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Permit (239) CITY OF TIGARD MASTER PERMIT ` 11 COMMUNITY DEVELOPMENT * x Permit#: MST2016-00553 13125 SW Hall Blvd.,Tigard OR 97223 503.718.24 `i/� Date Issued: 12/29/2016 T f .i `G? 9 Parcel: 25110BC07400 Jurisdiction: Tigard Site address: 12340 SW ASPEN RIDGE DR Subdivision: THORNWOOD Lot: 45 Project: Johnson Project Description: Split loft area with partition wall to create new bedroom. 1/4/17, changed electrical contractor from owner to Frahler Electric. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 1 First: 0 sf Basement 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front: 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $6,800.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer: 0 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: Catch Basins: 0 Bckflw Prevntr: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Other Fixtures: 0 Drywell-Trench Drain: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add l 500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 3 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: JOHNSON,ZACHARY K&MONIQUE GPC CONTRACTING LLC Required Items and Reports(Conditions) 12340 SW ASPEN RIDGE DR 17224 SW MONTEGUE WAY TIGARD,OR 97224 TIGARD,OR 97224 PHONE: PHONE: 503-784-8172 FAX: Total Fees: $647.04 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 952-001-0 r..•- ••R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issue By: 7 �►• . Permittee Signatu( �'_' �'iuvl�Z�L/y et--,-----1 Call 503.639.4175 by 7:00 a.m.for the next available inspection d-te. 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 Applicat' Folz()HA( i. i i oyI.l g(, EiVED Received H 6.-7--- ,Oita--1,065. Clty ofTigard Date/B : Permit#: -Ill/ 13125 SW Hall Blvd.,Tigard,OR 9722 4 2017 Plan Review Related Permit#: Phone: 503.718.2439 Fax: 503.598.1 W Date/B : Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for -I I C,A R D Internet: www.tigard-or.gov CITY F. E iLiAliD Notified/Method: Supplemental Information TYPE eqUittiigIG DIVISION PLAN REVIEW ❑New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more 0 Building over three stories. 0 Demolition ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 0 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 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 ❑Addition of new motor load of system. Job#: Job site address: j X2744 ,w c_13 .g.l 1)&!L 100HP or more. ❑"A","E","1-2",°°l-3", City/State/ZIP: ❑Six or more residential units. occupancy. ❑Health-care facilities. El Recreational vehicle parks. Suite/bldg./apt.#: Project name: 04-t-I SO 1,3 0 Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 0 TENANT 0 PROPERTY OWNERServices or feeders installation,alteration,and/or relocation Name: 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 601 amps to 1,000 amps 301.04 2 Phone:( ) 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 0 APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel 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 Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I 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 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: , �4 � d�� Fr�k C l M� Sign or outline lighting 67.84 2 t� Signal circuit(s)or limited-energy Address: I t' 'rvO �,,A) ,...„,,,,,\:„,:7 hd panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: —1-.174,--c4 C 9722-3 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) 3 y_4L 27 Fax:(�t3) 1‘31.--11S-73Investigation(1 hr min) 90.00/hr (� Industrial plant(1 hr min) 78.18/hr Email: i ca�,�ec-�<<is;c,d Dort Inspections for which no fee is CCB Lic.: 1.9717 2. Electrical Lic.: 6 Suprv.Lic.: 5 r in s specifically listed('/Z hr min) 90.00/hr ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:/�y , Subtotal: Print name: / c"'"`- C. EA-1,,,„,-, Date: I/4/(7 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: This permit application expires if a permit is not obtained within 180 PI'int name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Fee for all residential systems combined: $75.00 DescriptionI Qty. I Each I Total3' 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: n Burglar Alarm 25.01 to 50 kva 301.04 2 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 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: n Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/2 hr min) COMMERCIAL WOR iONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): y * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: [II Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation El Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling ❑ 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 CITY OF TIGARD MASTER PERMIT COMMUNITY DEVELOPMENT Permit#: MST2016-00553 13125 SW Hall Blvd.,Ti Date Issued: 12/29/2016 T[Ca1[t.0 and OR 97223 503.718.2439 9 Parcel: 2S110BC07400 Jurisdiction: Tigard Site address: 12340 SW ASPEN RIDGE DR Subdivision: THORNWOOD Lot: 45 Project: Johnson Project Description: Split loft area with partition wall to create new bedroom. BUILDING Floor Areas Required Setbacks Required Stories: 0 Bedrooms: 1 First: 0 sf Basement: 0 sf Left: 0 Parking Spaces: 0 Height: 0 Bathrooms: 0 Second: 0 sf Garage: 0 sf Front 0 Smoke Dwelling Units: 0 Third: 0 sf Right: 0 Detectors: Yes Total: 0 sf Value: $6,800.00 Rear: 0 PLUMBING Sinks: 0 Water Closets: 0 Washing Mach: 0 Laundry Trays: 0 Rain Drain: 0 Urinals: 0 Lavatories: 0 Dishwashers: 0 Floor Drains: 0 Sewer Lines: 0 SF Rain Storm Sewer 0 Tubs/Showers: 0 Garbage Disp: 0 Water Heaters: 0 Water Lines: 0 Drains: 0 Catch Basins: 0 Footing Drain: 0 Ice Maker: 0 Hose Bib: 0 Backwater Value: 0 Bckflw Prevntr: 0 Drywell-Trench Drain: 0 Other Fixtures: 0 Other Fixture Units: MECHANICAL Fuel Types Air Conditioning: N Vent Fans: 0 Clothes Dryers: 0 Heat Pump: N Hoods: 0 Other Units: 0 Furn<100K: 0 Vents: 0 Woodstoves: 0 Gas Outlets: 0 Furn>=100K: 0 ELECTRICAL Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits 1000 sf or less: 0 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0 Ea add!500 sf: 0 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 3 Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0 601-1000 amp: 0 601+amp-1000v: 0 1000+amp/volt: 0 ELECTRICAL-RESTRICTED ENERGY SF Residential Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All Other: N Other Description: Ecompasing: N BUILDING INFO Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet: ALT SF VB R-3 0 Owner: Contractor: JOHNSON,ZACHARY K&MONIQUE GPC CONTRACTING LLC Required Items and Reports(Conditions) 12340 SW ASPEN RIDGE DR 17224 SW MONTEGUE WAY TIGARD,OR 97224 TIGARD,OR 97224 PHONE: PHONE: 503-784-8172 FAX: Total Fees: $501.24 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 in accor•-• e 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 d s. ATTENTION: Or-•on = requires you to follow the rules adopted by the Oregon Utility Notification C--ter. T••se rules are set forth in OAR 52-001-0010 through OARA:' 2-00 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.23 • or 1.8•• '.•344. 1 ��I �.ia / �1 sued By: _r_ _� Permittee Signature: /ky ,• 1.... Call 503.639.4175 by 7:00 a.m.for the next available inspecti6n d.te. This permit card shall be kept in a conspicuous place on the job site until comple on of the project. Approved plans are required on the job site at the time of each inspection. RECE VED Building Perm itApplicati Residentii' DEC 1 9 2016 FOR OFFICE l)::-,E ONLY City of Tigard Received DateBy: �� /, 4 p Permit N f f 13125 SW Hall Blvd.,Tigard,OR(J�OFTIGARD I2Ii/ v G��tr ���jr� Phone: 503.718.2939 Fax: 503.,, IGA tJ Plan Review Date/By: 'ot, .4; Other Permit: lIc;Attt3 Inspection Line: 503.639.4175BUILDINGDIVISION DateReady/By: �9 �� Jarts: I ®SSeeP.ge2r0- Internet: www.tigard-or.gov Notified/Method: �ppie enter Intel tion s w b .; ti T1'4'E O'6A/ORIC: _ t i s y 1.I • 1��.� ;,a ac •. g: ;. _ ':,r 1 ,+. .,<,.. '� � � �Il \` ❑New construction ❑ Demolition Permit fees*are based on the value of the work performed. Indicate the value(rounded to the nearest dollar)of all g Addition/alteration/replacement ❑Other: equipment,materials,labor,overhead,and the profit for the C EGORY }F ON$1RtCTlON work indicated on this application. X 1-and 2-family dwelling a Commercial/industrial Valuation: $ CeaCC) a Accessory building a Multi-family Number of bedrooms: a Master builder 0 Other: Number of bathrooms: y; '4W FOB SlTI JNF RMRThbf AN LO AT)N Total number of floors: Job site address: ' 2340 5w A$P fZ 1 p(,. VIZ, New dwelling area: square feet City/State/ZIP: -Tya,„4 ILI, c,iz. 97444. Garage/carport area: square feet Suite/bldg./apt.no.: Project name: Birchope A,PD,170"I Covered porch area: square feet Cross street/directions to job site: w O Sr PIEa#s4 lc(cA..r. O ISI Deck area: square feet 13 G.)11 #01/74. RcI. ru/Z/V c.,i.a, 0.J Other structure area: square feet 45 pcn.t 2 c cry c QIZ. Riau' IRED Im.A M ;.Cia-tl USE C1 Subdivision: nieb etu W ores f Lot no.: ' s- Permit fees*are based on the value of the work performed. Z,S�lO 13CJ� ���0 Indicate the value(rounded to the nearest dollar)of all Tax map/parcel no.: ..., equipment,materials,labor,overhead,and the profit for the i � DEkRIPP-ION%OF AN.66k : work indicated on this application. Srt.if' Lar=rAna►n &J/fk e t2r7nor4 &A ri1 Valuation: $ Te) CRCI47 -C Je C.r_j � ,w'! • Existing building area: square feet New building area: square feet 4, 1iI; RQ.,�." •'t`•1 ? IN ( g*RNT ,, Number of stories: Name: z04.c 641'4Y .TQ.1"1Nso/J Type of constriction: Address: ,Z.340 SCJ + �ay...4 Occupancy groups: City/State/ZIP: q� r r"/9/AP OR. /l4 Existing: Phone: ( ) Fax: ( ) New: APPt I ANT ❑ C 3t1TACT1! RSOC�( 5 a ,. ., Co ... ' 1111LJl�I PERAAITFEE-s �� •, PG �..L7 ....-4,,-;,.-.-� letatlse fete Yp,l e ce!?mt P.kej • Business name: N,771444-0,1q, � •"" Structural plan review fee(or deposit): Contact name: ,/CNI� C I�14YCL_ Address: / 7 Z 24 5 W mO c i wA,ci FLS plan review fee(if applicable): Total fees due upon application: City/State/ZIP: /-d perk ci 012, f 7zz4 Phone: ( ) 71,- 8 l 7 Z Fax: : ( ) Amount received E-mail: POT �J'OLTA�:SOLAR1?A(IF� M F1=, * q0CGbNn2A.cTJ GL.0 Gv /s'!441 Com °o, � 1Commercial and residential prescriptive installation of ' --,, C fi c R -0" . ;- roof-top mounted PhotoVoltaic Solar Panel System. Business name: �C` Lor.J7n4.cr-r L.�C Submit two(2)sets of roof plan with connection details and fire department access,along with the 2010 Oregon Address: i 7 Z a sq' 5 o•1 �7OAf Uel �''�'�f Soar Installation Specr,ity Code checklist. City/State/ZIP: ;� ©� �Z� / Permit Fee(includes plan review $180.00 Q and administrative fees): Phone 7 4 - ©� �� Fax: ( ) State surcharge(12%of permit fee): $21.60 ,,,,, Total fee due upon application: $201.60 This permit it.application expires if perm it.is not obtained /73,, Authorized signature: cs� pe E aai xp V q within 180 days after it has boon accepted as complete. Print name:G/eA,NF. CW4 V�L,_ Date: /I2///4/20�� Fee icethodology set by Tri-County Building Industry Service Board. I:\Building\Permits\BUP-RESPermitApp.doc 02/24/2011 440-4613T(1COM/WEB) VEL) Mechanical Permit Applica ' C ,ld FOR OFFICE USE ONLY City of Tigard Eew DEC 19 206 DPernutNo//111 13125 SW Hall Blvd. Tigard,OR 97223 �� !<Phone: 503.718.2439 Fax: 503.598.1960 Other Permit: on Date/By: 1 tC;ARt} Inspection Line: 503.639.4175 OF TI � Date Ready/By:j 1 1 i�l 1 Y Y Ju s: ® See Pact2Ivr Internet: www.tigard-or.gov Notified/Method: S BUILDING DIVISIONpGlen,ental of rn,ati n : r Print name: I `IYPE OF.WOR ❑New construction Addition/alteration replacement C t{1M& tk.. *; 1 t: pUI E""t',459,..-171%) iK T Mechanical permit fees*are based on the value of the work ❑ Demolition ❑Other: performed.Indicate the value(rounded to the nearest dollar)of all CATEGORY OF CONSTRU~TION ` mechanical materials,equipment,labor,overhead,and profit. Value:$ 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building \ Rl .-'' NTiAI 'Ellf'rl I t sv >M ❑ Multi family ❑ Master builder ❑Other: F r special ,fo,matian use checklist. .ter, IOU SITE INFORMATION AND: OC TIO j , = v Description Qty. Ea. Total Job site address: 1 Z.390 SW Ac,2 RI c17 p� • H� tiny/cooling se 1� Air conditioning 46.75 City/State/ZIP: 7-7,/m ©i 97ZZ4 Furnace 100,000 BTU(ducts/vents) 46.75 Suite/bldg./apt.no.: Project name: Cityi+ 5r,il Furnace 100,000+BTU(ducts/vents) 54.91 arj Heat pump 61.06 Cross street/directions to job site: CST0.7.4 qU 11 /_7 rN, Duct work 23.32 rileYS/i W �� ��A C/�/ Z, Hydropic hot water system 23.32 Residential boiler(radiator or hydronic) 23.32 Unit heaters(fuel-type,not electric). in-wail,in-duct,suspended,etc. 46.75 Subdivision: 7,/ ajCSIC>� Lot no.: LIS— Flue/vent ent for any of above 23.32 Other: 23.32 map/parcel noZ //6! _ O 7Q"C �; ether fuel applianoes: ; ', :.; ' ..Y_. isESCRfpTION OF WORK .a : . A = Water heater _.. 23.32 5 fe /r- L�crS,7/V�f LO�'r— CC//z./2,v.5114.Pr-- Gas fireplace/insert for water 33.39 // - t Flue vent for water heater or gas S(. ,4y /�.lai�! bGp/I'ZCilwL e#4_ fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Q 'RiPEFRT`1! 0mER „ - [ ."f.EN* ' '" Chimney/liner/flue/vent 23.32 Name: Other: 23.32 Environmental exhaust anti ventilation' Address: Range hood/other kitchen equipment 33.39 City/State/ZIP: Clothes dryer exhaust 33.39 Single-duct exhaust(bathrooms. Phone: ( ) Fax: ( ) toilet compartments,utility rooms) 23.32 © Al II, GAN' - E C P 1RSON ' C�_= ��� , .. ° �.• � " � ��' Attic/crawlspace fans 23.32 Business name: Other: 23.32 Fuel piping: Contact Warne: $14.15 for rlra.roar;$4.03 each ,diicronal Address: Furnace,etc. City/State/ZIP: Gas heat pump Wall/suspended/unit heater Phone: ( ) Fax:: ( ) Water heater E-mail: Fireplace '-.40';'''',,44,,;;.F;''' F cONTE2 TOR V. ,. .- . Barbecue cue Ra Barb Business name: 4 r2� C 7-74}e r"-.1"�� LL c Clothes dryer(gas) ,{ Other: Address: !7 2-24 S nlGV c esL- Ey 64_= i MCHmIlp t- Fitt!� iwE� �� City/State/Z1P: 7 ///���! 7 Z� ., Subtotal Phone: (S-cyy 7 fz a('7 Z_ Fax: ( ) 1...-1741,--' '-�/ Minimum permit fee($90.00) 3 Plan review(25%of permit fee) CCB lic.: Zc.,(- C7� ... �.�/ State surcharge(12%of permit fee) �� TOTAL PERMIT FEE Authorized signature? i --owooll7. `.Z//9/7 Thi<perm t,ppr_ t exGires rr a PNrmir,J,ot btainea ,it n 180 ys ttar ii has been ucceGtetl a- m le:a IaBoilding\Permits\MEC_e' 13 or /�" 440-4617T 01/IV/COM/WEB) Electrical Permit Application FOR OIF1( : SE o\l.v Cl ofTigard #:/1.57"c20/6 /jo2 ill RECEIVE ', •eceived r � Date/By: Permit 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review = Phone: 503.718.2439 Fax: 503.598.1960 N O V 1 tI 2 016 Date/By: Related Permit#: Inspection Line: 503.639.4175 e7 Ready Date/By: Juris: ® See Page 2 for 1 I GA R D Internet: www.ti and-or. ov Notified/Method: g g Supplemental Information I$;1:T'1/OF. 'UGA TYPE OF WO PLAN REVIEW allot!GT�» Please check all that apply(submit 2 sets ofplans w/items ❑New construction Af Addition/alteraC1t (_� pp y checked): 0 Service or feeder 400 amps or more 0 Building over three stories. El Demolition ❑Other; where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. IZI 1-and 2-familydwelling0Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural 0Commercial/industrialamps for all other installations. buildings. 0 Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 7 ❑Addition of new motor load of system. t'.3463 ,Jt A5-10 .4.).- i i if c' Pe IOOHP or more. ❑«A» «E» «1 2» «1 3» City/State/ZIP: / 0 Six or more residential units. occupancy. ty 77fx/.l,P Chir' 772 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:.5,9e/f—� yi ❑Hazardous locations. 0 Supply voltage for more than t � Q ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: GUMS, eye f ✓1( of v' a FEE SCHEDULE Description Qty. I Each I Total I *. �/2 1 l g/ LL- GL,-,------,— o.....1 11 S�re�,t:' V-4 C /,e-- New residential single-or multifamily 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 DESCRIPTION OF WORK Limited energy,residential 75.00 2 r (with above sq.ft.) -121.// 1./� `^`'r7 AI/-� 4`-���ni��Tx� �'`"'�//F Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation taC......A A-N5',,,,,eName: '"2_ti c!AYE / 200 amps or less 100.70 2 Address: 1 2 3,16 sl 6,...2. Q��.�EX1^ R.,(;Cz �_ 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: e � /�'l'Z4, ©dam— 17Z.Zei< 601 amps to 1,000 amps 301.04 2 Phone:./-03 .4 _ y8 z Z Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installati an is bein• made on property that I own which is not 200 amps or less 59.36 1 )intended for sale,lease I •x,hangeill . ,act ording to ORS 447,449,670,an701. 201 amps to 400 amps 125.08 2 Owner signature: Date:f'"/7/4 401 amps to 599 amps 168.54 2 0 APPLIC' 0 CONTACT `E ON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, jr each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit / 56.18 2 City/State/ZIP: Each add'-branch circuit rQ., 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 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: O 1.0 10 Ea— Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. 0 See Page 2 2 City/State/ZIP: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('h hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: 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. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description I Qty. I Each I Total I * Fee for all residential systems combined: $75.00 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* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 n 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr min) COMMERCIAL WORK'ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 per Subtotal(Enter on Page 1): 3r * Number of inspections allowed pepermit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 E 1 V 71 City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT JAN 4 Z01f Request for Permit Action ,p CITY r + TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 •.5, f1t t' :gb t 14,' TO: CITY OF TIGARD Building Division 13125 SW Hall Blvd.,Tigard,OR 97223 Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov FROM: ❑ Owner ❑ Applicant ❑ Contractor ❑ City Staff Check(i)one REFUND OR Name: INVOICE TO: (Business or Individual) /17' J Mailing Address: City/State/Zip: Phone No.: PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1): O CANCEL/VOID PERMIT APPLICATION. ❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below). 0 INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below). REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit). Permit#: F'1 -i- 46 ( (0-00S5 ?j Site Address or Parcel#: 1 3 q O 1..J A g KI bre c.. Subdivision Name: Lot#: EXPLANATION: ifCIA,evvy mi ee vTst4-crc ...1=Y ►-i OLe1".s---1.-l. To , ./c4.1'i' fes Signature: �A #` `� Date: 1/4/7 Print Name: - � Refund Policy 1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of: • Any fee which was erroneously paid or collected. • Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort has been expended. • Not more than 80%of the application or permit fee for issued permits prior to any inspection requests. 2. All refunds will be returned to the original payer in the form of a check via US postal service. 3. Please allow 3-4 weeks for processing refund requests. Route to Sys Admin: Date By Route to Records: Date By Refund Processed: Date By Invoice Processed: Date By Permit Canceled: Date By Parcel Tag Added: Date By I:\Building\Forms\RegPermitAction_092314.doc 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12340 SW ASPEN RIDGE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: FA I L Comments: Tel: 503.718.2439 Inspection Date: January 3, 2017 at 8:01:33 AM Record ID: MST2016-00553 Inspector: David Young Mechanical, electrical rough in covered prior to inspection. Licensed electrical contractor to be added to permit for work covered prior to inspection. Electrical work not done by owner listed on permit. Investigative fee applied for covering work prior to inspection, to be paid prior to final inspections. Final inspections to be rescheduled after corrections are complete. Violation Summary: Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12340 SW ASPEN RIDGE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 199 Electrical final Result: PASS Comments: Extension of existing branch circuits ok. Checked by new electrical contractor on permit. Violation Summary: Tel: 503.718.2439 Inspection Date: January 5, 2017 at 11:59:37 AM Record ID: MST2016-00553 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12340 SW ASPEN RIDGE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 699 Mechanical final Result: PASS Comments: Extension of existing duct work ok. Violation Summary: Tel: 503.718.2439 Inspection Date: January 5, 2017 at 11:56:47 AM Record ID: MST2016-00553 Inspector: David Young Inspector Contractor 13125 SW Hall Blvd. Tigard, OR 97223 City of Tigard Location: 12340 SW ASPEN RIDGE DR, TIGARD, OR, 97224 Record Type: Residential - Master Permit Inspection Type: 299 Final inspection Result: PASS- NoCofO Comments: Smoke detectors installed. Egress window ok. Violation Summary: Tel: 503.718.2439 Inspection Date: January 5, 2017 at 12:00:52 PM Record ID: MST2016-00553 Inspector: David Young Inspector Contractor