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Permit (29) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2019-00057 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2019 T E'Ca 1 Parcel: 1 S 136C B 10900 Jurisdiction: Tigard Site address: 8465 SW PFAFFLE ST Project: Corea Subdivision: ASH CREEK MEADOWS Lot: 13 Project Description: Reconnect only. Contractor: Owner: FEDERAL NATIONAL MORTGAGE ASSN BY REVERSE MORTGAGE SOLUTIONS INC 14405 WALTERS RD STE 200 HOUSTON, TX 77014 PHONE: PHONE: FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 02/04/2019 $67.84 Specifics: 1 ea 12%State Surcharge- 02/04/2019 $8.14 Electrical Type of Use: SF Class of Work: OTR Type of Const: Occupancy Grp: Total $75.98 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Co s and all other applicabl- law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issua ce, or if work is suspe••=d for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rul= e set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma obtain a c•• of t - les or direct questions to OUNC by calling 503.23 .1987 or'1)).:#1.332.. Issued By: Permittee—Signature: U 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 [012 of i It i. I SI:ON Ll City of Tigard Received Permit#: 14 13125 SW Hall Blvd.,Tigard,OR 97223 e/B . Q Phone: 503.718.2439 :is JRelated Permit#: Email: TigardBuildingPennits@Tigard-or.gov � Ready Date/By: Juris: ® See Page 2 for [I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov .�n otified/Method: Supplemental Information TYPE OF WORK ��� PLAN REVIEW' ❑New construction ❑Addition/alteration/replpa Bill,?( t Please check all that apply(submit 2 sets of plans w/items checked): p w fe`Ftq R�1 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition Other: Uttj - 't :''i A-1` �" �� where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. -and 2-family dwelling ❑Commercial/industrial ❑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 SITEINFORMATIONAND LOCATION 0 Emergency system. larger separately derived AddJob#: 65, 5 v 7 Q f )f 5 0 100H ion of new motor load of system. 100HP or more. ❑"A","E","1-2","1-3", ❑Six or more residential units. occupancy. City/State/ZIP: 'Tibia{( O ---- ��� ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: I Project name: ❑Hazardous locations. 0 Supply voltage for more than t/C��'fll 0 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'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential / f (with above sq.ft.) 75.00 2 1�C.0 ali v"y`am' AJ ia- ` Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name: /�_- /1/4754,14.,,,,, �r % ty. c5N 4) u p , 20°amps or less 100.70 2 Address: t/" "t1-�'1'` �� - Are-) A � 201 amps to 400 amps 133.56 2 [ 401 amps to 600 amps 200.34 2 City/State/ZIP: /L 45 y,,,,� " y. 77d/ 601 amps to 1,000 amps 301.04 2 Phone: ��V 1 / 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 ❑ 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: 1 '03 0_0 Ni e('-,v B.Fee for branch circuits without Address: 1 t C�'&.2,„GJw , ��P e�t"v�I,4 '-C �, 3� branch circuit service or feeder fee,first 56.18 2 �- City/State/ZIP: ---r-, 5 aj '�'Z. Each add'l branch circuit 7.42 2 © 6Miscellaneous(service or feeder not included) Phone:ci 7f )_,5-. .. (y y -2_5�5 Z(;.i Each manufactured or modular 67.84 2 Email: t dwelling,service and/or feeder Reconnect only / 67.84 C�/2„�1� 2 CONTRACTOR Pump or irrigation circle 67.84 _ 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. 0 See Page 2 2 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('A hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signa e,r:euired: Subtotal: Print name: Date: 0 Plan Review Required(25%of permit fee): --- (1/1.7N----' State surcharge(12%of permit fee): f,1 ii TOTAL PERMIT FEE: '7 ,y Authorized signature: This permit application expires if a permit is not obtained within 180 Print name: s ( 1��/�Q,/�,. Date: 2, t>I 1 * days after it has been accepted as complete. Number of inspections allowed per permit. 1:\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 I * Fee for all residential systems combined: $75.00 Description Qtyf Each Total 3' 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 El 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('V hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES 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 ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* E Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Budding\Permits\ELC_Pern itApp_ELR_ERE.doc Rev 10/26/2017 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 8465 SW PFAFFLE ST, TIGARD, OR, 97223 February 5, 2019 at 9:11 :55 AM Record Type: Record ID: Residential - Electrical ELC2019-00057 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Electrical appears original and ok for re connect. Violation Summary: Inspector Contractor