Permit (21) CITY OF TIGARD ELECTRICAL PERMIT
111 . '> COMMUNITY DEVELOPMENT Permit#: ELC2019-00377
Date Issued: 06/06/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S110BA05200
Jurisdiction: Tigard
Site address: 11755 SW WILDWOOD ST
Project: Jaeger Subdivision: SHADOW HILLS Lot: 13
Project Description: Adding(1)branch circuit to reconnect AC.
Contractor: LEONARD ELECTRIC INC Owner: JAEGER, JULIE&STEVEN
PO BOX 411 11755 SW WILDWOOD ST
HUBBARD, OR 97032 TIGARD, OR 97224
PHONE: 971-570-8103 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 06/06/2019 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/06/2019 $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 follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through O 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.50
Issued By: �'��— Permittee Signature: �,E-V--- \C—\T\ .
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 FOR 01111 l: l 'E oy l_v
City of Tigard Received
I Permit# _
Date/B 4t' E.V.r�JI:A\ C:pS
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
a Phone: 503.718.2439 Fax: 503.598.1960 (� Date/B : Related Permit#'(Y�rG-(jam jy,�i
T I c i n R D Inspection Line: 503.639.4175 R EC E IV E I Ready Date/By: Juris: El See Page 2 for
Internet: www.tigard-or.gov v Notified/Method: Supplemental Information
TYPE OF WORKJUN .. 5 9019 PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 1 sets of plans w/items checked):
❑Demolition ❑Other: CITY OF TIGARD 0 Service or feeder 400 amps or more 0 Building over three stories.
'''' nn''��((;;DIVISION where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONmitk4 OR exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 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 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: I Job site address: 11755 SW Wildwood St ❑Addition of new motor load of system.
100HP or more. ❑«A„ «E>, a l_2,>,«i_3„
City/State/ZIP:Portland OR 97224 0 Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Hazardouslocations. 0 Supply voltage for more than
Suite/bldg./apt.#: Project name: )06... Q.„ ❑
❑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: I Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Reconect A/C
with above ft.) 75.00 2
Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy 0 See Page 2
0 TENANT
0 PROPERTY OWNERServices or feeders installation,alteration,and/or relocation
Name: 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:( ) I 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 l
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 I 0 CONTACT PERSON 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: 13.Fee for branch circuits without
Address: service or feeder fee,first 1 56 18 56.18 2
branch circuit
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) 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:Leonard Electric Inc. Sign or outline lighting 67.84 2
Address:PO Box 411 Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Hubbard OR 97032 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(971)570-8103 Fax:(503)981-2343 estigation(1 hr min) 90.00/hr
Email:leonardelectricinc®gmail.com ndustlral plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.001 hr
CCB Lic.: 218984 Electrical Lic.: C1348 Su .Lic.• 5S specifically listed CA hr min)
..o ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ,� ,;, Subtotal: 56.18
Print name: Keith Leonard Date: 6/5/2019 `f, 0 Plan Review Required(25%of permit fee):
0 State surcharge(12%of permit fee): 6.75
Authorized signature: TOTAL PERMIT FEE: 62.93
This permit application expires if a permit is not obtained within 180
Print name. date• dar afl.r it h..haan accepted aQ cempl.tik
' Number of inspections allowed per permit.
1.\Building\Permits\ELC_PermitApp ELR_ERE.doe Rev 06/17/2015 440-46151(11/05/COM/WEB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
11755 SW WILDWOOD ST, TIGARD, OR, 97224 June 14, 2019 at 11 :22:43 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00377
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor