Permit (44) CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00254
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2019
Parcel: 25111 CB00102
Jurisdiction: Tigard
Site address: 10150 SW MURDOCK ST
Project: ALEXANDER Subdivision: None Lot: None
Project Description: (3)branch circuits for dryer,washer,and exhaust fan light.
Contractor: EDWARD MILLER & DOMINGO DEOCALES ELECTRIi Owner: ALEXANDER, RONALD E &MARY T
2928 ROBINWOOD DR NE 10150 SW MURDOCK ST
FOREST GROVE, OR 97116 TIGARD, OR 97224
PHONE: 503-502-9667 PHONE:
FAX:
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 04/18/2019 $71.02
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/18/2019 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 th rui pted by the Oregon Utility Notification Center. Those rules a set forth in OAR
952-001-0010 through OAR 952-001-0090rol may obtai copy of the rules or.irect questions to OUNC by calling 503.232.19 or .800.332.2344.
Issued By: 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 14 r,� '
i()R in i 1 i( 1. 1 ,i c t )
City of Tigard ° Q1` Received
C E 3.
13125 SW Hall Blvd.,Tigard,OR 97223 \ P�Review 6.� .i
a Phone; 503.718.2439 Fax: 503.598.1960 c.1 t ,• . Related Permit#:
Inspection Line: 503.639.4175 {� e1',- I 1N-AP}�' ',early Date/By: ® See Page 2 for
1 I G. R D Internet: www.tigard-or.gov �i�11�*lt'±®�1+.��a Notified/Method: Supplemental Information
TYPE;OF W6RK ,v1J1 PLAN REVIEW
❑New construction
~_ IgAddition/alteration/replacement Please check all that apply(submit 1 sets of plans w/items checked):
Demolition ❑Other:
0 Service or feeder 400 amps or more 0 Building over three stories.
0 where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
iyi 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 ❑Master builder 0 Other: 0 Fire pump. 0 Installation of ISO KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
{ J� () ❑Addition of new motor load of system.
Job#: Job site address: I O t 7 n SW 'Y 11A 0 CA4 `T I IOOHP or more. ❑"A"."E,"1-2"."1-3".
City/State/ZIP: T I C/ARIDID o Six or more residential units. occupancy.
t U�' t `T 0 Healthcare facilities_
0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: Li t..1 t4 pps,,( ?i,(1 �OW( ' ❑Hazardous locations. ❑Supply voltage for more than
1 ❑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.
Tax map/parcel#: 1,000 sq.ft or less 168.54 4
Ea.add'!500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with ) 75.00 2
� L�� 111�l0 V1)(l�>i i 6T� f J0��� �'3Lt r P 9 Limited energy,multi-family
75.00 2
i 120v, �� 0i �I EA IC-t1.47- residential(with above sq.ft.)
Renewable Energy 0 See Page 2
Ey) 1OPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: t1,04 i Iti1l A lik N MA 1/0.-,4 V t Z 200 amps or less 100.70 2
Address: k O i5 0 5 /(;P-917 C .').-r- 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: T.64 cQP, O Q- CI,10 4 601 amps to 1,000 amps 301.04 2
Phone:(5 p3) W 39- ).3 51 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 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
APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
0A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 1 ��-7
branch circuit 56.18 7 4.1 1 2
City/State/ZIP: Each add'l branch circuit Z 7.42 //.1 2
Miscellaneous(service or feeder not iaduded)
Phone:( ) Fax::( ) Each manufactured or modular
67.84 2
Email: dwelling,service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Igt)tUitfid
+, l`'(yam, 1) ( \�1 I� �� Sign or outline lighting - 67.84 2
Address: t2 Clt2 , ',,b Pi l AUS D iLi VL-0,
circuit(s)or limited-energy See Page 2 2
panel,alteration,or extension.
City/State/ZIP• tl� C-� 6 t (4 Z 1 1 Each additional inspection over allowable in any of the above
sf
Additional inspection(1 hr min) 66.25/hr
Phone:(6�3) , 11;,2- - 0i(2(0 1 Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Q iv1 old e�0,1252 r .� ) = Industrial plant(1 hr min} 78.18!hr
11 u °L 0 Inspections for which no fee is
CCB Lic.: U D�ai, Electrical Lic.: -C( 3 Suprv.Lic.: 9&2,9 S specifically listed(h hr min) �/h`
/� ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: �'��fz'�`�C, /��%<.��f Subtotal: 7/.Oy�
Print name: E'dWc Yd C,. /�/f! /j e Y Date: ,,��,, 0 Plan Review Required(25%of permit fee):
/ '�! /9 State surcharge(12%of permit fee): t,c�
tally fI p,-.. .� TOTAL PERMIT FEE: `1.
Authorized signature: v
This permit application expires if a permit is not obtained within 180
Print name-:1)O 'I IVC • r li(('l)` Jr Date: ci/j (. . 1 Ci days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Bwldmg\Permits\ELC_PermitApp ELR ERE.doc Rev 06/17/2015 440-4615T(I I/05/COMM/EB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
10150 SW MURDOCK ST, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2019-00254
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor