Permit (79) CITY OF TIGARD ELECTRICAL PERMIT
74 .
r,
is COMMUNITY DEVELOPMENT Permit#: ELC2019-00356
!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/28/2019
T'
Parcel: 1S134CB12100
Jurisdiction: Tigard
Site address: 12149 SW MILLVIEW CT
Project: Reconnect only Subdivision: MILL VIEW Lot: 21
Project Description: Reconnect only.
Contractor: Owner: ATIGH, FARID
12149 SW MILLVIEW CT
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Reconnect Only 05/28/2019 $67.84
Specifics: 1 ea 12%State Surcharge- 05/28/2019 $8.14
Electrical
Type of Use: SF
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 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. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or1.800.332.2344.
Issued By: �' Permittee Signature: JE1— et--?' LAC KI\CC\
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.
I # `�
Electrical Permit Application FOR OFFICE USE ONLY
City of Tigard MAY 8 �� 9Received j _
Date/By: �J 1 Permit#:� „ 1��_(N�
.� 13125 SW Hall Blvd..Tigard.OR 97223 • e ""���
* Review
'" Phone: 503.718.2439 Fax: 503.598.1960 CIT OF � r Related Permit#:
a: /By:
TIGARD Inspection Line: 503.639.4175 BUILDING fI!/i 1-a"17 Loris: 0 See Page 2 for
Internet: www.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).
0 Service or feeder 400 amps or more 0 Building over three stories.
❑ Demolition1.:RtOther: where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRICTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
ElI-and 2-family dwelling ❑Commercial/industrial CIAccessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑ Multi-family ❑ Master builder v Other:
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION ANDLOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system
Job#: Job site address: J 1I49 5� MOlvi ei,Cii-
1 I OOHP or more. ❑"A","E","I-2","I-3-',
City/State/ZIP: t'1 1 ❑Sixormoreresidentialunits. occupancy.
I Dv, 002.2,5 0./�5 ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:fitod, r� ,CI ��r (k ❑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:f 14min�,,,,�P}-��p ' FEE SCHEDULE
1 LY Description I Qty. I Each I Total 1 *
_IV;(1 DmL p 5k ' eh Al,/h4 New residential single-or multi-family dwelling unit.
Subdivision: /V ') 4 .�/)ff.f.-) Lot#: I Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
1 S 137 L.b4/t'�ton /4tx �d# R1�1(pSl oy Ea.add'I 500 sq.ft.or portion 33.92 I
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: Ofd e( ._ 200 amps or less 100.70 2
Ate: 1‘ ' 201 amps to 400 amps 133.56 2
a S5 _ �.�' /h i 7,-t 401 amps to 600 amps 200.34 2
City/State/ZIP:�d 12.4,2 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
1 Temporaryrelocation services or feeders installation,alteration,and/or
frrnail:CAcL
bena r.�,rolt , r {i + .o�1wner installation. This installation is being made on property at I own which is not 200 amps or less 59.36ntended for sale. leas x�nt-or exchange, cording to ORS 447.449,670,and 701. 201 amps to 400 amps 125.08 2
O}Ytitl signature. � Canriv-r 'Hate: 401 amps to 599 amps 168.54 2
A PLICANT 4 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
1 t each branch circuit 7.42 2
Contact name:eA� n mi -� /��:. be 1/ B.Fee for branch circuits without
5 �1 service or feeder fee,first
Address: Ben adaroliyn Campbell
�' branch circuit 56.18 2
City/State/ZIP: � �834 Each add'1 branch circuit 7.42 2
i Miscellaneous(service or feeder not included)
Phone:( ) 16420 S McGi1ii? :Skite 103 3 &'/ '7� Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Vancouver, WA 986833461 Reconnect only 67.84 (b7 iti 2
CONTRACTOR
Pump or irrigation circle 67.84 2
Rttcinvc. s-pa ie: l
4 (,QSS Cm� e�✓1,14 ��1,t.,,t .5,),,Q,�� , 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:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Email: Industrial plant(1 hr min) 78.18/hr
I
Inspections for which no fee is
CCB Lic.: 1 Electrical Lie.: Suprv. Lie.: specifically listed(1/4hr min) 90.00/hr
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal: to).?Li
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): ` '.)4
Authorized signature: TOTAL PERMIT FEE: 5
47
This permit application expires if a permit is not obtained within 180
Prttlin3tnr' Date: .Lays aftr.;tints been accepted-as complete.
* Number of inspections allowed per permit.
iABuilding APermits\ELC Pe]nitApp ELR_FRE.doe Rev 06/17/2015 440-4615101/05/COM/WEB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12149 SW MILLVIEW CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2019-00356
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor