Permit (116) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
Permit#: ELC2018-00680
Date Issued: 10/15/2018
Ti Cat\R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1 S134DC01000
Jurisdiction: Tigard
Site address: 11645 SW 114TH PL
Project: CHANDLER Subdivision: 114TH PLACE Lot: 3
Project Description: Panel replacement.
Contractor: STAR ELECTRICAL SERVICE Owner: CHANDLER, ERIC BRADFORD
PO BOX 1784 HULINGS, LISA
BEAVERTON, OR 97075 11645 SW 114TH PL
TIGARD, OR 97223
PHONE: 503-579-9201 PHONE:
FAX: 503-579-4581
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/15/2018 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 10/15/2018 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is spended for more the 180
days. ATTENTION: Oregon law requires you to follow the - .•o.ted by the Oregon Utility Notification Cent . Those u-- =re set OAR
952-001-0010 through OAR 952-001-0090. .. -ay o• - opy of the rules or.irect questions to OUNC by calling 503.232.19 or 1.8 0. 344:
•
Issued By: L �L�- �.�� Qcamittne Sia nature: f G
,00110'�
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4176 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Electrical Permit Application FOR 0111( 1 1x1. ONI.1
City of Tigard .. Received
FIEMMINIMII
• 13125 SW Hall Blvd.,Tigard,OR 97223R t! : f ,
: M Phone: 503.718.2439 g " ' t r. Related Permit#:
Email: TigardBuildingPermits@Tigard-or.gov Ready Date/By: Ilikl ® See Page 2 for
T I G A is D Inspection Line: 503.639.4175 Internet: www.ti p'd'{or$ole , . Notified/Method: • Supplemental Information
Cl i.. I ia 4 li 1
• TYPE OF WORK 7 PLAN REVIEW
❑ aC t S Please check all that apply(submit 2 sets ofplanschecked):
New construction �Addition/alteration/re�I ��' �r,� pp y w/items
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: til,
yr)EN I.: i• / -,,,- where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building
4.
Multi-family ❑Master builder ❑Other: less to ground,or exceeds 14,000 ❑Commercial-use agricultural
ampFire buildings.
for all other installations.
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION / 0 Emergency system. larger separately derived
Job#: I Job site address://17 1/41:- /?J' 0 Addition of new motor load of system.
address://‘
/ � + 100HP or more. ❑system.
City/State/ZIP: ? ❑Six or more residential units. occupancy.
// —a...T 1AA 9., 0Recreational vehicle
/ �' v`+ Health-care facilities. 0 parks.
Suite/bldg./apt.#: Project name: (yt�litri�tf� ❑Hazardous locations. 0
volts nominal.1y voltage for more than
600
0 Service or feeder 600 amps or more.
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: I 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 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
Rep/� f (with above sq.ft.)
/ old" P19-/VP/tz Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
"PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
4.
Name: 5,%c l-h' /X is /e / 200 amps or less / 100.70 AIL 7,..? 2
1 r 61:6-` �(4 f / ) 201 amps to 400 amps 133.56 2
Address: //40,_ /(/tom e/
401 amps to 600 amps 200.34 2
City/State/ZIP:
/ JG�L,f.►, !'t`J. /} 601 amps to 1,000 amps 301.04 2
Phone:(� `/i. 7 r _9i.),9 Over 1,000 amps or volts 552.26 2
Y 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 I
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
40 A
APPLICANT ❑ CONTACT PERSON Branch circuits—new,alterations or extension,per panel
A.Fee for branch circuits with
Business name: �7 ,z/ I----;,./. r`F above service or feeder fee,eac7.42 2
4/L ( ft./.720?-i4<1
ft�'�2�' Feeh branch circuit irc
Contact name: L7 B. for branch circuits without
service or feeder fee,first
Address: fw (( _7J.944 branch circuit 56.18 2
City/State/ p / ve./70; /�7 ' i 97',7 Each add'l branch circuit 7.42 2
Phone: ` l� (/ Miscellaneous(service or feeder not included)
�j® 71 9�0f 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: , ,42 E�//ln f Sign or outline lighting 67.84 2
/ !!� L ` l/I/� Signal circuit(s)or limited-energy
Address: f7: 0 ,, /3'65)( / /�. panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: '/ Each additional inspection over allowable in any of the above
pt�:T ��, OK 92,9,7_, '�i 7 Additional inspection(1 hr min) 66.25/hr
Phone:(yd ,,y, 9 9 v.„.;/ (7,/ 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..;;;2 r r 3prv.Lic.: �/' specifically listed(V hr min))
� f l ,/ ELECTRICAL PERMIT FEES
Suprv.Elects an signature,required: � ��% �� 1ztJ 7(1
Subtotal:
Print name: Date: ElPlan Review Required(25%of permit fee):
/
State surcharge(12%of permit fee): ,e,02,_ or
Authorized signature: TOTAL PERMIT FEE: //I`7f7'
This permit application expires if a permit is not o tained 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(I1/05/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
Description
Fee for all residential systems combined: $75.00 Qty. Each Total
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
❑ 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(y2 hr min)
COMMtittikt WORK ONLY: !: VACTRIC4 1):EloitifttEs >`_
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
-Ittsffitmtier3
❑ 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
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
11645 SW 114TH PL, TIGARD, OR, 97223 October 25, 2018 at
10:54:40 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00680
Inspection Type: Inspector:
115 Electrical service Aaron Cillo-Gobel
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor