Permit (98) CITY OF TIGIiiARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00871
T[GA,RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/22/2017
Parcel: 25111 BD00600
Jurisdiction: Tigard
Site address: 9665 SW DARMEL CT
Project: RUPPERT Subdivision: DARMEL NO.2 Lot: 33
Project Description: Replacing service panel and(6)branch circuits.
Contractor: OWNER Owner: JOHN RUPPERT
JOHN RUPPERT 9665 SW DARMEL CT
9665 SW DARMEL TIGARD, OR 97224
TIGARD, OR 97225
PHONE: 503-828-6685 PHONE: 503-828-6685
FAX:
FEES
Quantity Description Date Amount
Specifics: 1 ea Services or Feeders-200 11/22/2017 $100.70
amps or less
6 crt Branch Circuits w/Purchase 11/22/2017 $44.52
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 11/22/2017 $17.43
Type of Const: Electrical
Occupancy Grp:
Total $162.65
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 al r 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 issuanc if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati Center. Those rules are set forth OAR
952-001-0010 through OA• -001-0190. Yo ay obtain a copy of the rules or.'ect questions to OUNC by callin 32.1987 or 1.800.332. 4.
i ;i A _•.�
Issued By:
/r-
f .,. �- ii/moi i Vii_— Permi"ee 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
I Folz orrlcE t sI: o.i.1
City of Tigard - Received /
13125 SW Hall Blvd.,Tigard,OR 97223
NOV 1 2017 Date/B : (l/ Permit#: EG CAG1 ._"0 pi'
Phone: 503.718.2439 Fax: 503.598.1960 2 Plan Review v
Date/B Related Permit#: ,.!' 69
-—
Inspection Line: 503.639.4175 tr�r V l�
T I G n K D G,+ 1 )� Ready Date/By: Jurs:
Internet: www.ti and-or. ov S I( i ® See Page 2 for
g g
BUILDING Notified/Method: Supplemental Information
1VC� I�1V��P�7lV
�,! apply
OF WORK PLAN REVIEW
❑New construction YCI Addition/alteration/replacement Please check all that a 1
!� y(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
6
1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building
Multi-family ❑Master builder 0 Other: less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations.
0 Fire pump. buildings.
JOB SITE INFORMATION AND LOCATION0 Installation of 150 KVA or
0 Emergency system. larger separately derived
Job#: I Job site addres ❑Addition of new motor load of system.
76, p �� "Q1 100HPormore. ❑`A» «E» <l_2» 1.3„
City/State/ZIP: -7—?,7 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description 1 Qty. 1 Each I Total 1 *
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'I 500 sq.ft.or portion 33.92 1
CA/' /� `� /�� /f Limited energy,residential
/Il'] ci/ v 9( L,(`L_G.�'' Pei-A-re-1 jb` . (with above sq.ft.) 75.00 2
G e. Y'e Limited energy,multi-family
` residential(with above sq.ft.) 75.00 2
PROPERTY OWNER I 0 TENANT Renewable Energy ❑ See Page 2
Y—f Ute 2O0 amps or f�eders installation,alteration,and/or relocation
Name: [[[ ,-..,_200 amps-of-fess
Q 100.70 2
Address: (66.c" 5" Dar Q L c7"-- 201 amps to 400 amps 133.56 2
, am
City/State/ZIP: T, al,._ 0 2,o,S'" 401 amps to 600 amps200.34 2
601 amps to 11,000 amps 301.04 2
Phone:(
) r� 6 6. .� I Fax:( )�-- Over 1,000 amps or volts 552.26 2
Email: t lP� ( G�./ / �+ Temporary services or feeders installation,alteration,and/or
VVV e M 7 ( relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less
56
intended for sale,1 , ent,or exchang�. ccor(di/n��+�`t�o.Q.B.S 447,449,670, d 701. 201 amps to 400 amps 125.08 2
./2-- �
Owner signature: , �Lr / Date/ ?p1—.(1 401 amps to 599 amps 168.54
2
APPLICANT I CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
‘6
Contact name:
each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first 56.18
branch circuit 2
City/State/ZIP: Each add'I branch circuit 7.42 2
Phone:( ) I Fax: :( ) Miscellaneous(service or feeder not included)
Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
CONTRACTOR Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:
Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy
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:( ) I Fax:( )
Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: I Electrical Lic.: I Suprv.Lic.: specifically listed('/z hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL_PERMIT FEES
Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
I Print name:
I Date:
I This permit application expires if a permit is not obtained within 180
s
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:
RESIDENTIAL WORK
RK ONLY: FEE SCHEDULE
.'.;"
Description
I 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
D
>100 kva-no additional charge 0.0 3
Vacuum Systems* 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)
*E*112.1CAL robin',gEES
COMMERCIALMO ONLV: r Subtotal(Enter on Pae 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
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
[1 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