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Permit (14) CITY OF TIGARD ELECTRICAL PERMIT `f Permit#: ELC2017-00319 COMMUNITY DEVELOPMENT 'PI13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/03/2017 T f ' "�jt t� g Parcel: 2S109AB00600 Jurisdiction: Tigard Site address: 14031 SW ALPINE CREST WAY Project: OTIS Subdivision: None Lot: None Project Description: 16.2 KW photovoltaic system. Contractor: LIGHTING ELECTRIC LLC Owner: OTIS, BRIAN D&LORRAINE M PO BOX 890 14031 SW ALPINE CREST WAY WOODBURN, OR 97071 TIGARD, OR 97224 PHONE: 971-338-8989 PHONE: FAX: FEES Quantity Description Date Amount 1 ea 15.01 to 25 kva 05/03/2017 $200.34 Specifics: 1 ea 12%State Surcharge- 05/03/2017 $24.04 Electrical Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Total $224.38 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_u le are set forth in OAR 952-001-0010 through OAR 952-001-0090. in a cop rules or direct questions to OUNC by calling 503. 987 or .800.332.234 Issued By: -�, 7---- Permittee Signature: _,--__..,:---c____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 I OR OFF1(1. 1 5l.0\l.1 City of Tigard a M Permit#: __ _ 1 71 ■ 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review s. Phone: 503.718.2439 Fax: 503.598.1960 ""\ DateB : Related Permit#: Inspection Line: 503.639.4175 Ready Date/By: Juris:�7T0 See Page 2 for Q!.3 Notified/Method: / —L/ Supplemental www trgard or govS lemental Information $ 4 k� Ms.:.k .{ z'c 4 .:: .'•N. q'"1 L3,et `r4 SE00141 ^. .. ,,,. u >,- _*,„ Fz. , x. o ❑New construction ®Addition/alterationreplacep t..c G Please check all that apply(submit 2 sets of plans w/items checked): ❑Demolition ❑Other: �j,;' r I WOO l� ® 0 Service or feeder 400 amps or more 0 Building over three stories. v where the available fault current 0 Marinas and boatyards. k k 4^q '. m , C. .-2 !,g 9 Yw a 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 ❑Commercial-use agricultural amps for all other installations. buildings. ❑Multi family 0 Master builder ❑Other: 0 Fire pump. ❑Installation of 150 KVA or l- ry 1: ', r 3:i i . 0 Emergency system. larger separately derived 0 Addition of new motor load of system. Job#: Job site address:14031 SW ALPINE CREST WAY IOOHP or more. ❑"A","E","I-2","l-3", ❑Six or more residential units. oec ati n City/State/ZIP:TIGARD OR 97224 ❑Health-care facilities. ❑Recrereational vehicle parks. Suite/bldg./apt. J/a t.#: I Project name:OTIS RESIDENCE ❑Hazardous locations. 0 Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominaL Cross street/directions to job site: ii ' . V . , . Description Q5'. Each Total * New residential single-or multi-family dwelling unit. Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: _ Ea.add'1500ft.or portion 33.92 1 � � r V r� t ��`�� a - � sq. ,� # ,4 1 s ; . ,1 f�t ? t , _r# Limited energy,residential .�.- 75.00 2 ADD 16.2 KW ROOFTOP PV SYSTEM (with above sq.R) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) , _ t � _ xr Renewable Energy ❑ See Page 2 ,•X21 , - .. ' a - - Services or feeders installation,alteration,and/or relocation Name:BRIAN OTIS 200 amps or less 100.70 2 Address:14031 SW ALPINE CREST WAY 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:TIGARD OR 97224 601 amps to 1,000 amps 301.04 2 Phone:(503)504-2185 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 z k a - i a s se. 'i '_r 'Ili ti, to i`s r :,< -. , ,€ _± c y ,,.. 5 g , 1 BA.ranChf ClrPllt3—ikW, or extension,por panel � �- _ iFee for branch circuits withalteration, Business name:PREMIER ENERGY,INC above service or feeder fee, 742 2 each branch circuit Contact name:DAN TRACY B.Fee for branch circuits without service or feeder fee,fust 56.18 2 Address:556 SOMMERSET ROAD branch circuit City/State/ZIP:WOODLAND WA 98674 Each add'1 branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(503)828-9500 Fax::(503)410-7110 Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:dtracy@premiersolarnw.com Reconnect only 67.84 2 VN _MIt€' giM> 4 '.� ttv )� - 1- � a _ Pumpor irrigation circle 67.84 2 Business name:LIGHTING ELECTRIC,LLC Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ 5ee Page 2 2 Address:PO BOX 890 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP:WOODBURN OR 97071 Additional inspection(1 hr min) 66.25/hr Phone:(971)338-8989 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/lirCCB Lic.: 198682 Electrical 904 Suprv.Lic.: 6019S s' fical listed hr min Suprv.Electrician signature,required: Subtotal: 200.34 Print name: ANDREY LOB ASYUK `Date: 4-26-2017 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 24.04 Authorized signature: TOTAL PERMIT FEL: 224.38 This permit application expires if a permit is not obtained within 180 Print name: DANIELB TRACY Date: 4-26-2017 days after it has been accepted as complete. * Number of inspections allowed per permit. 1\BuildingtPermiitstELC_PemiitApp ELR_ERE.dnc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electtical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: 4.77,. . em , . .r _ WINIM Fee for all residential systems combined: $75.00 yRenewable electrical energy systems: 11111 Check Type of Work Involved: 5 kva less 100.70 _© 5.01 to 15 kva 1111 133.56 _© ❑ Audio and Stereo Systems* 15.01 to 25 kva © 20034 200.34 El Wind L eneration • ems in excess of 25 kva: ❑ Burglar Alarm 25.01 to 50 kva - 301.04 _© 50.01 to 100 kva 552.26 _© ❑ Garage Door Opener* >100in accordance 1111 552.26 —© withth OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 11111 7.42 _© ❑ Vacuum Systems* >100 kva-no additional charge - 0.0 _© Each additional ins w on over allowable in an of the above: O Other: Each additional inspection is ■ 66.25/hr 1111 c . •. at an hour 1 hr min Inspections for which no fee is ■ 90.00!hr —. € ,: � cal R t .(�i b � ctfi .. * ,_ f �� :.. Subtotal(Enter on Page 1): 20034 Fee for each commercial system: $75.00 * Number of inspections allowed per pemnt, (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC O Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* O Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling O Other: Total number of commercial systems: _• *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_Penn tApp_ELR_ERE.doc Rev 06117!2015