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Permit (19) CITY OF TIGARD t ELECTRICAL PERMIT i • ' COMMUNITY DEVELOPMENT Wa Permit*: ELC2017-00101 TIC.AR:D13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017 Parcel: 1 S 134CB01800 Jurisdiction: Tigard Site address: 12130 SW SUMMER ST Project: LAMB Subdivision: SUMMER HILLS PARK Lot: 21 Project Description: Panel replacement.3/2/17,REPRINTED to correct scope of work from panel replacement to(4)branch circuits. Contractor: OWNER Owner: LAMB, PIERCE PIERCE LAMB 12130 SW SUMMER ST TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503-351-9886 PHONE: 503-351-9886 FAX: FEES Quantity Description Date Amount Specifics: 4 crt Branch Circuits wo/Purchase 02/16/2017 $78.44 Service or Feeder 1 ea 12%State Surcharge- 02/16/2017 $9.41 Type of Use: SF Electrical Class of Work: ALT 45 Misc Administration Fee 03/02/2017 $45.00 Type of Const: Occupancy Grp: Total $132.85 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. AT TION: Ore.:. law re.uires you to follow the rules adopted by the Oregon Uti'. -' ca'.• Center. Those rules are set forth in OAR 952-001 0010 through OAR 95 /0 '09.. You may obtain a copy of the rules or direct questions to O 'C by .- ' a 51'.232.1987 or 1.800.332.2344. Issue By: 0 i�� Permittee •ignature: pit - ( 14- --- 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 Applicatio �f 4 ` - w i'.`1 lz OI 1.o 1 R. i. t s►:()NENfir . City of Tigard Received i i°t 2 Date/B : -�irem Permit#: � /7—Gb/!3/ 13125 SW Hall Blvd.,Tigard,OR 97223 ` i2015 Plan Review IIIII Date/B C Phone: 503.718.2439 Fax: 503.5984196Q 1960 Related Permit#: Inspection Line: 503.639.4175 ReadyDate/By: gi See Page 2 for I I G A R p 3 Juris: Internet: www.tigard-or.gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW 0 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 El 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. ❑ 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural 0 amps for all other installations. buildings. Multi-family 0 Master builder ❑Other: ❑Fireum . P P 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: 2-1 ❑Addition of new motor load of system. Su.fit✓ S I-- 10011P or more. ❑"A","E","1-2","1-3", C1ty/State/ZIP: Ti m� Q (� ZZ El Six or more residential units. occupancy. _/ 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description - IQtyI ,Each I.. Total 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'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential !� ,g5 L•o,L /6 (1 . �l (with above sq.ft.) 75.00 2 �-`�'�-+E� O N�� J �''r`�`- Limited energy,multi-family (q) fQt,I U C , , n, , -• f}-�� residential(with above sq.ft.) 75.00 2 RI PROPERTY OWNER 0 � IJNfTc.�-LxiJ Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: K i(u ''�/�`a P �©✓t(/` 200 amps or less 100.70 2 Address: 121')jC2 5�) s C 17.- 401 (_ 201 amps to 400 amps 133.56 2 v 1 401 amps to 600 amps 200.34 2 City/State/ZIP: Tt c r"u 1 i ql ZZ S 601 amps to 1,000 amps 301.04 2 Phone:(51'( ) 8 c j U — Fax: Over 1,000 amps or volts 3�- ( ) 552.26 2 Email: Temporary services or feeders installation,alteration,and/or I U vt tea- vkrAe_�✓O✓Ll1g_.) G)moo- (-014.k relocation Owner tllstallation:This installation is being rhaileon 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, d 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 0 APPLICANT' I 0 CONTACT PERSON Branch circuits-c new,alteration,or extension, .er panel A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first / 56.18 2 branch circuit City/State/ZIP: Each add'l branch circuit r. 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax::( ) Each manufactured or modular dwellin 67.84 2 Email: g,service and/or feeder Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: D w A /✓I 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 CCB Lic.: Electrical Lic.: specifically listed(V2 hr min) 90.00/hr Suprv.Lic.: Pe Y Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES 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\Petmits\ELC_PetmitApp_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: FEE SCHEDULE RESIDENTIAL WORK ONLY: Description I Qty. I Each I Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 133.56 2 5.01 to 15 kva F7 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 El 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: ❑ Other: Each additional inspection is 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/a hr min) * *;` ELECTRICAL PERMIT FEES COMMERCIAL WORK ONLY: . Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: El Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems El Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation El Intercom and Paging Systems n Landscape Irrigation Control* El Medical El Nurse Calls n Outdoor Landscape Lighting* El Protective Signaling El Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 CITY OF TIGARD ELECTRICAL PERMIT w 8 COMMUNITY DEVELOPMENT Permit#: ELC2017-00101 T I GA RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/16/2017 Parcel: 1S134CB01800 Jurisdiction: Tigard Site address: 12130 SW SUMMER ST Project: LAMB Subdivision: SUMMER HILLS PARK Lot: 21 Project Description: Panel replacement. Contractor: OWNER Owner: LAMB, PIERCE PIERCE LAMB 12130 SW SUMMER ST TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503-351-9886 PHONE: 503-351-9886 FAX: ' FEES Quantity Description Date Amount 1 ea Services or Feeders-200 02/16/2017 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 02/16/2017 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 .,ther 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 issuan , or if 'ork is suspended or more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification enter. Those rules are -et forth in OAR 952-001-0010 through OAR 952-001-0090. You in a e rules or direct questions to OUNC by calling 503.23 .1987 or .800.3 2.2344. Issued By: /- ,,-1 2 L.. 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. El•ctrical Permit Application ' City of Tigard V E ,,. Received l /� ?'- iC !G Date/By: Permit#: • ' g ~ 13125 SW Hall Blvd.,Tigard,OR 97 It Plan Review Phone: 501718.2439 Fax: 503.598. 960 By. Related Permit#: Inspection Line: 503.639.4175 1, G Z�\"' Read DatGg Juris: ® See Page 2 for TIG;IRD p y Y Internet: www.tigard-or.gov ��© , - ' Notified/Method: j Sup,lementalInformation TYPE OF WOaTV O'f. 11°tic ��1 isE�r� PLAN REVIEW ❑New construction El Addition/alterffeitketVitkWint# Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: 0 Service or feeder 400 ❑ CATEGORY OF CONSTRUCTION amps or more Building over three ,®1-and 2-family dwelling ❑Commercial/industrial ❑Accesso building where the 10,00000able fault 150volts current stories. �' g exceeds amps at volts 0 Marinas ❑Multi-family ❑Master builder ❑Other: °r and boatyards. less to ground,or exceeds 14,000 JOB SITE INFORMATION AND LOCATION amps for all other installations. ❑ Floating i buildings. Job#: Job site address: )2)30- S W 5✓ ►ef s.- ❑ Fire pump. ❑ City/State/ZIP: "r7/nb,1rtL C /Z 172?? 0 Emergency system. Commercial-use J ❑ Addition of new motor agricultural Suite/bldg./apt.#: Project name: load of b,,;ldings- Cross street/directions to job site: 1'l -1 y t 7 l,• t m- IOot1P or more. ❑ S t �' ❑ Six or more residential KVA or Installation of 150 units. larger separately derived Subdivision: r Lot#: I=1Health rare facilities. system. Tax map/parcel#: 1-,5`1- Ci j 01<e-00 ❑ Hazardous locations. ❑ "A", ❑ E","1-2","1-3^,occupancy. DESCRIPTION OF WORK Service or feeder 600 ❑ ff{^ A p l amps or more. ej,S mill i l .'Z.1 LJ:I'/-t(,y Ai vital 4 l / I i(J tel% .f /v'1 Recreational vehicle ,J ` �/ parks. "0. e- ❑ Supply n PROPERTY OWNER I n TENANT voltage for more than i l 600 volts nominal. Name: Lo, FEE SCHEDULE Address: 12,1 3 0 c L/ 5v i C4- Description I Qtr- I EI Total 1 New residential single-or multi-family dwelling unit. City/State/ZIP: r 0`1`y 0k. 4 7 7 7 7 Includes attached garage. Phone:(535) 35/ (,l c 6' % Fax:( ) 1,000 sq.ft.or less 168.54 4 ` 0 Ea.add'1500 sq,ft.or portion 33.92 1 Email: Limited energy,residential 75.00 2 Owner installation:This installation is being made on property that I own which is not (with above sq.ft.) Limited enermulti-family intended for sale,l e,rent,or exchange,according to ORS 447,449,670,and 701. 75.00 2gy, ,/� ` residential(with above sq.ft.) Owner signature: ^r.�. Date:©v/ // 7 Renewable Energy ❑ See Page ® APPLICANT 0 CONTACT PERSON` 2 Services or feeders installation,alteration,and/or relocation Business name:^� 200 amps or less /1 100.70 2 Contact name: tt/ ` j,,,6 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Address: I'. 30 c(4/ .5(,,,,,,,i,„ _t- 601 amps to 1,000 amps 301.04 2 City/State/ZIP: 7---i.).‘,,,/,�� 0/2 t 7?Z 3 Over 1,000 amps or volts 552.26 2 Phone:( � ) 3 -GL. Fax::( ) Temporary services or feeders installation,alteration, and/or relocation Email:P i -rl trey y lc",hi (Akt c*( - avo 200 amps or less 59.36 1 CONTRACTOR 201 amps to 400 amps 125.08 2 401 amps to 599 amps 168.54 2 Business name: Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Address: above service or feeder fee, each branch circuit 7'42 2 City/State/ZIP: B.Fee for branch circuits Phone: without service or feeder fee, ( ) Fax:( ) fust branch circuit 56.18 2 Email: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) CCB Lie.: Electrical Lie.: Suprv.Lic.: Each manufactured or modular 67.84 2 dwelling,service and/or feeder Suprv.Electrician signature,required: Reconnect only 67.84 2 Print name: Date: Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 Signal circuit(s)or limited- Authorized signature: 12-:::—..._.>- i f energy panel,alteration,or 0 See Page 2 extension. 2 Print name: P i t s"c.t.-. (,Gtal/1/a Date: '� )// �l/07117 Each additional inspection over allowable in any of the above I:\Builtling1PennitslELCPennitApp_ELRERE_doe Rev 06/17/2015 440-4615T(11/05/COM/WEB iii-- 7 Additional inspection(1 hr min) 66.25/hr A Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is kir specifically listed(%z hr min) 90'00/ ELECTRICAL PERMIT FEES �--ry Subtotal: /00 ,7 1 1 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): (A, TOTAL PERMIT FEE: //ill t 7; This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. * Number of inspections allowed per permit. • I:1Bui4ling\PermiteTLC_PermitApp ELR_ERE.doc Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 12130 SW SUMMER ST, TIGARD, OR, 97223 April 21 , 2017 at 12:33:16 PM Record Type: Record ID: Residential - Electrical ELC2017-00101 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor