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Permit (55) CITY OF TIGARD ELECTRICAL PERMIT Permit#: ELC2017-00820 COMMUNITY DEVELOPMENT Date Issued: 11/02/2017 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S02/2012200 Jurisdiction: Tigard Site address: 9975 SW JOHNSON ST None Lot: None Project: Stroum Subdivision: Project Description: Replace panel and add(4)branch circuits Owner: STROUM, DONALD M& Contractor: VAST ELECTRIC ANDREA J 1525 SEATTLE SLEW DR. SE ANDAND EASW JOHNSON ST SALEM, OR 97317 9975TIGARD, OR 97223 PHONE: PHONE: 503-566-7274 FAX: 503-585-8828 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 11/02/2017 $100.70 Specifics: amps or less 29 68 4 cit Branch Circuits w/Purchase 11/02/2017 $ Service or Feeder TypeClass of15.65 Use: SF 1 ea 12%State Surcharge- 11/02/2017 $ Class Work: ALT Electrical Type of Const: Occupancy Grp: Total $146.03 Required Items and Reports(Conditions) ll other applicable aw. All work will This permit in accordanceuwitht pprovedeplanto the s. Th so permit will heTigard if work nislpnot started Stateal Code, of 180 days Specialty issuance, ordifaIwork is suspended for more the 180 be done days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notific ion Center. Those rules are set forth in OAR 952-001-0010 throu AR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calli g 3.232.1987 or 1.800. .2344. t,4s Permittee Signature: VM-A..-i-_-= r'— Issued B OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. Date: OWNER'S SIGNATURE CONTRACTOR INSTALLATION ONLY Date: SIGNATURE OF SUPR.ELEC' 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 Applicata J I c 1.OR 01.1 ci.: L St: 011.1 City of Tigard ` `" "' "' Received � .... 13125 SW Hall Blvd.,Tigard,OR 97221 2017 Date/B : �� �� Permit# � �� � Phone: 503.718.2439 Fax: 503.598.1960 U Plan Review Date/B Related Permit#: Inspection Line: 503.639.4175 CITY II G A 11 D Internet: www.ti and-or. ov CITY Of- H i /AR Ready Date/By: Jur s: (� See Page 2 for g g _ Notified Method: Supplemental Information TYPE O 3U ING DIVISION PLAN REVIEW 0 New construction Addition/alteration/replacement Please check all that apply eP pp y(submit 2 sets of plans w/items checked): ❑Demolition Other: 0 Service or feeder 400 amps or more 0 Building over three stories. CATEGORY OF CONSTRUCTION where the available fault current ElMarinas and boatyards. exceeds 10,000 amps at 150 volts or 0 Floating buildings. pt 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural ❑Multi-familyamps for all other installations. buildings. 0 Master builder 0 Other: ❑Fire pump. JOB SITE INFORMATION.AND LOCATION0 Installationea 150 RVA or 0Emergency system. larrgerrseparately derived Job#: I Job site address: e 0 Addition of new motor load of system. R97 5 5 ) T�hn5r 5-EIOOHP or more. ❑"A" "E" "1-2> "1-3" City/State/ZIP: maid id / ) t,7']9, 5 0 Six or more residential units. occupancy. Jam^i t 1 I t7` ❑Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: I Project name: 0 Hazardous locations. ❑Supply voltage for more than /`_(/I ` 1/L ,� 0 or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: (� l f n�1 FEE SCHEDULE Description Qty. Each i Total 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 DESCRIPTION OF WORK Ea.add'1500 sq.ft.or portion 33.92 1 Limited energy,residential (with above sq.ft.) 75.00 2 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 x PROPERTY OWNER I 0 TENANT Renewable Energy 0 See Page 2 NI 3t i Tl i I 20Seamps or feeders installation,alteration,and/or relocation Name.'�u� A V 1. 200 amps or less 1 100.70 l O0•1 2 Address:gq'75 � � b n ,y� �,_1-- 201 amps to 400 amps 133.56 2 City/State/ZIP: 1 1 /1 r,-) 19 g, �/?D. 401 amps to 600 amps 200.34 2 (� �j 601 amps to 1,000 amps 301.04 2 Phone ). OW)* �-1-��)54 :3/ 3- Over 1,000 amps or volts 552.26 2 EJ Temporary services or feeders installation,alteration,and/or Email:Q.raceaSt r c urs Dq 1°)')(I 11. C.ut''Y-) relocation bang made on property installation:This installation is 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 Branch circuits—new,alteration,or extension,per panel 0 APPLICANT I 0 CONTACT PERSON V3 5_\* C A.Feo for e branchveeits with 2 bg Business name: J 1� '� �G ) �(� above service or feeder fee, Contact name: each branch circuit 7.42 2 B.Fee for branch circuits without Address: K service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: X Each add'l branch circuit 7.42 2 Phone: Miscellaneous(service or feeder not included) ( ) I 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 vast C Business name: [�'� ; ) Sign or outline lighting 67.84 2 Address: %C)a Signal circuit(s)or limited-energy MQ``n �� , `,t \ CC) panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP: �pn�� ��{-�' / �� �� 01-4 � Each additional inspection over allowable in any of the above Phone:(S 1 S 3 .... O g 1, + `f F`aJ:(503) r,, ^ estional inspection ) hr min) 66.25/hr LD I "�(�3 Investigation(1 hr min) 90.00/hr Email: -\---r ur bro1''\ells © C� •1 1 , G�l Industrial plant(1 hr min) 78.18/hr 5SInspections for which no fee is CCB Lic.: `� 3 I I Electrical Lic.C a I Suprv.Lic.: 4 3(p(7S specifically listed('A hr min) 90.00/hr Suprv.Electrician signature,required: ,' �1 ELECTRICAL PERMIT FEES k,,,_....L 2� Subtotal: I S 0,3 g Print name: \I i Vann`er�J c t neJ) I Date: \\ \' a O,, 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): /,57 a s' Authorized signature: �� 5 i C.,/1C� 1 71 , �� 1� "�'� TOTAL PERMIT FEE: / �(�, r a� ��� D This permit application expires if a permit is not obtained within 1801 Print name: 7� I aO�.1 U �` l lI days after it has been accepted as complete. r * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_EL RE.doc Rev 06/17/2 440-46151(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RES..IDENTIAL WORK© V• , FEE SCREW-LE Description Qty. Each I,.. Total I *u. 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 ❑ >100 kva-no additional charge 0.0 3 V• acuum Systems* Each additional inspection over allowable in any of the above: Fl O• ther: Each additional inspection is 66.25/hr charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/�hr min) ELE�TYtIGAL PERMIT FEES,�' COMMERCIAL-WORK 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: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls [1 Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitAppELR_ERE.doe Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 9975 SW JOHNSON ST, TIGARD, OR, 97223 September 11 , 2018 at 11 :52:20 AM Record Type: Record ID: Residential - Electrical ELC2017-00820 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor