Date Amount 4 crt Branch Circuits wo/Purchase 11/10/2016 $78.44 Specifics: Service or Feeder 1 ea 12%State Surcharge- 11/10/2016 $9.41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87.85 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 o• -'• - •.y of the direct questions to OUNC by calling .1987 or 1.800.332.2344. Issued By: �sl _:� 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 ,Ct(li4ktti, FOR OFFICE USE ONLY City of-Tigard Received �`� � DateB 1I m w '13125 SW Hall Blvd.,Tigard,OR 9 Plan Review Phone: 503.718.2439 Fax: 503" Date/B : Related Permit g. � I '�t/6, t iii Inspection Line: 503.639.4175 - q.%I\� Ready Date/By: 1MM ® See Page 2 for I GARD © Notified/Method: Supplemental Information Internet www.tigard-or.gov gT PLAN REVIEW ❑New constructionjAddition/alteratioi Please check all that apply(submit 2 sets of plans w/items checked). 0 Demolition ❑Other: "jtc�, ; 0 Service or feeder 400 amps or more 0 Building over three stories. where the available fault current 0 Marinas and boatyards. `V.t(.� OA:toldVONv = ' exceeds 10,000 amps at 150 volts or 0 Floating buildings. ._, .nNY . bei -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 JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived " r 0 Addition of new motor load of system. / Job#: Job site address: 15.085 SW L)' imv.. 100HP or more. ❑"A","E "1-2"•°°1 s ❑Six or more residential units. occupancy. City/State/ZIP: `7;6�n49 04. 72 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: ' ' Project name: /6.14 0 Hazardous locations. 0 Supply voltage for more than J R7�ClJ 600 volts nominal. ❑Service or feeder 600 amps or more. Cross street/directions to job site: 3'G, ....sh7rL r , 'FEE.SCHEDULE Description 1 Qty. 1 Each 1 Total 1 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 .RR,Scwv4I0I =WOR(.: _ ,-. '., Limited energy,residential 75.00 2 ' a r (with above ft.) y 75.00 2 �f JC Limited energy,multi-family CCresidential(with above sq.ft.) !�C+•/ •• Renewable Energy ❑ See Page 2 ❑ PRPP [t"I` a► R, : ::' '4. 'V—TENAIT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Address: 401 amps to 600 amps 200.34 2 -ity/State/ZIP: 601 amps to 1,000 amps 301.04 2 1 •hone:( ) 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 Branch circuits-new,alteration,or extension,per panel (] APPLICANT ;; [] CONTACT' 'PERSON A.Fee for branch circuits with Business name: above service or feeder fee, 7.42 2 each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 ��4 2 Address: branch circuit City/State/ZIP: Each add'l branch circuit a 7.42 22 0 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: �tr L rieeL'_/7. c_ 1 e Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address: e'7 31.‘", it/�, S.�} j t,u S 2_0 , panel,alteration,or extension. ,-�._ Each additional inspection over allowable in any of the above City/State/ZIP: V14-74}e-0 v Vr-n-- �A 9 iC " Additional inspection(1 hr min) 66.25/hr Phone:( S-74,,... /344, Fax:(360) 6 73 3 72 a. Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 4/667? 3 7-553i/ p �C iC 5 specifically listed('A hr mm) 90.00/hr CCB Lic.: Electrical Lic.: J J Suprv.Lic.: -1 J ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: 1 L:,__5,.,..-cE >-'( Subtotal: 71 94 i 0 Plan Review Required(25%of permit fee): rint name: 1�,,i,, -rN.-t t2_ j rx..-t_ Date: : l / ,t16, State surcharge(12%of permit fee): q �// TOTAL PERMIT FEE: g-7,..gc- Authorized signature: 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. 1'\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB I City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 15085 SW DAWN CT, TIGARD, OR, 97224 August 4, 2017 at 10:17:16 AM Record Type: Record ID: Residential - Electrical ELC2016-00873 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor