Permit CITY OF TIGARD ELECTRICAL PERMIT
II, .
. ... .,. COMMUNITY DEVELOPMENT2439 Permit#: ELC2018-00815
„��,IT k r,,
13125 SW Hall Blvd.,Tigard OR 97223 503.718. „>� . ,`_ = Date Issued: 12/17/2018
T[ �eF L� Parcel: 2S111CC22800
Jurisdiction: Tigard
Site address: 10400 SW GREENLEAF TER
Project: Barnett Subdivision: SUMMERFIELD NO.5 Lot: 286
Project Description: Altering(1)branch circuit for kitchen remodel. 1/22/19: REPRINTED permit to include(4)branch circuits.
Contractor: ABC ELECTRIC Owner: BARNETT, KIMBERLY K&ROBERT W
135 NE 9TH AVE 10400 SW GREENLEAF TER
PORTLAND, OR 97232 TIGARD, OR 97224
PHONE: 503-233-7551 PHONE:
FAX: 503-233-7552
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 01/22/2019 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/22/2019 $10.30
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 or more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Centers Those rules - e -et forth in OAR
952-001-0010 through OAR 952-001-0090. You may obta'n a copy o s or ' ct questions to OUNC by calling 50 2.1987.r .800.332.2344:•
Issued By: / Rermittee.cion_atu�e: ./ `L 'All
OWNER INSTALLATION ONLY IfY
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 Ap lication FOR OFFICE USE ONLY
2
City g ofTigard SIE
AN
Date/B
Er
13125 SW Hall Blvd.,Tigard,OR 97223 2 Plan Review
• Phone: 503.718.2439 Fax: 503.598.1960 � Lp�9 Date/B : Related Permit#:
Inspection Line: 503.639.4175 y Ready Date/By: Innis: El See Page 2 for
TIGARD Internet: www.tigard-or.gov CITY OF tIG AHD Notified/Method: Supplemental Information
. 'TYPE'OF *WILDING Prt lON. PLAN,REVIEW
❑New construction tg Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more El Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
Q. 1-and 2-family dwelling ElCommercial/industrial ElAccessory building less to ground,or exceeds 14,000 DI Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB;SITE"I TT!ORMA ION:AND=LOCATION ' ElEmergency system. larger separately derived
Ell Addition of new motor load of system.
Job#:R-19- t1 S Job site address: /p q o r. GREEN 1-61F re-R 100HP or more. ❑"A","E","t-2",`°t-3",
City/State/ZIP: P64/25 d �? Z Z 4' ❑Six or more residential units. R occupancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑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
• 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'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential 75.00 2
kl TcHEA) RENeD (with above sq.ft.)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
/ 1 41 r �`00-* C �t�'/ Renewable Energy 0 See Page 2
0;� ROP ATV'OWNED ❑ 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:( ) 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 t
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
Branch circuits—new,alteration,or extension,per panel
❑ APPLICANT' ❑ CONTACT:°PERSb1�T A.Fee for branch circuits with
Business name: above service or feeder fee,
eci
i�..._ LQC �f�/ each branch circuit 7.42 2
Contact name: l r/. //' /}j r' B.Fee for branch circuits without
/ "'`�'�� "t r` L-- service or feeder fee,first 56.18 2
Address: i LI3 O ��Cn I /� �( (;\1-- branch circuit
�J ! 1 2
�/1 t Each add'l branch circuit 7.42 1q.(0-b
City/State/ZIP: / ,
1 rl ci '
y _/ �''{ ��,�����Gti� �._/� �� --7—'•;\
`� `� Miscellaneous(service or feeder not included)
Phone:(,; :).%)) „,;:2 "----� 1 Fax: :( ) ' - Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: 1 i �^ .+ (% / ) lc I e r t( �• j Z 1 Reconnect only 67.84 2
”/C0NTRAC 6 R f Pump or irrigation circle 67.84 2
i
Business name: Cr `li t n Sign or outline lighting 67.84 2
• ..-' K _K C" ! i �' Signal circuit(s)or limited-energy
r 0 See Page 2 2
Address: 1 q J( l :(•3 / -{-(� + l^� panel,alteration,or extension.
City/State/ZIP: , ! �1 Each additional inspection over allowable in any of the above
y . (,i C`�(C, .t?���.t �` O L-(, Additional inspection(1 hr min) 66.25/hr
Phone:(50. , 3-3.7 ,-s-5--1 Fax:( ) -- Investigation(1 hr min) 90.00/hr
t 1 Industrial plant(1 hr min) 78.18/hr
Email: ?J� /°1 ,C. G C '/'1 (' t n Inspections for which no fee is 90.00/hr,
CCB Lic.: Electrical Lic. C Su rv.Lic.:f�y�/ specifically listed(%hr min)
(�• 1J�, rs�� � C !!i t Kl.,.S ELECTR'ICAL PERMIT FEES
Suprv.Electrician signature,required: i Subtotal: 29...60 y
Print nam C /' Date: 0 Plan Review Required(25%of permit fee):
(�1( ��t / n f�� State surcharge(12%of permit fee): 1 S 40
Authorized signature: TOTAL PERMIT FEE: 3,3„1:.1
This permit application expires if a permit is not obtained within 180
Print name s1')G,G,;1 1 j '')C�77 , /(CI 1 --) Date: t days after it has been accepted as complete.
Number of inspections allowed per permit.
L\Building\Permits\ELCPermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB
CITY OF TIGARD ELECTRICAL PERMIT
: I COMMUNITY DEVELOPMENT Permit#: ELC2018-00815
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/17/2018
T f(;A R 1) g Parcel: 2S111CC22800
Jurisdiction: Tigard
Site address: 10400 SW GREENLEAF TER
Project: Barnett Subdivision: SUMMERFIELD NO.5 Lot: 286
Project Description: Altering(1)branch circuit for kitchen remodel.
Contractor: OWNER Owner: BARNETT, KIMBERLY K&ROBERT W
BOB BARNETT 10400 SW GREENLEAF TER
10400 SW GREENLEAF TER TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-522-4848 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 12/17/2018 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/17/2018 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
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 rules adopted by the Oregon Utility Notification Ceti r. Those rule a, set forth in OAR
952-001-0010 through o r- 952-cc ''-0091,You may ob in a copy of the r.- _ •' questions to OUNC by calling' ,i.232.19:]or 1.800.332.2344.� ►
Issued By: r �9 / / `/rte 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.
Electrical Permit Application RECEIVETORR(H.R : I si:Oyl.v
City Of Tigard Deceived /
Date/BY, p/ 7/r( 1I Permit#: F I Pte_,,.y)S(��*- -
13125 SW Hall Blvd.,Tigard,OR 97223 v� n / l Related Permit#: !/1 (Jt/(J
Phone: 503.718.2439 Fax: 503.598.1960 �� �` ZO�� DateRByiew /'z1-.-cidir
Inspection Line: 503.639.4175 y a� t /,+ r ady Date/By: Inns: El See Page 2 for
l i f rtt it t? Internet: www.tigard-or.gov CITY 3 OF A Citified/Method:
` t f." ij Supplemental Information
• w v
7A �,,,; „.�., /�! lTCO,,� mo o,. ,., .. x a txltiltl ?x 1Fi
❑New construction •Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked)
❑Demolition El Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current Marinas and boatyards.
.'d')(' I t&Y tw ;, STRIJ ,,,,:,,,c:: exceeds 10,000 amps at 150 volts or 0 Floating buildings.
• 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 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or
:: ,; a, jj y g ,y '11:i1,1
1 ' A 1" 1+ ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 1 d if"0 f I qr e a in ,.Q�- f rev-. 100HP or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy.
City/State/ZIP: T 1(-1 ig-p i 6 1�'n-' 1}--.)---i 0 Recreational vehicle parks.
❑Health-care facilities.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 5-1/vk 144;14- , (,1�,, PR_ - �. Ftp*ift '4
Description I Qty I Each I Total -1-"-
New
"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'l 500 sq.ft.or portion 33.92 l
• Limited energy,residential 75.00 2
lei lc l (with above sq.ft.)
tl Limited energy,multi-family
614,9i-14,4,e �A ,, residential(with above sq.ft.) 75.00 2
y� Renewable Energy ❑ See Page 2
,„ ? PJ! Y 00:4111341'-', s
Services or feeders installation,alteration,and/or relocation
Name: 13 g '3 B )R_ ^,e 200 amps or less 100.70 2
Address: 1 0 II e 6 r IA) 0-1.,pe,� 1,,�",/ reit-- 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: r'I a A D / 6 r-- 411 1"-1"--1 601 amps to 1,000 amps 301.04 2
Phone:(j d3) 5.2z-- q f L, " Fax:( ) Over 1,000 amps or volts 552.26 2
j Temporary services or feeders installation,alteration,and/or
Email: id 6--frfrn - Dtt 1- he il e comALets Ae it' relocation
Owner installation: This installation is s-.ing made on property that I own which is not 200 amps or less 59.36 1
intended for sale,1 e tont or exch 4according to ORS 447,449,670,and 701. 201 amps to400 amps 125.08 2
Owner signature / Date I L 1,r- ' 168.54 2
„ 'I?I O : '744:1:
F :' . � 1 - ew,aI h r extension,per panel
amps to amp
Branch circuits n tera'ono -
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 I 56.18 - /r/2
branch circuit ✓- X
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email
Reconnect only 67.84
2
'% ' ,: " OEC% � ,€`''
- = aC�. Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy ❑ See Page 2 2
_ panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:t ) Fax:( ) Investigation(I hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
C Inspections for which no fee is 90.00/hr
CCB Lic.:, Electrical Lic.: Suprv.Lic.: specifically listed 0 hr mm
Suprv.Electrician signature,required: Subtotal: 5z,,.f e
Print name: I Date: 0 Plan Review Required(25%of permit fee): ----
State surcharge(12%of permit fee): C.7y
Authorized signature: TOTAL PERMIT FEE: G V.
��
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\ETCPermitAppELR ERE doc 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:
y� a •
tf s a,t
'- Description Qty. I Each I Total I '
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s kva or less 100.70 2
5.O1to15kva 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
n Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
EI 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
s.ecificall listed(1/4 hr min)
COMMERCIAL WOR. ONLY ,:s, ,,,,,,, ,,,, Mtr s .
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
❑ 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\ELCPermitAppELR_ERE.doc Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10400 SW GREENLEAF TER, TIGARD, February 21 , 2019 at
OR, 97224 10:05:01 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00815
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor