Permit (185) CITY OF TIGARD ELECTRICAL PERMIT
2.. COMMUNITY DEVELOPMENT ,' Permit#: ELC2018-00586
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 / Date Issued; 09/04/2018
TR-31\R. g `' Parcel: 2S111AD02400
Jurisdiction: Tigard
Site address: 14635 SW 88TH AVE
Project: SACKETT Subdivision: PINEBROOK TERRACE Lot: 21
Project Description: Relocating panel and(2)branch circuits.
Contractor: DICKINSONS ELECTRIC Owner: SACKETT, NATHAN A&MELISSA A
8449 SW BARBUR BLVD REVOCABLE LIVING TRUST
PORTLAND, OR 97217 3215 S 7TH ST
TACOMA,WA 98405
PHONE: 503-246-3550 PHONE:
FAX: 503-213-6049
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 09/04/2018 $100.70
Specifics: amps or less
2 crt Branch Circuits w/Purchase 09/04/2018 $14.84
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 09/04/2018 $13.86
Electrical
Type of Const:
Occupancy Grp:
Total $129.40
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 . R•opted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You , obtain a •py of the rules•r direct questions to OUNC by calling 503.232.1987 or:;- .si.
Issued By: t, �-- i ttee Signature: ` ' �_—�y"
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 1 o z o i i ( i I s l ()NIA
City of Tigard RevedR _I
ilh • 13125 SW Hall Blvd.,Tigard,OR 97223 DiB
Plan Review
—
TI
Phone: 503.718.2439 OCT 2018 Date/B : Related Permit#:
Email: TigardBuildingPermits@Tigard-or.gov 0 Ready Date/By: Juris: H See Page 2 for
I I G A K I) Inspection Line: 503.639.4175 Internes` w�tieardrpy:ggy�yg-� Notified/Method: Supplemental Information
TYPE OF DINJl7TG" iiDI�uVISIIION PLAN REVIEW
[2'AS
❑New construction ddition/alteration/replacement 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.
❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards.
_ CATEGORY OF CONSTRUCTION Xrexceeds 10,000 amps at 150 volts or 0 Floating buildings.
11: 11 less to ground,or exceeds 14,000 0 Commercial-use agricultural
�]'1'and 2-family dwelling ❑Commercial/industrial ❑A � ti n:/; amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑O� 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
V� ❑Addition of new motor load of system.
Job#: Job site address: A.I6 jC- l
100HP or more. ❑"
City/State/ZIP:
0 Six or more residential units. occupancy.
0 Health-care facilities. ❑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
j Y n �� AF...,/,,c.� Description I Qty. I Each I Total
i4/S IO A9,-
1�14h F--LC New residential single-or multi-family dwelling unit.
Subdivision: if,' Lr/hd� Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 I
DESCRIPTION OF WORK Limited energy,residential
,/�L,fie 7:% �-..e-� /,,,4'f--- (with above sq.ft.) 75.00 2
�iCC� /4�✓ Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
❑ PROPERTY OWNER El 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:( ) Over 1,000 amps or volts 552.26 2
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 I
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: above service or feeder fee,
7'42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 ' 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: ,l/ f�` � �Z Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address /r/14 S; 0, ,e,, v 4,, 64,17panel,alteration,or extension. 0 See Page 2 2
City/State/ZIPs< Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:', 2 y6 3 j' Com. Investigation(1 hr min) 90.00/hr
Email:14,44 c/�`' %LLSd7,45.e �s r, Industrial plant(I min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic66, Electrical Lid 76,./Vee., Suprv.Lx�3`® .5 v7specifically listed(%hr min)
vvll ELECTRICAL PERMIT FEES
Suprv.Elec+' __,...e:._..-- ---'-'- Subtotal:
Print name: r �/�� Date: ;� 7 ❑Plan Review Required(25%of permit fee):
�G / State surcharge(12%of permit fee):
Authorized signatur- � "'� TOTAL PERMIT FEE:
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 10/26/2017 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
*
Fee for all residential systems combined: $75.00 DescriptioQty. Each Tota
Ren
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("A hr min)
ELECTile AL PERMIT' EES
COMMERCIAL WORK ONLY: 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
I� 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_PermitApp_ELR_ERE.doc Rev 10/26/2017
CITY OF TIGARD ELECTRICAL PERMIT
IIIIIICOMMUNITY DEVELOPMENT Permit#: ELC2018-00586
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/04/2018
f �kFd. g Parcel: 2S111AD02400
Jurisdiction: Tigard
Site address: 14635 SW 88TH AVE
Project: SACKETT Subdivision: PINEBROOK TERRACE Lot: 21
Project Description: Relocating panel and(2)branch circuits.
Contractor: OWNER Owner: SACKETT, NATHAN A&MELISSA A
MELISSA SACKETT REVOCABLE LIVING TRUST
14635 SW 88TH 3215 S 7TH ST
TIGARD, OR 97224 TACOMA,WA 98405
PHONE: 503-799-4267 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 09/04/2018 $100.70
Specifics: amps or less
2 crt Branch Circuits w/Purchase 09/04/2018 $14.84
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 09/04/2018 $13.86
Electrical
Type of Const:
Occupancy Grp:
Total $129.40
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 fo • rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through R 952-001-0090. You may obt-'.a copy of the les or direct questions to OUNC by calling 50,.23 a 987 or 1..8800.3322..2344.
Issued By: Perm ee Signature: ' 1. J' /1111 /v\
Pr
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 LSE OMEN
Received /
City of Tigardte/sy: `� k/ /r , Permit#: jib ,
III13125 SW Hall Blvd.,Tigard,OR 97223 ) n Review
= Phone: 503.718.2439 Date/Hi Related Permit#:
T I G A K D Email: TigardBuildingPermits@Tigard-or.gov . R_a to/By: Juris: la See Page 2 for
Inspection Line: 503.639.4175 Internet: www tt,,gaic-d.gio y toM-�ethod: '5 I Supplemental Information
TYPE OF WORK i Ufl 1�IS tV PLAN REVIEW
❑New construction Addition/alteration/replacement 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.
INV-and 2-family dwelling 0 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: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
` � 0Addition of new motor load of system.
Job#: Job site address: `5F' �� g /' 100HP or more. ❑
Ci/State/ZIP: �+/y # //� ❑Six or more residential units. occupancy.
ty � t7 �! U — - `� ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: o Hazardous locations. ❑Supply voltage for more than
,..54.,, ��'�/ ❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: ,r;‘,/ el) r d a K FEE SCHEDULE
C ` Description I Qty. I Each I Total I *
New residential single-or multi-family)dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#:
Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
pp (with above sq.ft.) 75.00 2
(10 e' ,Palet,t/ /Z Irl 1'11(1 V rC/� Limited energy,multi-family
f residential(with above sq.ft.) 75.00 2
44 a v"// Renewable Energy 0 See Page 2
PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 1 % 200 amps or less i 100.70 0:).713 2
201 amps to 400 amps 133.56 2
Address: „, .r ire ' 4 Lc S 11.,) 8641"--PSA401 amps to 600 amps 200.34 2
City/State/ZIP: r 1 eta)/ 0 cl 1 Z z41 601 amps to 1,000 amps 301.04 2
Phone:(6 03) --9 q y 201 7 Over 1,000 amps or volts 552.26 2
Fa- Temporary services or feeders installation,alteration,and/or
Email: . esaL'�+f Fa i- 7c. 4 t,Co''�, 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,/t,or exchange, ccording to RS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: ` " Date: q/./I') 401 amps to 599 amps 168.54 2
0
APPT ICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuitv(7.42 � Cn( 2
Contact name: B.Fee for branch circuits without 0
Address: service or feeder fee,first
branch circuit 5 18 540./I$ 2
City/State/ZIP: Each add'l branch circuit 7. 7.
Miscellaneous(service or feeder n t included)
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
- Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension. g
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('/hr min)
.. . „EL.FCTRICAL,PERMIT.FEES - ._ .�-, ,.: .
Suprv.Electrician signature,required:
Subtotal: }j1„:..3$�
�Ssv1
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):a -(G . 1
Authorized signature: TOTAL PERMIT FEE: a'PI
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complet.
* Number of inspections allowed per permit. 1 {J
I:\Building\Permits\ELC_PermitApp_ELRERE.doc Rev 10/26/2017 440-4615T(1l/05/COM/WEB V /
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIALWORK ONLY: # FEE SCHEDULE
Description I Qty. I Each I Total *
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
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
n Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n 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 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(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/*hr min)
COMMERCIAL WORK ONLY
ELECTRICAL;PEOHt
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
*
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
• Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
17 Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
14635 SW 88TH AVE, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2018-00586
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor