Permit CITY OF TIGARD ELECTRICAL PERMIT
I • ' COMMUNITY DEVELOPMENT Permit#: ELC2019-00205
T t(;A k.13 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/01/2019
Parcel: 2S110DB90791
Jurisdiction: Tigard
Site address: 15478 SW 114TH CT 79
Project: FOUNTAINS AT SUMMERFIELD Subdivision:rAINS AT SUMMERFIELD CONDO-PHI Lot: 79
Project Description: Reconnect only.
Contractor: Owner: USA SECRETARY OF HOUSING&URBAN
BY ISN CORP--WESTERN OPERATIONS
CE
2401 NW 23RD AVE STE 1D
OKLAHOMA CITY, OK 73107
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 04/01/2019 $67.84
Specifics: 1 ea 12%State Surcharge- 04/01/2019 $8.14
Electrical
Type of Use: MF
Class of Work: ALT
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 a . . 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 issua.--, or ' work is suspended for •re the 180
days. ATTENTION: Oregon law requires you follow the rules adopted by the Oregon Utility Notificati• Ce - . Those rules are s- f. h in OAR
0,952-001-0010 through OAR 90)1-007. m twin a cop r he rul j•.- ions to OUNC by calling 4.2 . 987 .800.332.2344.
WO
Issued By: /�" �� 4,._.,-._ � �" Permittee Signatur ,' - I - " P
ir
I OWNER INSTALLATION ONLY ( , // O
l
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.
"*7 775
Electrical Permit Applicatil _ .,`, Y ."'"' i OR o r r I i is t SI.o'1.1
City of Tigard ._ Received AMA 'a�
13125 SW Hall Blvd.,Tigard,OR 97223�� 1 Plan Review
= Phone: 503.718.2439 :,'1 Date/B : Related Permit#:
Email: TigardBuildingPennits@Tigrrd+prgoy , R,I Ready Date/By: Juris: ® See Page 2 for
-"GA" Inspection Line: 503.639.4175 hi(er'net::w'.'tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked):
Other:
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
01-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
O Multi-family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION/ANDD LOCATION y�— 0 Emergency system. larger separately derived
Job#: Job site address: M7 X .� I mi 1 l t 0 Addition of new motor load of system.
ty A J V t 7 Six or or more. ❑occupancy.
cc
City/State/ZIP: /� ��p�(/,t(/ �j Recreational
cu anc
�" I Six or more residential units.
❑Health-care facilities. ❑Rvehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 37A4N1 ‘Lit/,..ti 4(W ipp FEE SCHEDULE
Description I Qty. I Each I Total 1 *
�O /���`� .:,, tNew residential single-or multi-family dwelling unit.
Subdivision: �wl��1-
r - , w` 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
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2 _
PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 41.IA,
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:( ) 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
- .AI' LICANT ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: Iiziel / ,-• r fi above service or feeder fee,
7.42 2
�� � each branch circuit _
Contact name: , lj', D /i /lK� B.Fee for branch circuits without
Address: -c2p17 I - /a. 5 llPoe, k //`� � o service or feeder fee,first 56.18 2
��' ////// branch circuit
City/State/ZIP: Pg We U Each add'I branch circuit 7.42 2
/� r Miscellaneous(service or feeder not included)
Phone:( ) `51// �( ( J2 Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: Reconnect only / 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Si
al circuit(s)or limited-energy
Address: panel,n 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 Lie.: Suprv.Lie.: specifically listed(1/2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: / Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Aut,• — •-_ < ,/ ' ' TOTAL PERMIT FEE:
j �' This permit application expires if a permit is not obtained within 180
' 1, n. e: i f7.4�(Z/ilt, OaAi6 Date: " 1 1 /9 days after it has been accepted as complete.
s'^ 1 * 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: FEEDULE
Fee for all residential systems combined: $75.00 Description ( Qty. Each Total
y 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
with OAR 918-309-0040) 552.26 2
❑ 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
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(Vz hr mm)
" � CAL,PERMIT FEES
CON CIAtt ONLY,
`
Fee for each commercial system: $75.00 Subtotal(Enter on Page I).* 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\ELC_PemtitApp_ELR_ERE.doc Rev 10/26/2017
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15478 SW 114TH CT 79, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2019-00205
Inspection Type: Inspector:
195 Misc. inspection Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15478 SW 114TH CT 79, TIGARD, OR, 97224
Record Type: Record ID:
Commercial - Electrical ELC2019-00205
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor