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Permit (149) 111.:1 CITY OF TIGARDENT Permit#:ELECTRICALELC2017-001PE43RMIT COMMUNITY DEVELOPM TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2017 Parcel: 2S109AA02700 Jurisdiction: Tigard Site address: 12905 SW WILMINGTON LN Project: Wilmington Heights Subdivision: WILMINGTON HEIGHTS Lot: 1 Project Description: Reconnect only. Contractor: OWNER Owner: TEA,JOHN K&ELIZABETH C 12905 SW WILMINGTON LN TIGARD, OR 97223 PHONE: PHONE: FAX: FEES Quantity Description Date Amount Specifics: 1 ea Reconnect Only 03/02/2017 $67.84 1 ea 12%State Surcharge- 03/02/2017 $8.14 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $75.98 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 9 -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. Issued By: _ � Permittee Signature: /�L/ / g tures � '� �'� %�O iii' 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 t _ FoR°Hi( 1. lSE011.1 City of Tigard =- Received)42 /7 .. Permit ! 0 13125 SW Hall Blvd.,Tigard,OR PlateB : sd 1 L{„�n�/7 r���y� 71 q''' Plan Review Phone: 503.718.2439 Fax. 503.5 8.1960 ��E 'i�` DateB : Related Permit#: Inspection Line: 503.639.4175 t T t G A R D Ready Date/By: Juris: H See Internet: Line:gard-or..4175 Page l nr ., c` Notified/Method: Supplemental Information )8'UIt. *© , fit^ ', R li,Y' ❑New construction r 0 Addition/alterati r1'r �'r1iiiit' Please check all that �1� , apply(submit 2 sets of plans w/items checked): ❑Demolition 0 •they RECOIV�'r Service or feeder 400 amps or more ❑Building over three stories. ❑where the available fault current 0 Marinas and boatyards. I :Y OE CONIt1RhTGT ON.^ ''`'1-and 2-family ',' exceeds 10,000 amps at 150 volts or P ❑Floating buildings.dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ilk'Multi-family ❑Master builder amps for all other installations. buildings. Other' 0 Fire pump. ❑Installation of 150 KVA or JOI sE kN XIAIAT N ANO LOCATION . 0 Emergency system. larger separately derived Job#: I Job site address: ,,a�Q ' ❑=':,,c:::motor load of system. '� 1 ��f 1 1 Ll ❑"A","E","l-2","1-3", City/State/ZIP: 1 �_.,1 OR q--/a�• � ❑Six or more residential units. occupancy. ill �-/ 1 G71 0 Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: J Project name: I ❑Hazardous locations. 0 Supply voltage for more than Cross street/directions to job site: 0 Service or feeder 600 amps or more. 600 volts nominal. Description l Qt9 I- Each ") Total I x i , New residential single-or multi-family dwelling unit. Subdivision: t-1 , 7 I Lot#: Includes attached garage. Tax map/parcel#: A •� 1,000 sq.ft.or less 168.54 4 Ea.add'1500 sq.ft.or portion 33.92 1 DESCRIPTIONFWO Limited energy, POWER HAS BEEN OFF MORE THAN 6 MONTHS (with above sq'ft) residential 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 CI,'l' FR *Y;-OWNER-': Renewable Energy ❑ See Page 2 Name: �s-}., ` � N Services or feeders installation,alteration,and/or relocation � � ��1 j e 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 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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,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 Arilicia4T, comikernitsol, Branch circuits—new,alteration,or extension,per panel Business name:ROSE COUNTRY REALRY A.Fee for branch circuits with above service or feeder fee, Contact name:ANNIE WRUCKE each branch circuit 7.42 2 B.Fee for branch circuits without Address:2050 BEAVERCREEK RD#101 service or feeder fee,first branch circuit 56.18 2 City/State/ZIP:OREGON CITY OR 97045 Each add'I branch circuit 7.42 2 Phone:(971)570-2216 I Fax::(503)200-1298 Miscellaneous(service or feeder not included) Each manufactured or modular Email:ASSISTANT@OREGONREO.COM dwelling,service and/or feeder 67.84 2 Reconnect only 1 67.84 67,84 2 CONTRACTOR , Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Address: Signal circuit(s)or limited-energy panel,alteration,or extension. ❑ 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:( ) I Fax:( ) Investigation(1 hr min) 9000/hr. Email: Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is CCB Lic.: 1 Electrical Lic.: i Suprv.Lic.: specifically listed(Y2 hr min) 90.00/hr Suprv.Electrician signature,required: # PERA1(tT`I ES ' Subtotal: 67.84 Print name: I Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 8.14 Authori,-d SI l ature: $ TOTAL PERMIT FEE: 75.98 Print n.t e: t"C_ This permit application expires if aa permit is not obtained within 180 I Date: jig/"`-���"� � �', days after it has been accepted as complete, * Number of inspections allowed per permit. IABuildingTermits\ELC_Pern itApp_ELR ERE.doc Rev 06/17/2015 440-4 15T(i1/ /CO