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Permit (85) 11111 ,, CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2017-00731 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/04/2017 Parcel: 2S104DC06600 Jurisdiction: Tigard Site address: 13814 SW FERNRIDGE TER Project: Miclau Subdivision: MORNINGSTAR Lot: 7 Project Description: (3)branch circuits for floor heating Contractor: OWNER Owner: MICLAU, ION&MARIA MICLAU, ION&MARIA 13814 SW FERNRIDGE TER 13814 SW FERNRIDGE TER TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 971-226-4615 PHONE: 971-226-4615 FAX: FEES Quantity Description Date Amount 3 crt Branch Circuits wo/Purchase 10/04/2017 $71.02 Specifics: Service or Feeder 1 ea 12%State Surcharge- 10/04/2017 $8.52 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $79.54 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 9 - --P00900. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. I Issued By: "" Permittee Signature: OWNER INSTALLATION ONLY The installation is being made on property wn wn which is not intended for sale,lease or rent. OWNER'S SIGNATURE C1/�( z�. ( GSL Date: /0// 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 ` r FOR orrlce tsl, o��l.1 City of Tigard Received e.,20/7_,,90 Date/B :4,/ if /7 4 Permit# � • 13125 SW Hall Blvd.,Tigard,OR 97223 0 C T 4 '1_017 Plan Revie 0 Phone: 503.718.2439 Fax: 503.598.1960III Date/B : Related Permit#: Inspection Line: 503.639.4175 4`i''L t i ,. e�. Ready Date/By: Jut-is: ® See Page 2 for 1WARD �� 1Z]J mr ' Supplemental Information Internet: www.tigard-or.gov ¢ � Notified/Method: Uli n B1 t 1 t ,� (�.fs TYPE OF WORK PLAN REVIEW 0 New construction ❑Addition/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. ❑Demolition ❑Other: where the available fault current ❑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 amps for all other installations. buildings. ❑Multi-family ❑Master builder 0 Other: ❑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: /3 #SA ,F-� 04-E ar/k�.• I00HP or more. / ❑ <A„ E„ `<l_2> 1.3> City/State/ZIP: /10 4 (pe, 97223 ❑Six or more residential units. occupancy. ❑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: ,d aE / 'J FEE SCHEDULE � Description Qty. I Each I Total I * 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 DESCRIPIION OF WORK Limited energy,residential 140,72N6' Ze2C9/) (with above sq.ft.) 75.00 2 r/ Limited energy,multi-family 75.00 2 residential(with above sq.ft.) j PROFER , OWNEREl TENANT Renewable Energy 0 See Page 2 !� '`- r Services or feeders installation,alteration,and/or relocation Name: /y/CtA(J /OA/ R.y(/,/, i7aj jQ.. 200 amps or less 100.70 2 Address:/j?e#Z.W, ' .4 - •vG'► I- 7�4,2 4 ' 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:7' tt ©'f_ 9 721.3 601 amps to 1,000 amps 301.04 2 Phone:(911) 22.6�y�6 Fax:( ) Over 1,000 amps or volts 552.26 2 p/O /6575 /( f/, j freoQ �`„ Temporary services or feeders installation,alteration,and/or Email:/� G,�/ ((�J ml/a/ , /j"/ relocation Owner installation:This installation is berg de on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease rent,ore changeef according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: (rte- el ct, Date: / -DY-/7- 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, 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 dwelling,service and/or feeder Email: 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: (J-l✓N Sign or outline lighting 67.84 2 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 Lie.: Electrical Lie.: Suprv.Lie.: specifically listed('/hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: 7/r dam Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): p, 5,2_ y Authorized signature: TOTAL PERMIT FEE: 'T,S ' Y 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_PermitApp_ELR_ERE.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: ENTIAL W 7111 ONLY �" Description " .z, QtY• I Each I FgE -,„.Total I Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 2 Check Type of Work Involved: 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 50.01 to 100 kva 552.26 2 ❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2 with OAR 918-309-0040) El 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: 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 CA hr min) E'CrRICAL FPERMLT.; ES m Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 = Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: El Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC El Instrumentation El Intercom and Paging Systems El Landscape Irrigation Control* El Medical El 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\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 13814 SW FERNRIDGE TER, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2017-00731 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor