Permit (256) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016-00882
Tf GAR.;[D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/16/2016
Parcel: 2S111AD12200
Jurisdiction: Tigard
Site address: 15120 SW 89TH PL
Project: Wong Subdivision: SCHECKLA PARK ESTATES Lot: 37
Project Description: (1)feeder and(1)branch circuit for kitchen remodel.
Contractor: OWNER Owner: DEUTSCHE BANK NATIONAL TRUST CO
LISA WONG BY OCWEN LOAN SERVICING LLC
15120 SW 89TH PL 1661 WORTHINGTON
TIGARD, OR 97223 WEST PALM BEACH, FL 33409
PHONE: 971-446-3523 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 11/16/2016 $100.70
Specifics: amps or less
1 crt Branch Circuits w/Purchase 11/16/2016 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/16/2016 $12.97
Electrical
Type of Const:
Occupancy Grp:
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 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 R 952-001-0090. You may obtain a y o rules 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.
Electrical Permit AIROC . -,--.1 FOR OFFICE USE ONLY
CEIV El) Received
City of Tigard DateB -,. //A1/1/6/ .ii
,i A •
, ig 13125 SW Hall Blvd.,Tigard,OR 97223
II/
: I Phone: 503.718.2439 Fa::: 503.598.1960 Th Related Penni'Ft. / .-3 -• i
T 1 GA R D. Inspection Line: 503.639,4 I 75 NOV 1 4 2016 Ready Date/By: , - Eii See Page 2 for
vt-Ci,,, rtil ' - -44 ' '1'4- PIAN REV'
Internet: www.tigard-orgov Notified/Method: i /5- / y,,,,j,- MN Supplemental Information
Aif TIGARD M
EW
0 New construction lOdditffitij@INiGEDI;ifiVOri
Please check all that apply(submit 2 sets of plans wiitems checked):
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.
C.. 524,/,': ',' ,'" CATEGORY OF colistitticrtoN , '.: , exceeds 10,000 amps at ISO volts or 0 Floating buildings.
-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-ase agricultural
amps for all other installations. buildings.
' 0 Multi-family 0 Master builder 0 Other 0 Fire pump. 0 Installation of 150 KVA or
JOE SITE, 11*1 R1t4TION ANIS,LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system,
Job#: Job site address: 15120 SW 89th Place 100HP or more.
,‘1 City/State/ZIP:Tigard 0 Six or more residential units. occupancy.
0 Health-care facilities_ 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: , , , ., „, , Y
- ''.LTE,SOIEttiAILC
SW Reiling and SW 89th Description I Qty.'I Each .1 Total I
New residential single-or multi-family dwelling unit.
N‘l Subdivision: Lot#: Includes attached garage.
1,000 sq,ft or less 168.54 4
Tax map/parcel#:
Ea.addl.300 sq.ft.or portion 33.92 1
,....4l1: zsmiito..-c,-o.rvoric .., ' . k., - .., 5Limited energy,residential
al
75.00 2
N,,, add new branch line,.relocate (with above sq.ft.) _
Limited energy,multi-family
75,00 2
In kitchen outlets residential(with above sq.ft) -
Renewable Energy 0 See Page 2
pottitty,0*Ntit,' ,,,f- f - -:, CI ,,,,i-., -,.-..%::, - - installation, - .
OWNER I-- - - ,, - , , - ,,,- Services or feeders alteration,and/or relocation
Name:Lisa Wong 200 amps or less I 100.70 100.70 2
Address:98-05 63111 road,apt 15 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
"*•::: City/State/ZIP:Rego Park,NV 11374 ,
v 601 amps to 1,000 amps 301.04 2
'-'11., Phone:(971446 3523 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 I
intended for sale,lea: ,rent,or exchange,according to ORS 447,449,670,a i 70 . 201 amps to 400 amps 125.08 2
-.:.-- Owner signature: ,.„,‘,..... .
Date: / 401 amps to 599 amps 168.54 2
0. .•,'-,i. ...'.... - ,,,,,00--- r-. - ,, .. ,CAC...,-= ......;‘,6,,,,,;.,,, ,,.. Branch circuits-new,alteration,or extension, ,er panel
AryssACAlli s ...„, ......., ...../..e. 4. s4 PERSON 1. .d..-
,.. . -'' A.Fee for branch circuits loth
Ll..-1Business name: above service or feeder fee. l 7.42
-,---------- each branch circuit 7.42 2
Contact name: /72j k6e....._ B.Fee for branch circuits wirhord
Address: service or feeder fee,first
branch circuit 56,18 2
,,---, City/State/ZIP: Each add'l branch circuit 7.42 2
Phone:(503)209 3671 Fax:: Miscellaneous(service or feeder not included)
-----'-3 ( ) Each manufacturedormodular
ii.
67,84 2
dwelling,service and/or feeder
Email:mkspros2003/ ).yahoo.com
Reconnect only 67.84 2
CONTRACTOR .-- ' irrigationcircle, - Pump or ci67.84 2
Business name: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energv
Address: panel,alteration,or extension - 0 Sec Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP:
Additional inspection(I lit nun) 66,29 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 Lie.: Electrical Lie.: Suprv. Lie.: specifically listed 0'1 hr mm)
— , ELECTRICAL PMIIT FEES,
Suprv.Electrician signature.required:
Subtotal: 108.12
l'rint name: Date: 0 Plan Review Required 125%of perniit fee):
State surcharge(12%of permit fee): ---1- 78-IA•17
.roTAL PERMIT FEE: J.24-rItt all eci
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 awned per permit.
1 Beading PeTrests'El C Permit Apd) Et RERI:doe Re,1O6'20.15 440405 I'd 1 1,Ri+CONIAVE.11
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
'RESWEN11AL womonY: izEt
Description Qty. Each I Tato' 1 "
Fee for all residential systems combined: 575.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
501 to 15 kva 133.56 2
O Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
[Ti Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n G• arage Door Opener* >100 kva(fee in accordance
552.26 2
with OAR 918-309-0040)
El Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7,42 3
EiV• acuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
U Other Each additional inspection
6625/hr
charged at an hourly(1 hr min) 1
Inspections for which no fee is 90 001 hr
specifically listed(4 hr mm)
V:44L1401, *CACI% FEEs
CO ; 4.4 Subtotal(Enter on Page I)
Fee for each commercial system: $75.00 Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
0 A• udio and Stereo Systems
0 Boiler Controls
O Clock Systems
0 D• ata Telecommunication Installation
O Fire Alarm Installation
LI HVAC
fl Instrumentation
n Intercom and Paging Systems
Fl L• andscape irrigation Control*
Lii M• edical
ri N• urse Calls
LI Outdoor Landscape Lighting*
0 Protective Signaling
n Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I 134ildtog Penn EL(.' PernatApp tL R I RFdoi Rev at?tW1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15120 SW 89TH PL, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2016-00882
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor