Permit (34) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENTPermit#: ELC2017-00232
T ft. AR 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/03/2017
Parcel: 2S115AD00100
Jurisdiction: Tigard
Site address: 10512 SW TUALATIN DR
Project: HATTON Subdivision: WILLOW-BROOK-FARM Lot: 32
Project Description: (17)branch circuits for remodel.
Contractor: FLOYD HATTON Owner: HATTON, FLOYD W&BARBARA W
10512 SW TUALATIN DR 10512 SW TUALATIN DR
TIGARD, OR 97224 TIGARD, OR 97224
•
PHONE: 503-209-4128 PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 17 crt Branch Circuits wo/Purchase 04/03/2017 $174.90
Service or Feeder
1 ea 12%State Surcharge- 04/03/2017 $20.99
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $195.89
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. ATTENT Orego law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-001.through OAR 952-rr 1-0.!i. Yo ay obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or .80..33
Issued B ��/' Permittee Signature: K
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intend;. .r:=I- lease or rent.
4111
OWNER'S SIGNATURE Date: 3 l
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 ApplicatipE��'VE®
��--�,{{ C rolz orrice: I:sl:oNl.\
City of Tigard Received MAIM
111 1111 13125 SW Hall Blvd.,Tigard,OR 97223 Date/B : �,�'E,IC�:ifl Permit#: �► l-�p1{5I 72��3 2-
C Phone: 503.718.2439 Fax: 503.598.1*PR .3 2017 Plan Review
Date/B Related Permit#:
I I G A It[� Inspection Line: 503.639.4175 Ready Date/By: Ju is;
Internet: www.tigard-or.gov CITY OF TIGARD Supplemental See Page 2Inr
��±± �+ Notified/Method: Information
TYPE-&HAWING DIVISION PLAN"REVIEW
0 New construction 0 Addition/alteration/replacement Please check all that apply pp y(submit 2 sets of plans w/items checked):
0 Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
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
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other:
0 Fire pump. 0 Installation of 150 KVA or
I105/2
J/� � N Emergency❑ system. larger separately derived
Job#: JOB SITE INFORMATIONONAND LOCATION ❑Addition n of new motor load of system.
Job site address: V ^�+ `l
-�-�- I Gt N� l Yl L i 100HP or more. ❑"A" "E" <1-2""1-3»
City/State/ZIP: 1 1 R 0 r / r 0 Q 9 72.2- ❑Six or more residential units. occupancy.
J Cy l�
0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name: /./oz/ILII iPF'ji dem cd. 0 Hazardous locations. 0 Supply voltage a for more than
Cross street/directions to job site: 0 Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description 1Qty. 1 Each I Total 1 *
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 1
j J Limited energy,residential
R`el'►;C�i/zre�ULs/(x�G �RI�j��htj C=/P.i,/I'JC. 1 (with above sq.ft.) 75.00 2
4/ALe) Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
0 PROPERTY OWNER ` 0;TENANT Renewable Energy ❑ See Page 2
/o e' 200 amps
Services or feeders installation,alteration,and/or relocation
Name: 200 aor less
100.70 2
Address: / v I L s t j �j�04-../....)4,1 D 201 amps to 400 amps 133.56 2
City/State/ZIP: /! 401 amps to 600 amps 200.34 2
A, /O47 2--2, ii 601 amps to 1,000 amps 301.04 2
Phone:(SW) 9 -8 552.26� Fax:( ) Over 1,000 amps or volts
O2
Email: Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is be' g made on property that I own which is not 200 amps or less 59.36 1 1
intended for sale,lease,rent, • exch,i•- according to ORS 447,449,670,a21. 201 amps to 400 amps 125.08
Owner signature: .��r/,,Iff� Date: Y' 47 7 401 amps to 599 amps 168.54 22
0 A-NT APPLI ANI CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:
above service or feeder fee,
Contact name: each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first / 56.186./g 2
branch circuit
City/State/ZIP: Each add'l branch circuit ib 7.42 //7.7?, 2
Phone:( ) I Fax::( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR
Pump or irrigation circle 67.84 2
Business name: art')/J) I ice Sign or outline lighting 67.84 2
Address: /'v l_ Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Phone:( ) I Fax:( )
Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: I Electrical Lic.: I Suprv.Lic.: specifically listed(V5 hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal: /74, p
Print name: I Date: 0 Plan Review Required(25%of permit fee): —
�,, '� State surcharge(12%of permit fee): 40.99
Authorized signatures �i�f%/ TOTAL PERMIT FEE: / 7 5; 77
I Print name: �� `' I This permit application expires if a permit is not obtained within 180
�y� g h I Date: 4//.4.17/ I days after it has been accepted as complete.
* Number of inspections allowed per permit.
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
FEE SCHEDULE
RESIDENTIAL WORK ONLY: Description Qty. I Each I Total 1
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved: 5.01 to 15 kva 133.56 2
❑ 15.01 to 25 kva 200.34 2
Audio and Stereo Systems*
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 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
>100 kva-no additional charge 0.0 3
❑ Vacuum Systems* Each additional inspection over allowable in any of the above:
Each additional inspection is 66.25/hr 1
n Other: charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('h hr min)
ELECTRICAL:PERMIT FEES
COMMERCIAL WORK QNLY: -_ 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:
❑ 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*
O Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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