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Permit Support Document (27) CITY OF TIGARDELECTRICAL PERMIT r COMMUNITY DEVELOPMENT ��; Permit#: ELC2016-00682 F13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 w4 3 Date Issued: 09/08/2016 TIGARD Parcel: 2S104DD07700 Jurisdiction: Tigard Site address: 12874 SW MORNINGSTAR DR Project: Dowers Residence Subdivision: MOUNTAIN HIGHLANDS NO.3 Lot: 35 Project Description: Repair to electrical meter-base enclosure and breaker panel due to damage sustained by vehicle collision with the dwelling. 10/18/17:REPRINT permit to include(4)panels and(70)circuits for remodel work in addition to vehicle damage repairs. Contractor: CRAFT ELECTRIC INC Owner: DOWERS, KEITH A 37333 NE REED RD 12874 SW MORNINGSTAR DR CORBETT, OR 97019 TIGARD, OR 97224 PHONE: 503-730-9484 PHONE: FAX: FEES Quantity Description Date Amount 3 ea Services or Feeders-200 10/19/2017 $302.10 Specifics: amps or less 1 ea Services or Feeders-201 to 10/19/2017 $133.56 Type of Use: SF 400 amps Class of Work: ALT 70 crt Branch Circuits w/Purchase 10/19/2017 $519.40 Service or Feeder Type of Const: 1 ea 12%State Surcharge- 10/19/2017 $114.61 Occupancy Grp: Electrical Total $1,069.67 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 OAF;-95 .^ .0x90.. ou may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987, or 1.800.332.2344. Issued B 2 fie_ Permittee Signature: L/ ,9 0 /'�G/�17 Y 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 FOR OFFICE I,SE 011.1 City of Tigard w Received / J/ /� �/ Date/B v t(i (,6//7 /7)'" Permit#: e4('01�p--titt G ;� � 13125 SW Hall Blvd.,Tigard,OR 9722 P Plan Review _�z 3 C Phone: 503.718.2439 Fax: 503.598.1 0 q a Z��1 Date/By: Related Permit#: Inspection Line: 503.639.4175 OC1 1 t7 Ready Date/By: Juris: ® See Page 2 for T I G AIL 11 Internet: www.tigard-or.gov `tiG Bt Notfied/Method: Supplemental Information i i - TYPE OF WO' I 'j �7 1 0. -, PLAN REVIEW ❑New construction IT 'ddition/alterati,i, .1,111'-ill < Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition Other: El Service or feeder 400 amps or more El Building over three stories. 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 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural amps for all other installations. buildings. 0 Multi-family 0 Master builder 0 Other: El Fire pump. El Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: a y(0 _ 7. I Job site address: 10 g S t") Yl ' ❑Addition of new motor load of system. 1 Y til1'1r.M. • 100HP or more. ❑«A„ .<E„ «1.2„ 1.3„ - r \ �Q 11(/ ❑Six or more residential units. occupancy. City/State/ZIP: i 1 ` w"'r Recreational vehicle ❑Health-care facilities. ❑ parks. Suite/bldg./apt.#: I Project name: Des„..,_, Ke$i 0 Hazardous locations. 0 Supply voltage for more than ElService 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: I Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential ter.S`II0� ' A .--14.- 1(0-0‘)(08.; with above s..ft. 75.00 2 cLimited energy,multi-family In Limited —© -p,, residential(with above ..ft.) t�l i�CItI 1CJ ''Al5"41.4'V44 4-11 RenewableEnera 0 See Pale 2 —� OPERTY OWNER I ❑ TENANT Services or feeders installation,alter:tion and/or relocation Name: / L 4g.67-leva.. 0 3 l/4f ar'-200 amps or less &ill 100.70 3ta au MI Address: �/� �� ( �� ,� � /�� otz_f C +s11 _, 201 amps to 400 amps 133.56 © Iv —T� 401 amps to 600 amps I= 200.34 —© City/State/ZIP: T i ii t C 601 amps to 1,000 amps 301.04 2 Phone:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2 Email: Temporary services or feeders installation,alteration,and/or 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: 5,4/`,,,- St_/ t above service or feeder fee, O� T'� each branch circuit 4a 7.42 5,/./4 2 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 Email: dwelling,service and/or feeder 67.84 2 Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: C rc\U a-lef�ri c-- (.,. C ,✓ 'f q Sign or outline lighting 67.84 /—© Address: 7 \U �Y� ✓v t l Signal circuit(s)or limited-energy ❑ See Page 2 Ale)37 33 f J f 8 Oc.� .anel,alteration,or extension. City/State/ZIP: e> 1 fl ^(� CO0 1 Each additional ins ection over allowable in an of the above '\ `] Additional inspection(1 hr min) 66.25/hr Phone:(Z, ) )3 0,,.. C1. ' (/ Fax:( ) Investigation(1 hr min) 90.00/hr II Email: C,v-c�Ck't I C.Q., t2m S d- , F- Industrialspecs plant(1 whichhr no 78.18/hr _■ Inspections for no fee is 90.00/hr CCB Lic.: to(igIoq�j Electrical Lic.:36 C, Suprv.Lic.: 3ti<, 5 specifically listed('A hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: )G��„/1�j Subtotal: ".SJ ti� Print name ev 4, t/'" Date: 10 -'g- () ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): J?l.` b 1 Authorized signature: TOTAL PERMIT FEE: f . to This permit application expires if a permit is not obtainec4within 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 0 ,b"-7� ��ac 5-•sg--(it," Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: s 4 FEE ,HE Description l' Qty. I Each I 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) ❑ 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('/hr min) 'n ' ELECTRICAL PER IT ES A.. CO R IAL;W Rf O .� Subtotal(Enter on Page� Fee for each commercial system: $75.00 * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n 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* n Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\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: 12874 SW MORNINGSTAR DR, TIGARD, November 7, 2018 at OR, 97223 11 :43:09 AM Record Type: Record ID: Residential - Electrical ELC2016-00682 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor