Permit Support Document (30) INCITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2017-00872
TRGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
` '_. a" Date Issued: 11/22/2017
Parcel: 1S125DC01900
MEM Jurisdiction: Tigard
Site address: 7065 SW VENTURA DR
Project: Lower level suite remodel Subdivision: WASHINGTON SQUARE ESTATES Lot: 9
Project Description: Lighting,GFCI receptacles,relocate existing sub-panel to code compliant location. 3/20/18:REPRINTED permit to
add(1)branch circuit.
Contractor: PDX ELECTRIC LLC Owner: BURKE, LAURIE
7933 WHITFURROWS CT 7065 SW VENTURA DR
DURHAM, OR 97224 TIGARD, OR 97223
PHONE: 503-997-1989 PHONE:
FAX: 503-200-1362
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 11/22/2017 $100.70
Specifics: amps or less
4 crt Branch Circuits w/Purchase 03/21/2018 $29.68
Type of Use: SF Service or Feeder
Class of Work: ADD 1 ea 12%State Surcharge- 03/21/2018 $15.65
Electrical
Type of Const:
Occupancy Grp:
Total $146.03
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 OAR 952-001-0090. You may obtain- __• - •-rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.7`44.
Issued By: /_ J"
-1_
OWNER INSTALLATION ONLY Y
�—• j Permittee Signature: d � Gs2
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.
Electrics) Permit Application FOR OFscE Lase ON •
•
`Icy 0/Tigard I) 1 };Y: I tai 1111[ /lam' , f_ •._..SlLL +sw_
w [31�.=,S��'Hol!Blvd.,Tigard,OR t)72"?3Review
7. V�+ / I
p MAR y �yIkt Rvµis k
S' Phone: 503.718,2430 Fax: 503.598.1960 'Y' t1 $ 2� 01)z tiv it 1 ro Permit
TIGARD Inspection Linc: 503.010.=1175 r TI
f'e/�Lkc,ct Ihn k31 Jart lo Ica P4ge 2Iut
,.., Internet tt tsw Umam al n pati 01 rr OF 1 11 A 'ficdAl diol Supplemental Infer MiltiOii
Cal �9tt,�YY}iii�fff — '— i
TYPE-OF wox P1 yN REVIEW
❑X New construction 4 Q Addition/alteration/replacement i f f Ie.rse cheek alt that apply(submit 2 sets of plans w.lime,cfteckcrl) -
QDelltolition Other Shim,iie mine or a le ivhr den ill3 icirenaPS or taas ❑M 13 $arnar'L to;bnnvard)ver atm 11ICS.
CA"I FLORA. OF CONSTRUC CIU r t t es cess 10 t�5!imp.at 150 volts or 0 l'IMIlint bu4ldir
E I-and )_taaut>•dwelling Ej Coital-lei-via Itllld:m,ttial t` i; - t less to ground or esa.ckis 14.000 ❑('onus r ial-uS :raisins rel
,nips tier all other inya})shots. hail h4 gs
Q Ka i lsatnily Q Master builder 11111ErMAIMO ' 0 Eire pump. E1 installation of 00 KVA vi
JOB SITE INFORMATION AND LOCATIOt 0 limenseney'system. larger separately derived
I ❑Addition of new minor load o€ system.
Job a I Job site address:7065SAA Ventura Dr. t tuull'at'rur,c
j ❑ '�' f 1 l t'.
Ci:y Sta4t..`L3P:Tigard,OR 97:23 _ U Sis or enure residential unit,. ipso y
_... LI It ahh-care i i-t itt s U Recreatiomi vehicle parks.
' 011'r. Edou 4 to),. 0 Supply voltage for more than
Suite/bldg./apt.`ap€ Project name:t: I I 6i0o 1 I.
_...._. .._.... ___... .._..-- ___--.__..___.. ._.._..,_._._...._.. _....__-....... _.......... .....__„___...a { 0 Service or t,cder((lt)snaps ormore. volts n.niutza
Cross strew/directions to job site I i
FEE SCHEDULE
it ariiilr l-Ury 1 1 h j f 1z1 ,
--,___i 1 New residential singly or multi family dwelling hint
Includes attuhsdgarage
Stlbdtc islun: Lot .._._._ __.._ ,. ,_.-..
.a—_.. }ilii)sq.}l-or 1 s ! 16N I t
Tax map/parcel 0: �._
_--_.. i Ea acid t 500 ct €t or portion 31.92
' I
DESCRIPTION OF WORK 1 I Limited energy.residential l.. 1
i (stilt above sq.It) ;.. f
Please add 1-circuit for tile floor heat to existing permit:ELC2017-00872 I• I Limited energy.multi-Family tltl( (u1
i
�c it 44:f.'44(
, .y_/� & p / i residential(with aboveof 11) 7S !r_
r !! "y�"'� fd t �s21�. RInCNNI3[t Fnct6'... i1 Sael Page❑ PROPERTY...___ OWNER _ . _ ._.__--______TENANT. ____ .. ......11 Sus tees or feederslam altanon ilteration andtnr relocttron
Name: 200 Mips I r l s i_.. 100 77_0 9
201 amps to 400 amiss 133 56 1 ?
Address: t.._ _. —._.- ) a_.
I 401 lnpsut600 amps 200.1.1 1 '
('iters€ltt.7l1' f.. I -_.
i 1601 amps to'OU( amps a 101 t 4 L..._ 1 3
Phone:( ) I Fax ( ) I 1 (her 1,000 amps or volts 552.26
1 1-Temporary 1—Temporarysersices or feeders installation,alteration,andlor_..
E tr l ill i rtloa ition
Owner installation:T Ins installation is being n Mutat:on property dist I own is ..
lush is not 1 200 amps or less i i9)6 1 T .
intended 'or sale,lease,rent,or exchange,according to ORS 447,449 670..and 701. , 20!amps to 1011 amps T-(25(IK i i _r
Owner signature: Date: 1 140[ a ups to 599 amps ... -_.. 168.54_1- ... .. 2_
i -._....., _--- , Br inch aireutts new ,alto ation,or exhnsaun.pet panel-
❑ APPLICANT ❑ CONTACT PERSON I r - ,
I i 1 A.Fee for bt uuh Cneui(s Lille i
Business name: I i above service or feeder fee, 1 1 I
- t 1 each branch ct crit l �' ' '.t
Contact t:uttte: i 1 It.Pee for bianehctruuts unfwrr( ! I
_- _.... ___. ..... service or(tt.der tee lull 1 6 lh i
Address: bt trate circuit i -
Cil5 Stals;Ili. 1ash add'i ba inch ciruurl 41 -i
_—_,-- _ --_ -- - i Miscellaneous(Scolio or feeder not included) r
('hone:( I Fax::( ) } Each maniith turcd or modular (7.54 r
I an)ul i,_dwelhn icrw t e and or iceih.r
_.- --_- Reconnect only .._. .. -- 6r 84 2
C.ONTRAC.COR ! ' Pu tnp en rri,,atiout Circle I 67,84 , 1 2
Business Mame PDX Electric 1 Sign or outline lighting i 67.84 f
Signal eirctiI(s)or minted-energy v
i - Q Sec Pa Ke 2 I L .Address: 15816 SW Booties Ferry Rd. : faanel.alteration,or extension. [ ._....__ L ; _...
i Ends additional inspection over allowable in any.of the above
City/State/ZIP:Lake Oswego,OR 97035 I
Ac ahnomat inspeelton(1 hr taint 1 r 66.251 nt.
Phone (503)639-9708 Fax:(503)200-1362 i I ins tu,.ttion(111r mini i 0000 hr i !
IIndustrial plant t l hr mit) 78,181 �hr I
Emailinfo(alrp(tcelect•ic.com r —t--- - I-
I —
1n pvctions for which n<.4 c 1
I
COI Lie.: 192731 , Electrical Lie.: • ( r 'u rs Lie.: 56125 t i.ia.calically listed t'•hr Min) ._� _ I
- - -- - ---j I ELECTRICAL PERMII FEES
Supr> Electrician signature,required: q a Subtotal: stk.
!! Pratt name: Marty Palmer,
LD_ate._:_.31._1412018—--.--. ._ I ' ❑
Plan Review Rix:loirul f25%of penrif tet)
AuthoriJed signature: I - state surcharg,e(12%Ptpertii fee):
TOTAL PERMIT FEE/R9^ 3
--------------1 Ihtx permit application expires if permit is not obtained within inn
_lll[
name: Marty r litTitl j Trllt. 3lilt(2018 '
{{ days after it has been accepted as complete.
._ ._... ... _. ..............._ .............- .............._. .L.._........ ......._._ ....-.........._.,.........f r. Number'of llspeetions a.iowid per permit.
Ltaudrlingt4r:wt.4.1.i',i'a,iniIApII-iaie_I.:Ht:_lar 0,,I.5.,1 7 20 1?. -140W511i4 I I-117-1,U\I:wli3
Jowled A1-191A1 stand Z9£1.00Z£OS 1. (1W O)£I.:9011.171.-£0-91.0Z Z to Z abed :01
To: Page 1 of 2 2018-03-14 17:06:13(GMT) 15032001362 From: Marty Palmer
FAX COVER SHEET
TO
COMPANY
FAXNUMBER 15035981960
FROM Marty Palmer
DATE 2018-03-14 16:54:03 GMT
RE PDX Electric(Adding to Existing Permit)
COVER MESSAGE
I have include a new electrical permit application to add an additional(1-circuit) permit for tile
floor heat. I have include Evan Adams in this email; I know he is wanting to get an inspection
scheduled sooner than later,if there would be a way this could be expedited it would be greatly
appreciated.
Thank you,
Kiely House
PDX Electric
(503) 639-9708
Info@pdxelectric.com
WWW.METROFAX.COM
Branden Taggart
From: Branden Taggart
Sent: Tuesday, March 20, 2018 1:19 PM
To: 'info@pdxelectric.com'
Cc: #Building Permit Technicians
Subject: Permit for 7065 SW Ventura Dr: ELC2017-00872
Hi Kiely,
I have added (1) branch circuit to your permit located at 7065 SW Ventura Drive. The balance due is$8.31, and the
permit fees can be paid online now at https://aca.accela.com/tigard/. Once you pay online, please notify us at
tigardbuildingpermits@tigard-or.gov, and I will email you a copy of the revised permit. If you have any questions, please
let us know.
Thank you,
Branden Taggart
74 it City of Tigard
i : . Senior Permit Technician
rCommunity,Development
TIGARD
13125 SW Hall Blvd
Tigard, OR 97223
(503)718-2449
brandentc tigard-or.gov
1
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
7065 SW VENTURA DR, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2017-00872
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor