Permit (94) � CITY OF TIGARD ELECTRICAL PERMIT
s�� � COMMUNITY DEVELOPMENT Permit#: ELC2019-00091
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/19/2019
[ t�Tx Parcel: 1 S 134AB00400
Jurisdiction: Tigard
Site address: 11306 SW IRONWOOD LOOP
Project: RENEWAL PROPERTIES LLC Subdivision: ENGLEWOOD Lot: 3
Project Description: Reconnect only.
Contractor: Owner: RENEWAL PROPERTIES LLC
45683 NW HARTWICK RD
BANKS, OR 97106
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 02/19/2019 $67.84
Specifics:
1 ea 12%State Surcharge- 02/19/2019 $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 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. .e rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You a obta' opy. the rules or direct questions to OUNC by calling 503 —. or 1 2.2.44.
Issued By: _ Permittee Signature: 41111Wi Y
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 coli OI FI( l. t is ON 1.1
City of Tigard 4\1 RDate/Beceived AfallrilErIZIMINErifill
1,1 • 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
Phone: 503.718.2439 1019 Related Permit#:
Date/B
Email: TigardBuildingPermits@Tigard- r.gov \,� Ready Date/By: Jury: ® See Page 2 for
TIGARD �U
Inspection Line: 503.639.4175 Internet: Af garrd-,k, \Q otified/Method: / Supplemental Information
TY�t-OF WORK ....\x �C30' S PLAN REVIEW
❑New construction I ddition/alteration/r rent Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition 11 Other:
where the available fault current 0 Marinas and boatyards.
„i CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0'1-and 2-family dwelling El Commercial/industrial El Accessory buildingampless to ground,or exceeds 14,000 ❑Commercial-use agricultural
ngs.
❑Multi-family ❑Master builder ❑Other: Fire for all other installations. Insbutallation
atio
0Fire pump. ❑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: 1 j 3 0 47,-, SS vV\� "wcl v C (_e, 100HP or more. ❑"A">"E","I-2","I-3",
„�.-r-"" q 0 Six or more residential units. occupancy.
City/State/ZIP: Q CS v� ( 7 ZZRecreational vehicle parks.
/ f a/-C. 0 Health-care facilities. 0
Suite/bldg./apt.#: Project name: n ) P -{ J ❑Hazardous locations. 0 Supply voltage for more than
l�Q�tl t�✓."�1 { /IJjJG`Ntf ( 600 volts nominal.
❑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: 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
(with above sq.ft.)
4..ceki/Vee.," OA* Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
0 PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 1 k ,- L C 200 amps or less 100.70 2
J.CGwE, y� r,`.v/ i i
CIS-6 /v W y'1-Z� e k Ed l 201 amps to 400 amps 133.56 2
Address: IC JI
401 amps to 600 amps 200.34 2
City/State/ZIP: a ., Ls C) e<7 j"7/10 ``( 601 amps to 1,000 amps 301.04 2
Phone:SS S3 '7 Gc�:—v G Q 77_ Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: k i,JC C (C l'lC o t/- t✓f N� 71 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, 7 42 2
Contact name: each branch circuit
t ` t f.Y-y( B.Fee for branch circuits without
Address: y s t ? N. i/�, f k p / service or feeder fee,first 56.18 2
J !(�c�=`I . branch circuit
City/State/ZIP: l / f' 0 re 7/ 0 _b Each add'I branch circuit 7.42 2
Phone: C r 4 Miscellaneous(service or feeder not included)
(� '7 7__j 6 c Each manufactured or modular
�J dwelling,service and/or feeder 67.84 2
Email: t , k �> t r 1i f.d G�4 A v' PL / y Reconnect only 67.84 G"7 v / 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(Y2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 67-, -If
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): r t,(LJ
Authorized signature: I f TOTAL PERMIT FEE .� l�
This permit application expires if a permit is not Zbtained within 180
Print name: ,K 1 -L Y i r I Date: -/ 19 l�7 days after it has been accepted as complete.
6 t * Number of inspections allowed per permit.
I:\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
Fee for all residential systems combined: $75.00 De j Qty. I Each I 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
❑ 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(A hr min
CO o 1:itrIAL WORK O*Y: NitEcnuoWfogyairr
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
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n M• edical
❑ Nurse Calls
n O• utdoor 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:
11306 SW IRONWOOD LOOP, TIGARD, February 21 , 2019 at
OR, 97223 10:12:51 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00091
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor