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Permit (149) CITY OF TIGARD ELECTRICAL PERMIT '1 1 ' COMMUNITY DEVELOPMENT Permit#: ELC2019-00300 T IG AR 0 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/06/2019 Parcel: 2S 109BA05800 Jurisdiction: Tigard Site address: 13736 SW MISTLETOE DR Project: DEBBAN Subdivision: HILLSHIRE SUMMIT NO.2 Lot: 44 Project Description: Adding(1)branch circuit for hot tub. Contractor: OWNER Owner: DEBBAN, BRENT M&DEBORAH H BRENT DEBBAN 13736 SW MISTLETOE DR 13736 SW MISTLETOE DRIVE TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 509-619-4064 PHONE: 509-619-4064 FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 05/06/2019 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 05/06/2019 $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 work is suspended for more the 180 days. ATTENTION: Oregon law requires you to foll.w the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-0 0090. You may obtai' copy of th. les or direct)--stions to OUNC by calling 503.232.1987 or 1.800.332.2344. 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 Applicatio ; t FOR OFFICE USE ONLv City g ofTigard 2U19 Date/B :Received �I Pe i� _ MAY o Ili A 13125 SW Hall Blvd.,Tigard,OR 97223 a Plan Review Phone: 503.718.2439 Fax: 503.598.196,0,. Date/B : Related Permit#:Inspection Line: 503.639.4175 ,1`'�; :til il Ready Date/By: Juris: ® See Page 2 for TIGARD Internet: www.tigard-or.gov '''"'' € - 9 i'.. •:,_u(l Notified/Method: Supplemental Information F �i il}iP z 4 ie� _« i 1 .as,,..r ice' rl ,i 4 n°5 ( �G �P ,I. t"� ' � EtA7�tii �w. ,_, r��*-�. __ �.[✓ i�;A�� r-.': E utii .,,',n .�. ,.. �4t�i i�i �. "jam'�!flet. �!,Arci�g9��1� �,,,a„ ,-. i "is I ._._ .rtii .„aa"J 11. ❑New construction Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. o where the available fault current 0 Marinas and boatyards. 01 - i i j ' e i e' 'II 7 � ,p iW 9 '= „ , exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural ngs. ❑Multi-family 0 Master builder 0 Other: ampsireform all other installations. Inbustdlatio 0 Fire pump. ❑Installation of 150 KVA or 7 ,, ( " O }`LO pi, l ❑Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: 13i 3G S h/ M is f rc t-oe Ur. 100HP or more. ❑" ❑Six or more residential units. occupancy. City/State/ZIP: 1-39 a rc( ©R 1/7224 Recreational vehicle parks. El facilities. 0 Suite/bldg./apt.#: (Project name: DebbaN L-4-0 A- Tub 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: Ainview "`° '` DescriptionI Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: /4 i!IS 17 ire, So m rvi;..e Lot#: 5860 Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: 5800 rEa.add'l 500 sq.ft.or portion 33.92 1 ........ ,!! 1 ::',!-2-W1;1"_atri ....... t r.° ...,.., ,Ji, Limited energy,residential E r � (with above sq.ft.) 75.00 2 l C ct r i c Q( cv r- new 1 CL ft)b Limited energy,multi-family 75.00 2 residential(with above sq.ft.) �, �,n . Renewable Energy 0 See Page 2 yi 1*I2Q ' at ,: © � a Services or feeders installation,alteration,and/or relocation Name: B re.yt,,It "De.b1Dc to 200 amps or less 100.70 2 Address: t.31 3(4, Sin) M i S 4-IL e_ P r. 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: Ti er ret , 0 . 91722-q 601 amps to 1,000 amps 301.04 2 Phone:(50e7 ) 611- LNG,4 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: bck 3Jc b€3rnai(. Com 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 r exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: She/1 q 401 amps to 599 amps 168.54 2 .i.s,'°, :i ' M3 r °r h t _ L -, -• :E 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: Bre yi,A- "Debi)a tr%. B.Fee for branch circuits without Address: 1357 3 6 S yJ M i S t l-e IT t, D r service or feeder fee,first 1 56.18 2 , branch circuit City/State/ZIP: Tl a rd O iz ejt7z24 Each add'l branch circuit 7.42 2 9 ( 1 Miscellaneous(service or feeder not included) Phone:(94 ) (019 _ 40671-1 Fax: :( ) Each manufactured or modular 67.84 2 • dwelling,service and/or feeder Email bd 3" C b .Mai I d CO)'V% Reconnect only 67.84 2 . -._; :.. " a,. kF - L,'." 5z" _ °,i. am:, Pump or irrigation circle 67.84 2 Business name: 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:( ) Fax:( ) Investigation(I 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.: speclficall listed %hr min Suprv.Electrician signature,required: Subtotal: Print name: I Date: 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): Authorized signature: TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. - * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitAppELR_ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB City of Tigard Tel: 503.718.2439 Location: Inspection Date: 13736 SW MISTLETOE DR, TIGARD, OR, 97224 Record Type: Record ID: Residential - Electrical ELC2019-00300 Inspection Type: Inspector: 199 Electrical final David Young Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor