Permit (182) CITY OF TIGARD ELECTRICAL PERMIT
1111 q
COMMUNITY DEVELOPMENT Permit#: ELC2018-00621
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/20/2018
Parcel: 25111 DC01900
Jurisdiction: Tigard
Site address: 15885 SW ALDERBROOK CIR
Project: MARMON Subdivision: SUMMERFIELD NO.8 Lot: 466
Project Description: (7)branch circuits to rewire kitchen and living area.
Contractor: AC ELECTRICAL CONTRACTOR LLC Owner: MARMON, BARBARA E
5 CENTER POINTE DR SUITE 400 EDERER, BETTE A
LAKE OSWEGO, OR 97035 15885 SW ALDERBROOK CIR
TIGARD, OR 97224
PHONE: 503-910-3514 PHONE:
FAX: 503-845-9633
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo/Purchase 09/20/2018 $100.70
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/20/2018 $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 permitis 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 Not tion Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. Yo I. obtain a co•, les or direct questions to OUNC by call' g 50 . 32.1987 1.800.332 344.
Issued By: Permittee Signature: �� �\r
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 ®` �� �>ll o r i 1 c l_ `NI. 1.1
t. Received �y
City of Tigard a Date/13 / !I �� Permit#: `'
,11111 g 13125 SW Hall Blvd.,Tigard,OR 97223 ° '` 1..\W/ Plan Review 4 Y?
t S Phone: 503.718.2439 Fax 503.598.196 ' t V _1,.Date/B : Related Permit#: Aido ". �� ' 5 i
Inspection Line: 503.639.4175 CjE ,,,, , F7 ' ate/B• y: J °L'�-�, El See Page for
T f G n u D Internet: www.tigard_nr.gov .4 0..- r,„a' ''••fed/Method: a we Supplemental Information
T
TYPE OF WORK G ,kAC1k, �`� PLAN REVIEW
0 New construction IS Addition/alteration/anent Please check all that apply(submit 2 sets of plans w/items checked):
Demolition
0 Service or feeder 400 amps or more 0 Building over three stories.
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.
ql 1-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 ❑Master builder 0 Other: ❑Fire pump. 0 Installation of 150 IKVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job Site address: 1 ❑Addition of new motor load of system.
l c 9 R S S t a.3 o_ol 4io� ❑.A„ .E„X1_2„ «1_3„
City/State/ZIP: �x�nr rare residential units. occupancy.
a L't �� ❑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
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
(with above sq.ft.) 75.00 2
U "�2 t `� '� 1 i l ' CI Y i2-. Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
0 PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2
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:( ) Fax:( ) 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
Owner signature: Date: 401 amps to 599 amps 168.54 2
0 APPLICANT 0 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 circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit 56.18 5-60,11( 2
City/State/ZIP: Each add'l branch circuit !O 7.42 ilk',� 2
Miscellaneous(service or feeder not included) i
Phone:( ) Fax: :( ) 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
0 See Page 2 2
Address: C H�. 4. jr* , ,A,L Q v ` Lil to panel,alteration,or extension. g
City/State/ZIP: „,,L_,
Each additional inspection over allowable in any of the above
lu`` ..'p CD , ' I'' C) Additional inspection(1 hr min) 66.25/hr
Phone:(Sc.,-) cl t 0 ....3 c--) 4 lax:( ) Investigation(I hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
Cha C e i r-L^5-, C�k �' 0A,`\-i 0.01%I- -C (” l/ t',10,a .Gutta Inspections for which no fee is
CCB Lic.:1 -1'C s��t I Electrical Lic.:C c j k Suprv.Lie.:�`lr S ly listed(4 hr min) 90.00/hr
j t(� ELECTRICAL PERMIT FEES
Suprv.Electrician signator required:RG S e, 9 rel C as',1 l\7 Subtotal: 1/ , 7t
Print name: 'c-01....)e..1 a ... 9��,(( Date: j 7c) ( / c, ❑Plan Review Required(25%of permit fee):
11 \ Cr! State surcharge(12%of permit fee): 0_el,
Authorized signature: 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:\BuildingTe`mits\ELC_PernitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15885 SW ALDERBROOK CIR, TIGARD, December 21 , 2018 at
OR, 97224 9:11 :23 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00621
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor