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Permit (58) IN CITY OF TIGARD ELECTRICAL PERMIT ' I • ' COMMUNITY DEVELOPMENT Permit#: ELC2019-00389 T I(;A R 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/10/2019 Parcel: 2S103DC06100 Jurisdiction: Tigard Site address: 11205 SW FAIRHAVEN ST Project: Michael Kosmala Subdivision: EXODUS Lot: 2 Project Description: Installing(1)200 amp service panel and(1)branch circuit. Contractor: POWER PLUS ELECTRIC LLC Owner: KOSMALA, MICHAEL W&SUSAN S 17675 SW FARMINGTON ROAD 256 11205 SW FAIRHAVEN ST ALOHA, OR 97007 TIGARD, OR 97223 PHONE: 971-808-9038 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 06/10/2019 $100.70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 06/10/2019 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 06/10/2019 $12.97 Electrical Type of Const: Occupancy Grp: Total $121.09 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 9 01-0090. You ;S obtain a copy•f the rules•r direct questions to OUNC by calling 503. 2.19 or 1.800. 2.2344. Issued By: i.>/ _ nL. ii AC/AAA%'� 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 { i OR 01 1 1( 1 I 'I: 0\I.1 City of Tigard Received 13125 SW Hall Blvd.,Tigard,OR 97223 . L. IN i I 0 —; Date/B : a q kit,rill Plan Review III Phone: 503.7182439 Date/B : Related Permit#: Email: TigardBuildingPern its@Tigard-or gov Ready Date/By: Juris: ® See Page 2 for TI G A R D Inspection Line: 503.639.4175 Intemet,_www,tigatd or gov Notified/Method: Supplemental Information TYPE OF WORK PLAN REVIEW 0 New construction ( ddition/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 ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. 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 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived 0 Addition of new motor load of system. Job#: Job site address:112 05\4;14 i "( 14ta,Ve-rist loop or more. ❑"A","E","t-2","t-3", City/State/ZIP: rt 17 Z Z 3 0 Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:I,h ca.,L 1<0 5 Yhq�[it 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: FEE SCHEDULE Description I Qty. 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'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 fa,,c,v-sQ-r v 4 . . Pa y.,.2-La g.. (with above sq.ft.) K� Limited energy,multi-family 75.00 2 residential(with above sq.ft.) PROPERTY OWNER 0TENANT Renewable Energy 0 See Page 2 JServices or feeders installation alteration,and/or relocation Name:AA` Q iZ & L Kos s Q,4, 200 amps or less I 100.70 2 Address:)I ZOO.. .sv LA.J Fa;F H .veiSi—. 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP: rill c ro ©fc 601 amps to 1,000 amps 301.04 2 Phone:(s tL t -'6 Su-- 7 z./ 1,000 amps or volts 552.26 2 Email: r 1 Gh a Q L & ..0( ivy! 0 tro w.P♦G.0 m Temporary services or feeders installation,alteration,and/or 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 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: poi.4.( 9 t t.t.s .Q.s!i j G above service or feeder fee, /'ry, each branch circuit 7.42 2 Contact name:�. 1 L+�x� 1D Q-- B.Fee for branch circuits without ' 'f �A D A ,f--/ service or feeder fee,first Address:l 7�j 7.,s� s`Vv` Q Ih. /�\ 6 branch circuit 56.18 2 City/State/ZIP:hi 0/1/711 / al2, 17 Q a 7 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(40.. .3)3 &07 Y Each manufactured or modular 67.84 2 1-6)-4-1 K p e�r Go y� dwelling,service and/or feeder Email:�fQ,1'� Q 'I` Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 1 Business name: pc,,„..., /044,,...‘ e 6.Q.C.71`r',c t: Sign or outline lighting 67.84 2 Address:)lb 7...1-- S, (Ai F.1/4.1 f^.<4� /4, IK .f ,;�6 Signal circuit(s)or limited-energy 0 See Page 2 2 .J rr, ��""""lll panel,alteration,or extension. City/State/ZIP: ,44.Co/1 Q1 1 7 OC7 7 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:*P03 3y' /�CS 7 y Investigation(1 hr min) 90.00/hr Email:6 1(Q,t^ 1 L.i?,e, p/da(i,co rK Industrial plant(1 hr min) 78.18/hr `� t172-711:24 Inspections for which no fee is CCB Lic.2 09 17 0 Electrical Lie.'�.�. _ p c�3 4-...s- specifically listed '/V.hr min) 90.00/hr �n •u rv.Lic2-3 Pe Y ( ELECTRICAL PERMIT FEES Suprv.Electrician signature,r��eq��ui//red � / Subtotal: Print name:Peck A. W o l iQ, , Date:6-(0-I? 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: Dato: drys after it has bees accepted as eemplctc. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitAppELR_ERE.doc Rev 10/26/2017 440-4615T(I1/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: !!JJ; Se(. WD Description FEE SCHEDULE Each I Total I * Fee for all residential systems combined: $75.00 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 n 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 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/hr min I a tt�•RCIAL WO i NI% .,s §: ,. rater onT FEES;# la Fee for each commercials stem: $75.00 Subtotal Enteron Page 1): 3r * Number of inspections allowed peer permit. (SEE OAR 918-309-0000) Check Type of Work Involved: TI A• udio and Stereo Systems n B• oiler Controls n Clock Systems El Data Telecommunication Installation El Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* Fl M• edical ❑ Nurse Calls n Outdoor Landscape Lighting* El Protective Signaling El Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\Building\Permits\ELC_PermitApp_ELRERE.doc Rev 10/26/2017 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11205 SW FAIRHAVEN ST, TIGARD, OR, 97223 June 20, 2019 at 2:45:43 PM Record Type: Record ID: Residential - Electrical ELC2019-00389 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor City of Tigard Tel: 503.718.2439 Location: Inspection Date: 11205 SW FAIRHAVEN ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2019-00389 Inspection Type: Inspector: 199 Electrical final David Young Result: FA I L Comments: Stopped by site, not ready for inspection. Meter main not installed. PGE to energize service as emergency reconnect per contractor as finish time for inspection will be after hours. Contractor to schedule final when complete. Violation Summary: Inspector Contractor