Permit (84) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
111
Permit#: ELC2019-00066
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/06/2019
f } Parcel: 1 S 133CD05000
Jurisdiction: Tigard
Site address: 13645 SW FEIRING LN
Project: WARNER Subdivision: COTSWALD MEADOWS Lot: 48
Project Description: (1)branch circuit for new furnace.
Contractor: OWNER Owner: WARNER, HAROLD E & BETTE K
HAROLD & BETTE WARNER 13645 SW FEIRING LN
13645 SW FEIRING LN TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-524-5710
PHONE: 503-804-3258
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 02/06/2019 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 02/06/2019 $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 •rk is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules ....ted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may•. -'. - .•. of e rules or di -ct questions to OUNC by calling 503.232.1987. :OP. .2344.
Issued By: ior. _ . 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 Mk k O U F I C E I. F OM.)
City of Tigard E C E I V E . Eiew
®
13125 SW Hall BlvdTigard,OR 9722
III Phone: 503.718.2439Date/B Related Permit#:
C
1 I G A K[) Email: TigardBuildingPermits@Tigard-or.goP EB 6 2019 Ready Date/By: ® See Page 2 for
Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: TIMM Supplemental Information
PE OF wl^^}ty IT(Y� OF TIGARD PLAN REVIEW
,--/ ion/re�lace DIVISION Please check all that apply(submit 2 sets of plans w/items checked):
❑New construction LJ Addition/alteration replacement
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other:
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-familydwellingCommercial/industrial less to ground,or exceeds 14,000 0 Commercial-use agricultural
amp❑ ❑Accessory building
Multi-familyMaster builder Other: Fire for all other installations. buildings.
❑ ❑ ❑ 0Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: .f3(p'-- t21 A)'6-Ltd 100HP or more. ❑"A","E">"l-2 "l-3",
City/State/ZIP: ` ((T J2 , 3
0 Six or more residential units. occupancy.
7 ZZ ❑Health-care facilities. 0 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:
C3'S.�/( O t---V- S c.4-11)LLS Cl` FEE SCHEDULE
,, n Description I Qty. Each Total I *
,v c-) ' I ('�� 00 ' 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
'-12.0
0 v e CQ G T'2(C✓ - S e."i 1 ce (with above sq.ft.)
1�✓ i, Limited energy,multi-family 75.00 2
12) itfJ Cll-k) , residential(with above sq.ft.)
--7 PROPERTY OWNER ❑ TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: ET Wi.l11J.{.jb f 200 amps or less 100.70 2
Address: t 3 04,5- SI.J >I!e la_1 N is-- L 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: Ti 6-, (, -R y Ci 7 Z Z 601 amps to 1,000 amps 301.04 2
Phone:(S03) 5-2.c/-5-7(Y) Over 1,000 amps or volts 552.26 2
�, nTemporary services or feeders installation,alteration,and/or
Email: /4/''f7, L �;/t0(�t_ c, ,.1`'
f' t ...arm/ relocation
Owner installation:This install. : 1-9 being made on property that I own which is not 200 amps or less 59.36 1
intended for s. e,lease,rent • : c - . according to ORS 447,449,670, d 701. 201 amps to 400 amps 125.08 2
Owner signatu= - �. '` 2 /, 401 amps to 599 amps 168.54 2
g .:s���/l//�' Date:
0 APPLIC a ❑ CONTACT PE N Branch circuits-new,alteration,or extension, .er panel
A.Fee for branch circuits with
Business name: »a /2-04 4- 7-"-s above service or feeder fee,
7.42 2
� each branch circuit
Contact name: '`k C j ` B.Fee for branch circuits without
service or feeder fee,first
Address: .4 7 ?f._ C 1 A s I ALE . branch circuit 56.18 SZ_4 2
City/State/ZIP: Each add'I branch circuit 7.42 2
) 5 Miscellaneous(service or feeder not included)
Phone:62:53) z el 47R-0 Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: .e S+4.---,pt L, C.QYf < Reconnect only --t 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Cj241,1,( -'t_r- 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:( ) 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(/Z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: �-Z,,.lg`
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 6,, 7 y
Authorized signature: TOTAL PERMIT FEE: (/� 9.,A
,,� / This permit application expires if a permit is not obtained within 180
Print name: (Zk �r,4...„ 2bcAeltujDate:,/62 �, days after it has been accepted as complete.
((( * Number of inspections allowed per permit.
I:\Building\Permits\ELC_Pe mitApp_ELRERE.doc Rev 10/26/2017 40-4615T(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: FE SCHEDULE
Fee for all residential systems combined: $75.00 Description Qty. Each 1 Total
3r Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70
5.01 to 15 kva 133.56 2 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
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>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('A hr min)
COMMERCIAL WORK ONLY; ELECCITFEES
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
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13645 SW FEIRING LN, TIGARD, OR, 97223 February 15, 2019 at
8:01 :21 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00066
Inspection Type: Inspector:
199 Electrical final David Young
Result:
FA I L
Comments:
Provide permit for ac reconnect.
Informed HVAC contractor of no permit for ac reconnect.
No inspection done at this time.
Violation Summary:
Inspector Contractor