Permit (139) CITY OF TIGARD ELECTRICAL PERMIT
111. COMMUNITY DEVELOPMENT Permit#: ELC2018-00653
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/02/2018
T[ } � Parcel: 2S102DB02300
Jurisdiction: Tigard
Site address: 13230 SW BURNHAM CT
Project: Steele Residence Subdivision: FREWING ORCHARD TRACTS Lot: 5
Project Description: (4)branch circuits for remodel.
Contractor: OWNER Owner: STEELE, MARK&MARIA
MARK&MARIA STEELE 13230 SW BURNHAM CT
13230 SW BURNHAM CT TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 402-304-6493 PHONE:
FAX:
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 10/02/2018 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/02/2018 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 cope f the rules or direct questions to OU NC by calling 503.232.1987 or 1.800.332.2344..
Issued By: TYILv��—' Permittee 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.
titi
Electrical Permit ApplicationCyl, FOR OFFICE USE ONLY
City of Tigard Received Permit#;
IN 't 13125 SW Hall Blvd.,Tigard,OR 972 3 c� Date/B : �'/ /- /54-e--1,..&__T-6061.)-3
1 c, }�C. Plan Review
0 Phone: 503.718.2439 Fax: 503.598,1960 1_� Date/By: Related Permit#: &G if. c,j7
Inspection Line: 503.639.4175 Ll`- " w cad •Date/B . Juris:
TIGARD p s �' y y. V1 See Page 2 for
Internet: www.tigard-or.gov �� i'%% 1; ,i led/Method: 6, Supplemental Information
TYPE OF WOR Nil'It"'' PLAN REVIEW
❑New construction $Addition/alteratl i�1Cnt� Please check all that apply(submit 2 sets of plans w/items checked):
{,3"•' ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other:
where the available fault current ❑Marines and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings,
less to ground,or exceeds 14,000 ClCommercial-useagricultural
�a I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
amps for all other installations. buildings.
❑Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address: 1.3:I 30 +A1 E3 bi,e N 1-I/t•a41 c_-t- l001 or more. ❑"A","E "1-2","t-3",
Ci /State/ZIP: Ti
5, „ n 6
❑Six or more residential units. occupancy.
ty � 0" 1? 2 1-3 0 lIealth-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: j-i-ee (e R•e,,..tJ,/L, r ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: e o evl e c)F N i II SI ci-., FEE SCHEDULE
// Description I Qty. I Each l Total I
/3 4,,4,,,y,ht" ri. 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#: .1 S f 0 2 O QO 2.30 0 • Ea,add'l 500 sq.ft.or portion 33.92 , 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
(with above sq.ft.)
Limited energy,multi-family 75.00 2
1,5 4 ,^J .1-U •�Kt `3 L r e , •I-j residential(with above sq.ft.) ',
' ` Renewable Energy ❑ See Page 2
[PROPERTY OWNER 0 TENANT' or i'
fServicesfeeders installation,alteration,and/or relocation
Name: Y"1 ct.,.k -le e I e 200 amps or less 100.70 2 ,
Address: 201 amps to 400 amps 133.56 2
13 Z 3 v S K ti,,,1,,,,,, C-r' 401 amps to 600 amps 200.34 2
City/State/ZIP: 'TiS d D 1P 97-Z 23 601 amps to 1,000 amps 301.04 2
Phone:(./f2) 3 U Li 611 93 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: r-1 r, 1•(61e / 6,5 et/i N; 1 t C 0,-1' relocation
Owner installation:This installation is.b ing made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,�7i r exc g9,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signatur,p ",' J-- ,2.2• Date: .7// 401 amps to 599 amps 168.54 2
APPLICANT ❑ 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 with71,011,q,
Address: service or feeder fee,first
branch circuit M� 1 56.18 56it 2
r7
City/State/ZIP: Bach add'l branch circuit ,,,,:,1`C3 7.42 ice, 2 f'
Miscellaneous(service or feed-4 not included)
Phone: ( ) Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email' Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy
0 See Page 2 2
panel,alteration,or extension.
Each additional Inspection over allowable in any of the above
City/State/ZIP; Additional inspection(1 hr min) 66.25/hr (
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lie.: specifically listed(%a hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: 7,„/..r-ert �';,
Print name: Date: 0 Plan Review Required(25%of permit fee): !
State surcharge(12%ofpennit fee): �,� 41 I.
Authorized signature: TOTAL PERMIT FEE: '•7• '"
This permit application expires if a permit is not obtained within 180 f
Print name: Date: days after it has been accepted ns complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE,doc Rev 06/17/2015 440-4615T(11/05/COM/wE_n
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13230 SW BURNHAM CT, TIGARD, OR, 97223 February 8, 2019 at
9:33:05 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00653
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor