Permit (76) CITY OF TIGARD ELECTRICAL PERMIT
2.. COMMUNITY DEVELOPMENT Permit#: ELC2017-00702
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/26/2017
TIGARD Parcel: 2S114AD03200
Jurisdiction: Tigard
Site address: 8910 SW WAVERLY DR
Project: RODGERS Subdivision: WAVERLY ESTATES Lot: 31
Project Description: (6)branch circuits for kitchen remodel.
Contractor: AFFINITY ELECTRIC LLC Owner: RODGERS,ANDREW R&STACEY M
24506 NE 72ND AVE 8910 SW WAVERLY DR
BATTLE GROUND,WA 98604 TIGARD, OR 97224
PHONE: 971-400-5354 PHONE:
FAX:
FEES
Quantity Description Date Amount
6 crt Branch Circuits wo/Purchase 09/26/2017 $93.28
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/26/2017 $11.19
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $104.47
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 Notificatiolenter. Those rules are set forth in OAR
1
952-001-0010 through OA 52-001-0090. Y may obtain a y of the r s or direct questions to OUNC by calling 503. 987 or 1.800.332.2344.
Issued By: .e,d; .f-tib'` 6e; 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.
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Electrical Permit Application rtriiii 1, 11 ro►z of i K is t el.O"l.l
Received f� /�, permit#: �' A'
City of Tigard Date/B f '�� ��
F 13125 SW Hall Blvd.,Tigard,OR 97223 r/�' Plan Review
. Related Permit# - `� 3 t
Phone: 503.718.2439 Fax: 503.598.1960 Date/B : L/
Inspection Line: 503.639.4175 C try s eady Date/By: Awls: ❑ See Page 2 for
1 I G A R D Internet: www.tigard-or.gov y Iii �q - " DIVISION y ��I1'I'? otified/Method: Supplemental Information
/TYPE OF WO1�NlLUING 1/I V i.7 1� PLAN REVIEW
0 New construction }6CJAddition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
0 Demolition 0 Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
DI
less to ground,or exceeds 14,000 0 Commercial-use agricultural
-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION`AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 39(0 / t.,./„,,,..i.,-/y 100HP or more. ❑"A","E","1-2","1-3",
p ❑Six or more residential units. occupancy.
City/State/ZIP: �C'.f ❑Recreational vehicle parks.
ty ❑Health-care facilities.
0 Hazardous locations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name:
0 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 I *
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 75.00 2
/, t '` / (with above sq.ft.)
]� e..4.--4.-4-"-- r,C�f-l..-Ocie_t e 4((_ t `"�T'"G.'--t!
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
p E TIAL\V i t*: ? M E c$i auvi:ir
Fee for all residential systems combined: $75.00 Description I Qty. I Each Total I *
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ 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
El Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance
with OAR 918-309-0040) 55226 2
❑ 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:
El Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('A hr mm)
.C9MMElICIA1.4 WORK'O 0,41Are: >E c at arr E
Fee for each commercial system: $75.00 subtotal(Enteron rage 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
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*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELCPermitApp_ELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8910 SW WAVERLY DR, TIGARD, OR, 97224 November 22, 2017 at
1 :53:06 PM
Record Type: Record ID:
Residential - Electrical ELC2017-00702
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
No access for inspection, no one home. 1 :51 pm.
Left message prior to arriving per inspection request.
Provide access for inspection. R109.1
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8910 SW WAVERLY DR, TIGARD, OR, 97224 November 22, 2017 at
1 :53:06 PM
Record Type: Record ID:
Residential - Electrical ELC2017-00702
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
No access for inspection, no one home. 1 :51 pm.
Left message prior to arriving per inspection request.
Provide access for inspection. R109.1
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8910 SW WAVERLY DR, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2017-00702
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor