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Permit CITY OF TIGARD 1; ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2018 00392 Date Issued: 06/12/2018 T r G A.F D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CC07300 Jurisdiction: Tigard Site address: 15865 SW GREENS WAY Project: PADDEN Subdivision: SUMMERFIELD NO.2 Lot: 100 Project Description: Panel replacement. Contractor: CONDUIT ELECTRIC Owner: PADDEN, BARBARA K TRUST 19461 SW 89TH AVE 15865 SW GREENS WAY TUALATIN, OR 97062 TIGARD, OR 97224 PHONE: 503-692-1428 PHONE: FAX: 503-692-3652 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 06/12/2018 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 06/12/2018 $12.08 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $112.78 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 tetF-by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 throw•"- 952-001-0090. You ma obtain a c y of the rules or direct qaestions to OUNC by calling 43. 42.1 :7 or 1.80.33 � Issued By y�� -- _ ..-Si.nature: _ _ ,. _ 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 FOR OFFICE IiSE OyL1 City of Tigard t" — Received / �g Permit#: t•�C Date/By: (,��/7t �1�1 ��L:) h7� q 13125 SW Hall Blvd.,Tigard,OR 97223 „ Plan Revie Phone: 503.718.2439 Fax: 503.598.1960Date/By: Related Permit#: Inspection Line: 503.639.4175 ION 1, 2 u i Ready Date/By: Juris: ® See Page 2 for T I G A R D Internet: www.tigard-or.gov Notified/Method: .►`, Supplemental Information TYPE OF WORI� tlNst l� .. IC+1[ ) MASON PLAN REVIEW 0 New construction Addition/alteratiltausAlg 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. 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. -and 2-family dwelling ElCommercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural Multi-familyMaster builderOther: Fireampform all other installations. butngs. ❑ 0 0 0Fire pump. Installation❑ of]50 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: Job site address: �y / 3/� ❑Addition of new motor load of system. / O t-_5Inl(,`7.-<-lw5/444 100HP or more. ❑occupancy. City/State/ZIP: i G 0 Six or more residential units. occupancy. ty j4/96,--).--(4 / 4//C 7 -2� 2. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than �'/l4� Q1��' ❑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 New residential single-or multi-family dwelling unit. Subdivision:S (1/ Lot#: Includes attached garage. Ji 1/h/1 1 l I- --� C'' 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 WORK Limited energy,residential 75.00 2 _ � - p (with above sq.ft.) Gf Limited energy,multi-family residential(with above sq.ft.) 75.00 2 jaPROPERTY OWNER TENANT Renewable Energy 0 See Page 2 Services or feeders installation,alteration,and/or relocation Name:Igar /4,vA �� 200 amps or less / 100.70 1, , 2(1, 2 [ / Address: J 5-8./5__ j7,,,, 7 e. .._c +lam'i 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: 7-2;974.,...71 '/ � L� � 1 ' 17 a2-2g 601 amps to 1,000 amps 301.04 2 Phone:( '3 )L 3 ....,9,5----_5-j-- Fax:( ) Over 1,000 amps or volts 552.26 2 J�' 111 �" 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 0 APPLICANT CONTACT`PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: v 4 '�/f £ 5 ,` ;, , „tee. �� above service or feeder fee, 7 42 2 / / �° ^`�[ each branch circuit Contact name: -3 'j7l '7�'/ 5 B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 /3 Miscellaneous(service or feeder not included) Phone:(S3) ro ii0 Fax: :(f') 4,0-- 29JZ Each manufactured or modular dwelling,service and/or feeder 67.84 2 EmailIA):b � ii ,,,,,,t / („„ii„..._ Reconnect only 67.84 2 NTRACTOR Pump or irrigation circle 67.84 2 Business name: /o'r`"„q�/�/ fie: ,,,�'` Sign or outline lighting 67.84 2 �" Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: l/�f lv`"l I ,Srl�� panel,alteration,or extension. � City/State/ZIP: / ^-� Each additional inspection over allowable in any of the above 76, G /4 Aki t ce 2d Additional inspection(1 hr min) 66.25/hr Phone:(,'z ) /.. trot -/t„�t fY Fax:( ) Investigation(1 hr min) 90.00/hr Email: /fit Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: /a 947 Electrical Lic.:26,q42496-c_ Suprv.Lic.: specifically listed hr min) ��( ('A ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: / Subtotal: f yt).7t) t' Print name: aezi,„ S' A`„X e r Date: 4-a ig 0 Plan Review Required(25%of permit fee): C State surcharge(12%of permit fee): ' Ai or " Authorized signature: TOTAL PERMIT FEE:/f j�r� 715 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: RESIDE*T AL WORK©1' i'Y, „ , ES ttED� Fee for all residential systems combined: $75.00 Qty1 ac Tota' 3r 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 552.26 2 with OAR 918-309-0040) ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 n V• acuum Systems* >100 kva—no additional charge 0.0 3 Each additional inspection over allowable in any of the above: n O• ther: 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('/..hr min) COMISOROAL WORK ONLY: t :r , ELEC RI )* a'° Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * 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 I:\Building\Permits\ELC_PermitAppELRERE.doc Rev 06/17/2015