Permit (83) CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC2018-00139
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/28/2018
Parcel: 2S114BA16600
Jurisdiction: Tigard
Site address: 9720 SW DURHAM RD
Project: Hunter Subdivision: 1995-135 PARTITION PLAT Lot: 1
Project Description: (1)branch circuit to ground house due to water piping replacement.
Contractor: ELECTRICAL WIRING BY JOHNNY Owner: HUNTER, KEITH E
950 NE 152ND AVE 9720 SW DURHAM RD
PORTLAND, OR 97230 TIGARD, OR 97224
PHONE: 503-267-6540 PHONE:
FAX: 503-735-1167
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 02/28/2018 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 02/28/2018 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 applicabl 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 suended f more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. ose r es are se forth in OAR
952-001-0010 through O•r •.2-001-0090.-.•u m-• •• -' - .•• of the rules or direct questions to OUNC by calling 5.03.232.1987.of .2344.
Issued By' `/ --- % ,r:;.r •. •e eeSignature: f 4 '7
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 RECEIVE holt ohhlcl: [si: ON 1.)
City of Tigard -'eceived
Date/By: p ermit#: �^
, _III .4 13125 SW Hall Blvd.,Tigard,OR 97223 FEB22018 plan Review �D I� Gam«�`°�/����
Phone: 503.718.2439 Fax: 503.598.1960 UU Date/By: Related Permit#:f ��' !��`ir- y 1�'-�3
Inspection Line: 503.639.4175 5 . eady Date/By: Juris: H See Pageat for
1 I G A R D CITY ,t
Internet: www.tigard-or.gov 4 �� � 1"' �ffied Method: Supplemental Information
,.J TYPE OF WO PLAN PLAN REVIEW
❑New construction Ad dition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
ElDemolition El 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.
and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other:
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: '9 71.5Z .5� ❑ 00m
Addition new motor load of system.
�1� 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: g 7ZZ ❑Six or more residential units, occupancy.
0 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.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK
Limited energy,residential
kie4ROu /�. t�
AtAa0V - it, AI " (with above sq.ft.) 75.00 2
Limited energy,multi-family
6---A— Cl"r residential(with above sq.ft.) 75.00 2
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
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
Branch circuits-new,alteration,or extension,per panel
0 APPLICANT ❑ CONTACT PERSON
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit 56.18 5-6,i Y 2
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: Q Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 4340..-1,* APg /s2"40 4 leG panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: tr fI?Z S�l(- Each additional inspection over allowable in any of the above
474
't-7 GP Fax.( ) f Additional inspection ) hr min) 66.25/hr
Phone: (�/ / _
�3 ��(p Investigation(1 hr min) 90.00/hr
Email: /C. • r. ! v� �?" / COW-peInspections
plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.•• joy Electrical Lic.: £127 SAS Lie.: 5 b75 specifically listed('Vs hr min)
Suprv.E( c'Ian signature,required: *'/ ELECTRICAL PERMIT FEES
%+S� �`La Subtotal: .i y
Print name: - 4,..-74 '1/4/ A ".1 r f-4a Da e: Z. Z -_ !r 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 7i/
Authorized signature: TOTAL PERMIT FEE: _411
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
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
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:
El 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(1/2 hr min)
trx cAc
COMMERCIAL WORK ONLY: ER 1 SEES
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
❑ 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.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
9720 SW DURHAM RD, TIGARD, OR, 97224 March 6, 2018 at 9:00:03 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00139
Inspection Type: Inspector:
199 Electrical final Chip Barnett
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor