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Permit
CITY OF TIGARD ELECTRICAL PERMIT 1 COMMUNITY DEVELOPMENT Permit#: ELC2018-00175 Date Issued: 03/12/2018 T!GAR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S136CB09600 Jurisdiction: Tigard Site address: 11300 SW 81ST AVE Project: WOO Subdivision: HERB AND PEGGIE'S PLACE Lot: 18 Project Description: Adding(1)service panel and(6)branch circuits to new garage. Contractor: OWNER Owner: WOO, SANG KIL AND OK SON CHANG WOO 11300 SW 81ST AVENUE 11300 SW 81ST AVENUE TIGARD, OR 97223 TIGARD, OR 97223 PHONE: PHONE: 503-442-3513 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 03/12/2018 $100.70 Specifics: amps or less 6 crt Branch Circuits w/Purchase 03/12/2018 $44.52 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 03/12/2018 $17.43 Electrical Type of Const: 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 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 AR 952-001-0090. pu may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � Permittee Signature: f / OWNER INSTALLATION ONLY The installation is being made on property I ow/n 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. RVIVINFr- Electrical Permit Application Received 3/r/2_fr1 yam Permit#:, _E,Zoir ri City of Tigard , ,a .i Date/By: x III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review Related Permit#:� O/��'�� " C Phone: 503.718.2439 Fax: 503.598.1940,11 Date/BY: ifr E ' aJ I` f 4. r A Ready Date/By: Jam. ® See Page 2 for Inspection Line: 503.639.4175 otified/Method: Supplemental Information 1 I G A R D Internet: www.tigard-or.gov r t '? 5 D F i s i, r3' i �, # �s r L° TYPE OF WORK PLAN REVIEW ElPlease check all that apply(submit 2 sets of plans w/items checked): New construction 0 Addition/alteration/replacement 0 Service or feeder 400 amps or more 0 Building over three stories. 0 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. less to ground,or exceeds 14,000 ❑Commercial-use agricultural 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building amps for all other installations. buildings. Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or ❑Multi-family 0 larger separately derived 0 Emergency system. g P Y JOB SITE INFORMATION AND LOCATION system. ❑Addition of new motor load of Y Job site address: �� 100HP or more. ❑"A","E","1-2","1-3", Job#: I � � CO�d S •� �� n� occupancy. a ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: "rp��r�( i Oreal-� /7oZ.2 3 0 Health-care facilities. �`JJ ❑Hazardous locations. 0 Supply voltage for more than Suite/bldg./apt.#: Project e: 0 Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: P - I2-/.0 -)—, FEE SCHEDULE Description I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. I Lot#: Includes attached garage. Subdivision: 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'!500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) ;I (e ) t�v;c,,_5pc,(l7k —Kia-�•( g., Limited energy,multi-family 75.00 2 1�j s IF residential(with above sq.ft.) {l t c'-(`-q.4, Renewable Energy 0 See Page 2 0 PROPERTY R I 0 TENANT Services or feeders installation,alteration,and/or relocation J1_� 200 amps or less i 100.70 ( 2 Name: Ok 50y) j�(J q 1 �'!t9)�l� ��t) 201 amps to 400 amps 133.56 2 Address: 1)300 , .j..J. '9 1 .' Ave. 401 amps to 600 amps 200.34 2 City/State/ZIP: T �1J ©r' ?0Ze23 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 Phone� Q 3) � � - 3 S Fax:( ) Temporary services or feeders installation,alteration,and/or Email: relocation or less 59.36 1 s Owner installation:This installation is being made on property that I own which is not 200 amps 125.08 2 intended for sale,lease,rent,or exc .nge,according to ORS 447,449,670, d 701. 201 amps to 400 amps 168.54 2 / , • Dat 401 amps to 599 amps Owner signature: w�/i // !�� r ppo Branch circuits-new,alteration,or extension,per panel 0 APPLICANT `CONTACT RSO A.Fee for branch circuits with above service or feeder fee, W 7.42 l,.- 2 Business name: each branch circuit Contact name: (,1k)47)144) i/000 B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: )1 3 oo S . 2 I - - hve, branch circuit 2 Each add'1 branch circuit 7.42 2 City/State/ZIP: 1►2 Gf 7.2.23 Miscellaneous(service or feeder not included) Phone:5 D ) 't'a,- . 513 I Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Sign or outline lighting 67.84 2 Business name: HO((� i xJ 11 C Signal circuit(s)or limited-energy 2 Address: /X1'( ,t P��C&' i c r\ panel,alteration,or extension. 0 See Page 2 Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Phone:( ) I Fax:( ) Investigation(1 hr min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr CCB Lic.: I Electrical Lic.: I Suprv.Lic.: specifically listed('/hr min) P ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Date: 0 Plan Review Required(25%of permit fee): Print name: State surcharge(12%of permit fee): TOTAL PERMIT FEE: Authorized signature: I This permit application expires if a permit is not obtained within 180 Print name: * 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: 9 D� "d'� . WO:AN ONLY; t Y #? _ Fee for all residential systems combined: $75.00 Description I Qty. I Each I 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 El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ElBurglar Alarm Wind generation systems in excess of 25 kva: 25.01 to 50 kva 301.04 2 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >100 kva(fee in accordance with OAR 918-309-0040) 552.26 2 Heating,Ventilation and Air Conditioning System* Solar generation systems in excess of 25 kva: 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 specifically listed('/z hr min) 90.00/hr iali 'C . '!�g� n O ,'' . ' ; >' At t PERvol '.n1 Fee for each commercial system: $75.00 Subtotal(Enter on Page ): (SEE OAR 918-309-0000) * Number of inspections allowed per permit. 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 n O• utdoor Landscape Lighting* ❑ P• rotective Signaling ❑ O• ther: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\Buildi ig\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: 11300 SW 81ST AVE, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2018-00175 Inspection Type: Inspector: 120 Electrical rough-in Jeff Grove Result: PASS Comments: Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11300 SW 81ST AVE, TIGARD, OR, 97223 June 18, 2019 at 1 :06:55 PM Record Type: Record ID: Residential - Electrical ELC2018-00175 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Previous corrections completed. Violation Summary: Inspector Contractor