Permit (144) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00464
Date Issued: 07/11/2018
TIL A I<:I7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S135BD02500
Jurisdiction: Tigard
Site address: 9514 SW ANNA BELLE CT
Project: Ash Creek Village,Lot 11 Subdivision: ASH CREEK VILLAGE Lot: 11
Project Description: Temporary service for new subdivision.
Contractor: ROSS ELECTRIC INC Owner: SAGE BUILT HOMES LLC
2870 SE 75TH AVE#203 1815 NW 169TH PL STE 1040
HILLSBORO, OR 97123 BEAVERTON, OR 97006
PHONE: 503-642-2800 PHONE: 971-221-4597
FAX: 503-642-5815
FEES
Quantity Description Date Amount
1 ea Temp Services or Feeders- 07/11/2018 $59.36
Specifics: 200 amps or less
1 ea 12%State Surcharge- 07/11/2018 $7.12
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $66.48
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 a copy of the rules or direct questions to OUNC by calling 5 32. 7 or 1.800.332.2344.
Issued By: /-00 __ � �- ----_� mittee Signature:
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.
FOR OFFICE I O\I.\
Electrical Permit ApplicatioPtrzr%r—p.y., d, SE
1
City of Tigard - --.- ---,, iz Li Received
''''' Date/B • i / ZAIIIIMMIWO2 lig 6,1A
III II 13125 SW Hall Blvd.,Tigard,OR
97221( s 1 - 2018 PlanReview
I Phone: 503.718.2439 Fax: 503.598.196a EMEeMIPAMMlil
T I 6 A n Inspection Line: 503.639.4175 Cri-y c,.. Ready Date/By: la See Page 2 for
Internet: www.tigard-or.gov Bijii..P6,,a; '46'i?1) Notified/Method: Supplemental Information
i7StZf;FfftnRtRSfig;;IA;W, Vjkl:i".,,;-#;tkkt'',i, rii;;;,;,-';',;.- . (441-:,:',?:;'::::,;;;Nyeicw ,,,,,,.;:regoz,,..::2T:z.,...:,;: ,, .),::, ::::,,,,,: ;: i,„„,,,,:v5R;;,;;T
Ei New construction 0 Addition/alteration/replacement Please check all that apply(submit 3 sets of plans w/items checked):
El Service or feeder 400 amps or more El Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
A :rE (.. .***'.0:<4.*LSTittticr.0.,--::',.4ki:-j,,,*':'',e:•a::-..c:':':: ;;; ; exceeds 10,000 amps at 150 volts or CI Floating buildings.
El 1-and 2-family dwelling El Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 [1 Commercial-use agricultural
amps for all other installations, buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
*tit: :titilkt:l:A$0,14,,OVATIO,/:r',':-`5.:''. ., li--,.:,: .::<-..5':` ,1;,: 0 Emergency system, larger separately derived
CI Addition of new motor load of system.
Job#: Job site address:9514 SW Anna Belle Ct 100111'or more.
El Six or more residential units. occupancy.
City/State/ZIP:Tigard,OR El Health-care facilities. El Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Ash Creek 0 Hazardous locations. ['Supply voltage for more than
o Service or feeder 600 amps or more 600 volts nominal.
Cross street/directions to job site: BB"'-,t.BEBT,jtt
Description /f Qty. I Each f Total I .
New residential single-or multi-family dwelling unit.
Subdivision:Ash Creek Lot#: 11 Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'l 500 sq.ft.or portion 33.92 1
ara-000$;.:.0:f::WORI, ‘.'!: : .:.,:',. :::::',".,-:,*' -.'i'-,:;',:'''',.:7,:';;:',' Limited energy,residential
75.00 2
NEW RESIDENTIAL CONSTRUCTION (with above sq.ft.)
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
0.*081'1*/*10:::::,,'--A: ,.f,:'fi'7.1 :.;.,!'-'/i.,:''f;a'a,II,orAlq,.'1:: :;c:';0;`.i-41 IStlei:Yeasbti)er ttneedregrys installation,allier:Leo:1,7teid2/or relocation
Name:SAGE BUILT HOMES LLC 200 amps or less 100.70 2
Address:1815 NW 169111 PL.SUITE 1040 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:BEAVERTON,OR.97006 601 amps to 1,000 amps 301.04 2
Phone:(503)533-5167 Fax:(503)533-5167 Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
Owner installation:This installation is being made on property that I own which is not 200 amps or less 1 59.36 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
4';'' ''' ''1'70:0714*A10:''1****: ',:', circuitstAuTei:ifibr IZ•iceuiwt;alteration,vvithor extension,
Per panel
Business name:SAGE BUILT HOMES LLC above service or feeder fee,
7.42 2
each branch circuit
Contact name:Ben Cooper B.Fee for branch circuits without
service or feeder first
Address:SAME AS ABOVE branch circuit 56.18 2
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(971 )258-6658 Fax::( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email:BEN@SAGEBUILTHOMESLLC.COM Reconnect only
67.84 2
Pump or irrigation circle 67.84 2
Business name:Ross Electric Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: 2870 SE 75th Ave,203panel, CI See Page 2 2
alteration,or extension
Each additional inspection over allowable in any of the above
City/State/ZIP:Hillsboro,Oregon 97123
Additional inspection(1 hr mm ) 66.25/hr
Phone:( 503 )642-2800 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
7in),,,, 90.00/hr
CCB Lic.:157891 Electrical Lic.:34-436C Suprv.Lic.: 4232-5 -s7if71}Ylisteri(/'115
signature,required:
Suprv.Electrician .,,,,,Jeizaw-,,00,-::::,::...,,,,,,,,::: ,
4611,—frO_ Subtotal:
Print name: Steve Ross I Date: 7/10/2018 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
, —
Authorized signature:1544V ee're4, TOTAL PERMIT FEE: ‘:70. (-*/
This permit application expires if a permit is not obtained within 180
Print name: Ben Cooper Date: 7/10/2018 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Perrnits\ELC_PermitApp_ELR_ERE doe 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:
. E 1't`il WO*ONLY: SCH az,
Description Qty. I Each I Total I-
Fee for all residential systems combined: $75.00 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
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:
❑ 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('h hr min)
CO,CIAL Wdl ONLY:
`:
METRICAL TQC kIcM. PERMITE $
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
y • 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
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9514 SW ANNA BELLE CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2018-00464
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Temporary service removed.
Violation Summary:
Inspector Contractor