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Permit CITY OF TIGARD ELECTRICAL PERMIT , '> COMMUNITY DEVELOPMENT 114 Permit#: ELC2017-00414 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2017 T f �"+ Parcel: 2S102CD00300 Jurisdiction: Tigard Site address: 9620 SW FREWING ST Project: Lewis Subdivision: FREWING'S ORCHARD TRACTS Lot: 25 Project Description: Replace electrical panel and alter(24)branch circuits. Contractor: OWNER Owner: LEWIS, PAMELA PAMELA LEWIS 9620 SW FREWING ST 9620 SW FREWING ST TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 541-990-7355 PHONE: 541-990-7355 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 06/06/2017 $100.70 Specifics:, amps or less 24 crt Branch Circuits w/Purchase 06/06/2017 $178.08 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 06/06/2017 $33.45 Electrical Type of Const: Occupancy Grp: Total $312.23 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 oth applicable law. All work will be done in with approved plans. This permit will expire if work is not started within 180 days of issuance, or if -• is uspended for more the 180 days. ENTION: Ore on law requires you to follow the rules adopted by the Oregon Utility Notification Center. hose r are set forth in OAR 952 01-0010 through OAR -0 1- 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987• 1.800,3 1/ sued By: 4 f /Permittee Signature: J� OWNER INSTALLATION ONLY The installation is being made on propert I own which is not intended for sale,lease or rent. ///j OWNER'S SIGNATURE ,%_,:i•� , ! !�� Date: 6 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 roiz 0141( i. I sl: 011.1 Cityo Tigard HECEIVED Received / Permit r g Date/B : 6 a 17 O E i �l -Ot70 Ili13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review /' _ Phone: 503.718.2439 Fax: 503.598.1 N 6 7 Date/B : Related Permit#: 1..�5j f-'�/jl(a/a) Inspection Line: 503.639.4175 O ( ReadyDate/By: Juris: TIGnRp p ® SeePage2for Internet: www.tigard-or.govI��OF rr47t'1 jJ G/�RD Notified/Method: Supplemental Information � TYPE 3,�uING DIVISION PLAN REVIEW O New construction ddition/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. 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural O ulti-family ❑Master builder 0 Other: ampFire forall other installations. buildings. 0Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived �j f } 0 Addition of new motor load of system. Job#: Job site address: 7 0249 5vFr'u 1 5t 100HP or more. ❑.,A„ .<E„ ..1.2„ ..1.3„ ❑Six or more residential units. occupancy. City/State/ZIP: "� J 0 ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 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 New residential single-or multi-family 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 ,, I _ j, I (with above sq.ft.) 75.00 2 � Dt-d-Q- 7�'��`� �` �ay �1�I e....4 �1 1,1..4, Limited energy,multi-family residential(with above sq.ft.) 75.00 2 ROPERTY OWNER ❑ TENANT` Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name: r/, W1.d' ( V'./LS 200 amps or less / 100.70 /a),70 2 Address: 9!_7 ' ''t, 1 P �'6- Si ! 201 amps to 400 amps 133.56 2 ll/L f/ W 401 amps to 600 amps 200.34 2 City/State/ZIP: p6..„,t 0{,,,, . 601 amps to 1,000 amps 301.04 2 Phone:(5-`//) /90 — -1 5 cc- Fax:( ) Over 1,000 amps or volts 552.26 2 / L Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is bein• made on property that I own which is not 200 amps or less 59.36 1 intended for sale,leas ma t,or exc mange,al ording 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 I Branch circuits-new,alteration,or extension,per panel ❑ APPLICANT ONTACT PERSON A.Fee for branch circuits with Business name: above service or feeder fee, ,,�� each branch circuit 7'42 7g;Of 2 Contact name: iitl e-0/ 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 7.42 2 � ) Miscellaneous(service or feeder not included) Phone:( 3 (e� ' -6.© g 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: 660/0) Sign or outline lighting 67.84 2 /l✓ 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(%z hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 7f, 7 g Print name: Date: 0 Plan Review Required(25%of permit fee): --- State surcharge(12%of permit fee): 3 3•f 5 TOTAL PERMIT FEE: Authorized si j/,:ture: 3/ a is /���///JJJ This permit application expires if a permit is not obtained within 180 Print name: / ,��// i/, • Date: 6, , j ' ` / days after it has been accepted as complete. /f✓vlr•( ( * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_E c_ RE.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 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.O1to15kva 133.56 2 n 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 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: h �IlL Each additional inspection is 66.25/hr 1 ❑ t/ charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(Yz hr min) COMMEiIAL WORK ONLY: ELECTRICAL'PERMIT TEES Subtotal Enteron Page 1): Fee for each commercial system: $75.00 3r * 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 n Nurse Calls ❑ 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\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015