Permit (87) CITY OF TIGARD ELECTRICAL PERMIT
: . ..' COMMUNITY DEVELOPMENT Permit#: ELC2017 00539
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/20/2017
( � �' 9 Parcel: 2S102BC05100
Jurisdiction: Tigard
Site address: 10675 SW WATKINS PL
Project: Christensen Subdivision: WATKINS PLACE Lot: 8
Project Description: Change out house panel&add(1)branch circuit for a/c
Contractor: HORTON ELECTRIC Owner: HARMS, DAVE B&
11266 SE 21ST AVE SUITE 107 JOYCE A
MILWAUKIE, OR 97222 10675 SW WATKINS PL
TIGARD, OR 97223
PHONE: 503-267-2797 PHONE:
FAX: 503-659-8864
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 07/20/2017 $100.70
Specifics: amps or less
1 crt Branch Circuits w/Purchase 07/20/2017 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 07/20/2017 $12.97
Electrical
Type of Const:
Occupancy Grp:
Total $121.09
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 accordance 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. •TTENTION: Oregon - -qui -s you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 thro gh OAR 95 .a 1-0090. Y: may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
I--uedBy: A �Li � �i / % Permittee Signature: k 1(pi
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' c iiiii - Date: 7 mol/,
LICENSE NO. 4(4475
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 Applicatla , ) l (,l< O1 1 ( I I l (,\l.\
City of TigardReceDate/Bed 2 ,31.0 ii ' Permit#: e l?
III13125 SW Hall Blvd.,Tigard,OR 97 2 0 !f`i% Plan Review
I Phone: 503.718.2439 Fax: 503.598.19@) Date/B : Related Permit#:
Inspection Line: 503.639.4175 CITY O TIGARD ReadyDateBy: 7uris: VI See Page 2 for
1 1(''1'.1) Internet: www.ti and-or. ov CITY I 11 ! i t IPS Notified/Method: Supplemental g g pplementalInformation
TYPEM I&4G DIVISION PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit l sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
EI 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
ngs.
❑Multi-family 0 Master builder ❑Other: ampsireform all other installations. Inbustallati
0 Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
AddJob#: Job site address: 10675 S.W.Watkins Pl. ❑I0000HPHP o of new motor load of system.
or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard Or,97223 ❑Six or more residential units. occupancy.
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
Descriptioa I Qty. I 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
75.00 2
House panel change (with above sq.ft.)
Limited energy,multi-family
75.00 2
1 new circuit for ac unit residential(with above sq.ft.)
'n PROPERTY OWNER ( ❑ TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name:Loren Christensen 200 amps or less 1 100.70 100.70 2
Address: 10675 S.W.Watkins PL 201 amps to 400 amps 133,56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard Or,97223 •
601 amps to 1,000 amps 301.04 2
Phone:(503)257-8743 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
0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee, 1
7.42 7.42 2
each branch circuit
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 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular
67,84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Horton Electric Sign or outline lighting 67,84 2
Address: 11266 S.E.21st Ave.#107 Signalnl,aclteration,
or extension. 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Milwaukie Or,97222 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(503)659-8448 Fax:( ) Investigation(1 hr min) 90.00/hr
Email:gardnerdavidb@yahoo.com Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is90.00/
hr
CCB Lic.: 818 Electrical Lie.: 3-11c Suprv.Lic.: 4497s specifically listed(%2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 108.12
Print name: Jay Horton Date: 7/19/2017 0 Plan Review Required(25%of permit fee): 12.97
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: 121.09
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\Permits\ELC_Pe nitApp_ELRERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10675 SW WATKINS PL, TIGARD, OR, 97223 August 30, 2017 at 1 :20:10
PM
Record Type: Record ID:
Residential - Electrical ELC2017-00539
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Supplemental ground rods installed.
Violation Summary:
Inspector Contractor