Permit (83) CITY OF TIGARD ELECTRICAL PERMIT
IN COMMUNITY DEVELOPMENT Permit#: ELC2019-00370
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/30/2019
Parcel: 1 S125DA12300
Jurisdiction: Tigard
Site address: 9108 SW 70TH AVE
Project: NJOS Subdivision: 2006-022 PARTITION PLAT Lot: 2
Project Description: Adding(4)branch circuits for patio wiring and modification of switches.
Contractor: R&D ELECTRIC INC Owner: NJOS, GAIL A
PO BOX 868 CHAUVIE, SUSAN L
MULINO, OR 97042 9108 SW 70TH AVE
PORTLAND, OR 97223
PHONE: 503-679-7987 PHONE:
FAX:
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 05/30/2019 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/30/2019 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
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 ou to follow the rules adopted by the Oregon Utility Notification C nter. Those rules are set forth in OAR
952-001-0010 through OAR= -001-0 . Yo ay obtain py of the rules or direct questions to OUNC by calling 3.232.1 7 or 1. 00.332.2344.
Issued By: 1/(.t54 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.
P Fr 77-7',1,i C:n
Electrical Permit Application' "—'''- '''-- '' ——1 FOR ou u l( F I. I1 0\1 l
City of Tigard NIM 2 9 2019 Received A P9
Date/B : - AWAITA&lir''Ai sillEriliMill_AL OP
, Il 13125 SW Hall Blvd.,Tigard,OR 97223
1,1Plan Revie., "
#:Ill Phone: 503.718.2439 (S., , . .",li.:' Date/B : Related Permit
I -I I(._,A RD Email: TigardBuildingPennits@Tigard-ailioY ,, ,'T.; t,i,.;,„-_,,,."._)!''I Ready Date/By: kris: lZI See Page 2 for
Inspection Line: 503.639.4175 Internet: www.tigard-or.gov Notified/Method: Supplemental Information
t
"
TYPE OF WORK PLAN REVIEW
, 0 New construction 1116Addition/alteration/replacement 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.
_._
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION 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 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION El Emergency system. larger separately derived
0 Addition of new motor load of
Job#: Job site address:9 c,<F, 5 to -r..)-iett. At...„
100HP or more. system.
El Six or more residential units. occupancy.
City/State/ZIP: --t-C,-- -(231„. ct7 V--2_ 0 Health-care facilities. 0 Recreational vehicle 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: FEE SCHEDULE
Description I QV. 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'l 500 sq.ft.or portion 33.92 1
• DESCRIPTION OF WORK Limited energy,residential
75.00 2
(
(with above sq.ft.)te•-c-k-i-_-C.--_-3 (-9-')l"4:'1.`,1 ,e m.. "i;: c)0_ VO•f_Li A'\-.4 . / Limited energy,multi-family
residential(with above sq.ft.)
Renewable Energy 75.00
Page 2
2
J El See
0 PROPER OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: K)• :ITC.--.) S 200 amps or less 100.70 2
Address: C -
‘ LI (..sz..) .7 c....)• t-•( • 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: -- s•:-
k C-1. '....A (5( Cr?D_-2,3 601 amps to 1,000 amps 301.04 2
Phone:(SC:..,5) --3 I `--C, -a-- 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
0 APPLICANT 0 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
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 1
56.18 D k... 2
Address: branch circuit
City/State/ZIP: Each add'l branch circuit 37.42 2.4
Ava 2
Miscellaneous(service or feeder not included)
Phone:( ) Each manufactured or modular
67.84 2
dwelling,service and/or feeder
Email: Reconnect only 67.84 2
Pump or iedgation circle 67.84 2,
Business name: ,..v. Ete ..‘--,---r_ 71-,-0-', c...._ Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: \ 0
-- i43 C3 t.,,,,. c).--7-b--t-t- tk-k3 Q_
_ panel,alteration,or extension. 0 See Page 2 2
Each additional inspection over allowable in any of the above
City/State/ZIP.:T ce,c.......4-- (3 ....__ ct-7 D......7._ Additional inspection(1 hr mm ) 66.25/hr
Phone:6-.),.3 ) 6*I(_-7 eA,4 -1 Investigation(1 hr mm ) 90.00/hr
Industrial plant(1 hr mm ) 78.18/hr
Email: 14t-Np ,,
Inspections for which no fee is
90.00/hr
CCB Lie.% 3A411/ Electrical Lic.‹....7.,3•ct Suprv.Lie...53_517S specifically listed('A hr min)
ELECTRICAL PERMIT
Suprv.Electrician signature,required: S. ...__..... ....s.42A-
"----A"-‘2..'-' -)e^-4 - -------
Subtotal:
FEES
Print namekkcloez-- ....zAz-. ‘5, .,j,,..., Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signatur : TOTAL PERMIT FEE:
Print name: -.'
S e/Lyr D
ate:b ----3c_,- k. et This permit application expires if a permit is not obtained within 180
days alter It has been acceptea as complete.
* Number of inspections allowed per permit.
440-4615T(11/05/COM/WEB
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 10/26/2017
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL 'L� systemssidential combined:
$75.00 Description. Qty. Each Total
Fee 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 66.25/hr 1
charged at an hourly(1 hr min) _
Inspections for which no fee is 90.00/hr
specs ica 'h Y listed hr min
CO 1 WORK� �'*. . ��� � m ELE.t „_. iCAY, PERMIT:FICs;
'v
a ' u.
Fee for each commercial system: $75.0 Subtotal(Enter on Page 1):* 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
fl 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_PermitApp_ELR_ERE.doc Rev 10/26/2017
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
9108 SW 70TH AVE, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2019-00370
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor