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Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT � Permit#: ELC2018-00304 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/10/2018 TGt ,lldf 9 Parcel: 2S 103DD00414 Jurisdiction: Tigard Site address: 10820 SW FAIRHAVEN ST Project: Winterboume Subdivision: FAIRHAVEN COURT Lot: 4 Project Description: Service, 1 circuit hot tub. 6/1/2018: REPRINT permit to add(3)branch circuits. Contractor: RED'S ELECTRIC CO INC Owner: WINTERBOURNE, JEANI &MICHAEL 3787 SE NAEF RD SUITE 3 10820 SW FAIRHAVEN ST MILWAUKIE, OR 97267 TIGARD, OR 97223 PHONE: 503-233-6467 PHONE: FAX: 503-233-1281 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 05/10/2018 $100.70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 05/10/2018 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 05/10/2018 $12.97 Electrical Type of Const: 0 ea 12%State Surcharge- 06/01/2018 $8.53 Occupancy Grp: Electrical 3 crt Branch Circuits w/Purchase 06/01/2018 $22.26 Service or Feeder 0 ea 12%State Surcharge- 06/01/2018 $-5.85 Electrical 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 0 R.952-001-0090. You 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: �� L'j ©`v 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 RECEIVED FOR OFFICE USE ONLY 171 City of Tigard MAY 2018 Received.: r A)/� Permit a (r ��_ 2 rt 13125 SW Hall Blvd.,Tigard,OR 9722_ Datr113•: — /�d Phone: 503.718.2439 Fax: 503.5918'� t� O i i AF'il) ERMIIIIIIME Related Permit k: TIGARD Inspection Line: 503.639.4175 J:3I 11Lill�tr� T11111�, �.t ReadyDateBy: �� _ "i hue ®See Pagel for 9 Internet: 15�Sw.tlgard-or.gov t' "` c"r'.,r`" \otided/NIethod.6Q• I_J /� Supplemental Information TYPE OF WORK L;,�,�/ - \7 7' PLAN REVIEW 0 New construction [Addition/alteration/replacement Please check all that apply(submit 2 sets of plans n./items checked): ❑Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 51-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ❑Multi-family ❑Master builder ❑Other' amps for all other installations. buildings. 0• Fire pump. 0 Installation of 1501 CVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: 80685 Job site address: 10820 SW Fairhaven St 10011P or more. 0"N',"E","1.2","1-3", City/State/Z1P: 97223 ©Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: Winterbourne 0 Hazardous locations. 0 Supply voltage for more than El Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE De:m ttoo I Qtr. I Each l 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'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK • .. Limited energy,residential adding 3 branch circuits to existing permit ELC2018-0030 (with above sq.R.) 75.00 2 Limited energy,multi-family 75.00 2 residential(with above sq.ft.) 0 PROPERTY OWNER Renewable Energy ❑ See Pae 2 ❑ TENANT g Services or feeders installationtalteration,and/or relocation Name: 200 amps or less 100.70 2 Address: 201 amps to 400 amps 133.56 2 City/State/ZIP: 401 amps to 600 amps 200.34 2 601 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,alienation,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I 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 0 APPLICAN ❑ CON ACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, each branch circuit 7.42 2 Contact name: 13.Fee for branch circuits withocu Address: service or feeder fee,first 56,18 2 branch circuit City/State/ZIP: Each add'!branch circuit 7.42 2 Phone: Miscellaneous(service or feeder not included) ( ) Fax::( ) Each manufactured or modular 67.84 2 Email: dwelling,service and/or feeder Reconnect only 67.84 2 CONTRACTOR OR Pump or irrigation circle 67.84 2 Business name: Reds Electric Sign or outline lighting 67.84 2 SignalAddress: 3787 SE Naef Rd,Suite#3 panel,circuii(s)orlextens•energy 0 See Page 2 2 panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Milwaukie,OR 97267 Additional inspection(1 hr min) 66.25/hr Phone:( 5d 233-6467 Fax:( 503) 233-1281 Investigation(I hr min) 90.00/hr Email: Industrial plant(I hr min) 78.18/lir jen redsefectrie.eom Inspections for which no fee is CCB Lic.: 4443 Electrical Lic.: 5010S Suprv.Lic.: 50108 specifically listed('/r hr nein) 90.001 hr Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES ,1-1 Subtotal: , , 4,name: Jim Ferris ,Date: '5-30-2018 ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 2, 6 8 Authorized signature: �' ,, TOTAL PERMIT FEE: o2 y r ci 9, ami This permit application expires if a permit is not obtained within ISO Print name: Jim Ferris Date: 5-30-2018 days after it has been accepted as complete. • Number of inspections allowed per permit. I:tBuitdinglPermitskELC PermitApp_EIR ERE,doc Rev 05557/2515 4-Ie-t615T(1405/COStWEB r City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10820 SW FAIRHAVEN ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2018-00304 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor