Permit (131) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00897
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/05/2017
Parcel: 2S111AD01100
Jurisdiction: Tigard
Site address: 14585 SW 87TH AVE
Project: IBOSHI Subdivision: PINEBROOK TERRACE Lot: 8
Project Description: Replacing (1)service panel and adding(3)branch circuits.
Contractor: ELECTRICAL WIRING BY JOHNNY Owner: IBOSHI, JOSHUA N&ALEXANDRIA JA
950 NE 152ND AVE 14585 SW 87TH AVE
PORTLAND, OR 97230 PORTLAND, OR 97224
PHONE: 503-267-6540 PHONE:
FAX: 503-735-1167
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 12/05/2017 $100.70
Specifics:
amps or less
3 crt Branch Circuits w/Purchase 12/05/2017 $22.26
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 12/05/2017 $14.76
Electrical
Type of Const:
Occupancy Grp:
Total $137.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other -•. -.- law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work i suspende• for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Cer>Zer Tho rules are set forth in OAR
952-001-0010 through OAR"001-0090. You obtain a copy• the rules irect questions to OUNC by calling 503.232.19; or 1.800 32.2344.
Issued By: ... ,.4 5' Or% Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 603.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
77'
Electrical Permit Applicat* / FOR OU UHT t:SE ON Ll
City of Tigard C } 17 ReceivDate/Bea /!/ ` � A— �/Mi3Al
III _ 13125 SW Hall Blvd.,Tigard,OR 97 c 1+ Plan Review Related Permit# T
Phone: 503.718.2439 Fax: 503.59$:I96Q Date/B : , , !i. AdJi►,
Inspection Line: 503.639.4175 s' ,',' Ready Date/By: Juris: VI See Page 2 for
T I G A R D Internet: www.tigard-or.gov t'1 " { �' ?i Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New constructionddition/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 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
„al': 2-family dwelling ElCommercial/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: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
c- ` ,,[0� 4j�_ ['Addition of new motor load of system.
/415-65cTi� �7r/i/7u►
Job#: Job site address: C lool-rn or more. ❑"
0 Six or more residential units. occupancy.
City/State/ZIP: ...7/(�� ❑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: 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 WORK10
Limited energy,residential
ANL&„/ , Q p, ( �/ (with above sq.ft.) 75.00 2
���f GCS Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less / 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: 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
APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
0A.Fee for branch circuits with
Business name: above service or feeder fee, 3 7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: 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 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR ...___, Pump or irrigation circle 67.84 2
Business name: e-,(+ T ,c/e,„ ,� 4,,,,,,,,„„i /4, Aty" Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy 0 See Page 2 2
Address: Cj / Atte /Sr "1.4 .-t;,'& panel,alteration,or extension.
City/State/ZIP: 1Uk,` .„...GQ 1,GQ et'-? z_. pl Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(�$D 2(p'7 10S-c/0 Fax:('NV% 738' //(p'7 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 Lic.: 7( ?toci Electrical Lic.: G//7p3 S rv.L' .: €j.(¢T?5 specifically listed(Y2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: �rA 7
ie-:- Date: ZS �7 ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE:
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:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
I *
Fee for all residential systems combined: $75.00 DescriptioQty. Each Total
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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 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:
❑ Other: Each additional inspection is
charged at an hourly(1 hr min) 66.25/hr ]
Inspections for which no fee is 90.00/hr
specifically listed(A hr min)
ELECTRICAL PERMIT FEES
m .
COMMERCIAL WORK ONLY:
$75.00 Subtotal(Enter on Page 1):
Fee for each commercial system: * 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
❑ 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\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14585 SW 87TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2017-00897
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor