Permit (46) CITY OF TIGARD ELECTRICAL PERMIT
. 2 . . COMMUNITY DEVELOPMENT
Permit#: ELC2017-00635
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2017
T "' R° Parcel: 2S110DA04200
Jurisdiction: Tigard
Site address: 10832 SW KABLE ST
Project: Nationstar Mortgage Subdivision: ERICKSON HEIGHTS Lot: 3
Project Description: Reconnect only.
Contractor: NATIONSTAR MORTGAGE LLC Owner: NATIONSTAR MORTGAGE LLC
ATTN: ANTINA L. HUBBARD PO BOX 293868
PO BOX 293868 LEWISVILLE,TX 75029
LEWISVILLE, TX 75029
PHONE: 813-387-1100 PHONE: 813-387-1100
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 09/19/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 09/19/2017 $8.14
Electrical
Type of Use: SF
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 OAR 952-001-0090. You may obtain a c les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. s / i
Issued By: {,^—�a�.�,. Permittee Signature:
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.
,, ,t.
Electrical Permit Application wviCVAN RecFOR OFFIC I+ ('SE ONI,Aeived/'
City of Tigard Date/By /7K1OL Permit it t �0 >-60 63
!pi .•
13125 SW Hall Blvd,, l�igatd.OR 97223 �\.WelifflIllMIII Related Permit 4
.. R Phone: 503 718 Fay.• 503,598.1960 } L
Inspection Line: 503,639,4175 A�1 Datei13y El See Page 2 for
"1' , y� i. Supplementalinformation
l`l1ertitLy ed.vizthodp
h leonet t,ttw lsgtud oi,gotl #
T:OE OF'W R y, I -.0.7,r, /( 11 '° a 7 1 >?'4 1C,'*,:. (��4
n W ��
❑Neta'colttiQuction 0 f�ddilion'ultc rttht>#t .a t "tPlease check all that apply(submit 2 sets of plans wrstems checked):
,�
r
B 1 r three stories
❑Demolition ilhc,r. � 'lel} r ❑whzre tha availabl�ttuulicurruntt f z ❑\!nr ntt��nd buvtyerds.
" , - = I�rT : ' t' . u,. - exceeds lU,OUII amps at 150 volts or ❑1Voattng buildu,gt,
' .. . � CATEGORY DoE auON • F�.1'ION � iii ', �•,.
� ate
less to ground,or exceeds 14.000 ❑t'on,mercial-use agricultural
I-and 2-family du clung 0 Commercial/industrial 0 Accessory building amps for all other rnsiallaurn buildings.
❑Multi-tinnily ❑Master builder ❑Other: 0 Fire p,uup
0 Instal lahon of tin Ikl 4 or
'' 0 timergency system. f lsargeryseparately derived
iQI3 [TINFURIIkTI(3N ANI [OGATIONh ollr ❑
,\dditton of ntw motor load ostem
ob tr; Job site address: 101 R. 5W gable Sitegef. loultP or more ❑„�. E',`"1 ' '"l_3„
uccu ane
� ❑bi.e err inure residential units. p y
Ctly State Ili). ` i o_r j / t Gil 274 ❑Health cart facilities ❑Rec eational vehicle parks
- ❑Ilar+rdous locations. 0 Supply voltage for more than
Suite;bldg.apt,ti• YroJeut name. s q 604)voltsnominal
'3t't z aWRh ❑Sentce nr feeder ti011 amps or more
Cross street%directions to Job site: i'J ro " Iliii t R_ d'Eib1 . iN '` =4J}i
Descupliun 1'OW. (� thuds i 1still I "
New residential single-or multi-Family dwelling unit.
Subdivision: l..ol#: Includes attached garage.
1,000 sq,ft,or less 168,54 4
Tax tuapiparcel c. Ea,add'l 500 sq,ft.or portion 33,92 1
73ESCRI'YID ;QF X kRK• ._ ' s' Limited energy°,residential 75.00 o
r (with above sq;ft.)
s c•ho-n rei(,(,fr //1 order" 412 s nre.-- Limited energy,multi-family 75.110 2
j#t residential(with above sq..ft.)
'.o�#e +• '� `�ir/G <'rt 11 n e Renewable r net v r 0 See Page 2
�ROPERTX iOWNLR ''t'.., 1, .i"yi; �;TENANT .Blit ': Services or feeders installation,alteration,and/or relocation
Name: Wia+litiStE r WI Li tea,
200 amps or less 100,70 2
201 amps to 400 amps 133,56 2
Address: 7 . 4 401 amps to 600 amps 20034 2
City/Slate•ZIY: j4iOISV I NC Te1 s $'0Zq' 601 amps to 1,000 amps 301.04 2
Phone:1 r3 ) 3s 7 - 5! o Fax:(3%o®) 554.-101M Crier 1,000 amiss or volts 552.26 2
r� Tempora y services or feeders installation,alteration,and/or
Email: 95Z VAR (4TJL.tTI ' a7 Hes' 36th . 6°PA relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 5936 t
's intended for sale,lease,rent,or exchange,according to ORS 447.449,670,and 701. 201 amps to 400 amps 125.08 2
Date: 401 amps to 599 amps 168,54
Owner stgttatuft. a c
2
E `. Br uich cu cults-new,alteration,of extension,firer panel
4i1 F fat tk!° _ ,',;',,,,c C ttfTACT ON m a�'1� I
,� Fzefoi branch
Business name: j� ' "tr ""#y,$tQG above service or feeder fee 7.42 2
f �
e wh br t
+n h w cun
Contact name: ri+ina L.. • 44t) �'el B.Fee forbrunehci uitsrr+lhau
service or feeder fee,first 56 l8
Address: branch circuit 2
Each add'l branch circuit 7,42 2
City Slate,ZIP:
�y Nfiseellaneous(service m•feeder not included)
Phone:(354 1 0 t lax: :(3(f ) S l q—r b 3 5 Each manufactured or modular 67.84 2
dwelline.se,vice and'or fender
Entail: ark4.4". 5°itt,hha.r-S p mes 3tap.GbAi Reconnect only 1 67.84 2
CONTRACTOR r Pump orirtigation eucle 67.84 2
]3usiness name: Sign or outline lighting 67.84 2
Signal cricuil(s)orlitnited�nergy
Address: panel.ahumtion,or extension, ❑ See Paget 2
Each additional inspection over allowable in may of the above
C1lV Slate'IIPr. Additional inspection(1hrmin) 6625/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90,00/br
Industrial plant(1 hr min) 78,18/1w
Email: Inspections for which no fee is
specifically listed I/ler min) 9tt 00''ht
CCI3 Lie.: Electrical Lie,: Su rv,Lic.: ' � • �-
P gt pis -k714g L' „-RMrr a? 8 . *SIV'-
Suprv,Electrician signahne.required; Subtotal: (c,7 rt7 /y
Print name: Date: 0 Plan Review Required(25%of permit fee):
Slate surcharge(12%of permit fee): f-,./7"
Ithorized signature: A.44 (, �,t_ti, _ TOTAL PLRilitl ILL; 7Jpt?e,
oil
• 'j ��/ "f1tiaNunbaroCto cher thasbeflucepte 38 notuhltdnrd)vilhini ?�8
ermitapplication ea L kC/i,7FP�
MA Immo: 11 19 L. t'S,61,(r ,i :. Date. cg.-Z ..- 1-1 da r after it has been accepted as couiplefe.
t<t e! L� ed perpermu
I,Buddwg,Eei auislt LC_Eenmrapp_ELtt_Intl?.doe Itev Oon%ROt5 -0a0.1615'r(t I/0S/COM/WEn
CITY OF TIGARD ELECTRICAL PERMIT
11111 111 COMMUNITY DEVELOPMENT Permit#: ELC2017-00635
RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2017
[ �} g Parcel: 2S110DA04200
Jurisdiction: Tigard
Site address: 10832 SW KABLE ST
Project: Nationstar Mortgage Subdivision: ERICKSON HEIGHTS Lot: 3
Project Description: Reconnect only.
Contractor: NATIONSTAR MORTGAGE LLC Owner: NATIONSTAR MORTGAGE LLC
ATTN: ANTINA L. HUBBARD PO BOX 293868
PO BOX 293868 LEWISVILLE, TX 75029
LEWISVILLE,TX 75029
PHONE: 813-387-1100 PHONE: 813-387-1100
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 09/19/2017 $67.84
Specifics:
1 ea 12%State Surcharge- 09/19/2017 $8.14
Electrical
Type of Use: SF
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 OAR 952-001-0090. You ma obtain a c'js. _les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. s
Issued By: -_ . -_` Permittee Signature:
/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 viCVo z o , c v.
ik J. Received - �jG ( �q
City of Tigard DateBv i7e4 /7 '�[�// Pernnta „.(W r17—V(.� �a
13125 S\V Hall Blvd.,Tigard.OR 97223 Plan Review t
I g' Phone: 503,718,2439 Fax: 503,598,1960 4 j !l)� Related Permit 6
p``( ¢d Date/By
Inspection line: 503,639,4175 P+VO c DateiBy /,t..../,^'� , 7 . VI See Page 2for
TIGARl7 lntetneL 3rww,tt•gatd-or,gov ,i Tit''k edlvlethod(r/L( / ,•r Supplewentallnfortnution
r /.,°'y r :TYX'E=OF WORK ^moi ' 1777 ° ®{4w W'It' ,
❑New eonstl fiction ❑Addititnt'alts,fattitni 1 t Please check all that apply(submit2 sets of plans whteins checked):
• ❑Service or feeder 400 amps or more ❑Building over three stories.
El1)enlolltlon lief" 0. a re where the available fault current ID Marinas and boatyards
', CATEGORY (jF.*C) `�` _ { 6}' .i . zxczeds 1 U,O110 amps at I SU r Olis or ❑1/tearing buiklmys,
V and 2-family dwelling ❑Commercial/industrial ❑Accessory building ess to ground,or exceeds 14.uU0 ❑Commercial-use agricultural
amps for all other installations buildings
❑Multi-leanly ❑Master builder ❑Other: ❑hire pump 0 humllation of 150 KVA or
JOB 'I't tfit0RMritTTO tND,LOCATIoiI AICHs ts'IRI, t 0 Emergency system larger separately derived
Job rr: I Job site address: II Ina*7 Cuieto ,{J` et ❑ \dditlun of rice motor toad of system
wv L le " t 10011P or more 0"A","E" -1.3"
�,..�� `, 124 ,
❑Six or more residential units Occupancy
City StatC ZIP: L l ar ig 4 1 2_ 4 /� _ ❑lleahh-care facilities ❑Recreational vehicle parks
Suiterbldg apt,f`: Project name. NB - Lit ❑Ilazardous locations. 0 Supply voltage for more t)un
'hj iJ ❑Set ice of feeder bW amps or store 600 volts norma it
Cross street'directions to job site: FE HE
''� D sclntla°n J Qty 1 tach ,j Total J -.
- New residential single-or multi-liunily dwelling unit.
Subdi vision: Lot 4: L eludes attached garage.
1,000 set,Ii,or less 168,54 4
Tax neap/parcel it:
Ea.add'l 500 sc,B:or portion 33,92
I
D c1i OF. *_....,,.. ;._ m. "- r - limited energy,residential 75,00 2
(with above sq.ft.)
..1 .:r' ..i .1A r ' • - in 'refer . , ". . 1.., • Limited energy,tnulti-fttnily .
.r I ri I j COk n 1_ resiclenttal(with above sc 7�00
I G•'1 2
" ' Renewable Energy 0 See Page 2
f pp'RTY 41ri'NER, I i a ;tT RM*i`,�)t ail a services or feeders installation,alteration,and/or relocation
Name:
WSJ())5T + Q ' - 200 amps or less 1(10,70 2
201 amps to 400 amps 133,56 2
Address: 7.0 . 302(
z R a$�a
p 1f y r 401 amps to 600 amps 200,34 2
City/State-ZIP: 14. is v I Q� j Te s -75.02..9.
( S0 Z 601 amps to 1,000 amps 301,04 2
Phone:It3 ) 5g7 - 110 Fax:(3{V 514•-10g1 Over 1,000 amps or volts 552.26 2
Temporary services m feeders installation,alteratlon,and/or
Email: $6Z VPR (..,Tit,IT/CS' Q/ MCS 3(00 . t!r a relocation
owner installation:This installation is being trade 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, 2111 amps to 400 amps 125:08 2,
Unt r siguatutc: Date: 401 amps to 599 amps 168,54 2
'�4� tt ° y F u Branch circuits-new,alteration,orextension'_Lter panel
- `" A.Fee fret brmch cnwits vide
Business name: I llirms4' r p.4 0—t-A 4 n 4 L I,G above branch c or leecler fee, 7.42 2
l 'I j} t — cacti bi inch circuit
Contact name: 1,...114-i in a L • I tots-, 1�-J -B.Feefoibranchcircuitswithout
service or feeder fee,hist 56.18
Address: branch circuit
Citi'/Slate'ZIP:
Each add'l branch circuit 7,42 2
�/� Miseellaneuus(service m feeder not included)
Plione:(3,4 t „•.(O/ lax: :(3 re ) ctT-_tvet. Each manufactured or modular t 67.84 2L
Emai I' - 360
dwellinm„.service anct/or feeder
(;j yy of y�.� + Yf C S 3 tea.CbF1 Reconnect.only I 67.84 2
Rift k �ub>�� va, .
CONTRACTOR . .t Pump or irrigation circle 67,84 2
13tisiness name: Sign or outline lighting 67.84 2
Signal circuil(s)at limited-energy
Address: panel,ahmation,or extension, ❑ See Yage 2 2
Each additional inspection over allowable in any of the above
CIlyState'ZIP;
Additional inspection(1 hr min) 66,25/hr
Phone:( ) Fax:( ) Investigation(1lu'min) 90,00/hr
Industtial plant(1 hr thin) 78;18/hr
Email.
Inspections for which no fee is
specifically listed 0/thr min) 90.00 hr
CCB Lie„ Electrical Lie,: Suprv,Lie.: � � ,
ELICTRtCAAL FERTT FEES '19i,Ikm1 'ii
Suprv,Electrician signature,required: Subtotal: 07,/.
Print name: Date: ❑Plan Review Required(25%of permit fee):
- State surcharge(12%of permit fee): t,i
'I'O 1'AL PFRMI l IEE: 5 ?F
tthoi'ized signature: r''� t
this permit upptlleation expires iris penult is not obtained within lila
tint name: `.14
L * .. . Date: �.Z.<... 1'i days after it has been accepted as complete. LL N[7
!!l���x 5 11 1111 r Number of inspections allowed per permit Pty,t
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