Permit (58) CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT711
Permit#: ELC2019 00469
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439111 Date Issued: 07/10/2019
Parcel: 2S101 DB00616
Q 77_. Jurisdiction: Tigard
Site address: 13355 SW 76TH AVE
Project: NESSETH Subdivision: ROLLING HILLS Lot: 21
Project Description: Relocating meter for garage addition, replacing main electrical panel, relocating circuit for A/C unit, and adding(6)
branch circuits. 12/5/2019: REPRINT permit to change contractor.
Contractor: BEAR ELECTRIC Owner: NESSETH,JERRY S &TRACY J
PO BOX 389 13355 SW 76TH AVE
DONALD, OR 97020 TIGARD, OR 97223
PHONE: 503-678-1355 PHONE:
FAX: 503-678-1108
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 07/10/2019 $201.40
Specifics: amps or less
6 crt Branch Circuits w/Purchase 07/10/2019 $44.52
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 07/10/2019 $29.51
Electrical
Type of Const: 45 Misc Administration Fee 12/06/2019 $45.00
Occupancy Grp:
Total $320.43
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 or 1.800.332.2344.
Issued By: _�-�j--f�,.�, ti �%' �7 Permittee Signature: 6: K `7� y��jr` r/
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 OFFICE USE ONLY
City ofTigard Received ' /,-
Date/By; /2/->' 7 7 4T' 'Permit"&`-7 /9—420 e/6,7
I. .4 13125 SW Hall Blvd.,Tigard,OR 97223
Plan Review
111 Phone: 503.718.2439 Fax: 503,598.1960 Date/By: Related Permit tit:
T I GAR D Inspection Line: 503.639.4175 Ready Date/By: furiv Iii See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
,:orilovritiongIhan,Tot toi#02:AgariT ,,:::36,::'E%O.MK:8:1ETgr".4:'1:4 !R--, :311114::i''::A;ift;:iii,4**4:::;AP:***MiralAU::
D New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans wiitems 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.
0.S.**00.044F,,00)07:00.110$41iii i!.i: 041ii:: -::!-,:41M-: [H: 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 gmund,or exceeds 14000 0 Commercial-use agricultural
amps for all other installations. buildings.
El Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 K VA or
40*.:407.0:Eit,2**14#0.14...,::*soi::140.ATtitor.:: ::;:,,i.,,E,,:30 ,,::;;',,,!0'q 0 Emergency system. larger separately derived
0 Addition of new motor load of system.
Job#: Job site address:
I 00HP Or more.
City/State/ZIP: 0 Six or more residential units. occupancy
0 health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.if: Project name: 0 hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or mom. 600 volts nominal.
Cross street/directions to job site:
1:01VIU '. ' ' 00':$0004,ti.i::;i;,!,: :::'::';:lai,::,:,ii:;::
Descriptto. i Qty. I Each I Total I .
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1.000 sq.B.or less 168.54 , 4
Tax map/parcel#:
Ea,add'l 500 sq.IT or portion , 33.92 I
01!.0.EKROTIONIOFEMPAX .i :.
.f! ':4 ii,!,43,4. :,'ii;:'''%1,g!:-.:,'.':.! Limited energy,residential
75.00 2
PiPAS? add gp...g,f-Lt-T,11 ,C1 -to pceryirT : (with above sq.It)
Limited energy,multi-family
75.00 2
2-0 I ci- 0 0 ti (499 residential(with above sq.II)
&„,„,c:, ,, ,,, ,„, Renewable Energy 0 See Page 2
C3:441.6**TV:**°:* -:::;314:11i:17W ' 'T:;'Ir'W6.-' ':'-'::31:.T Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
2
201 amps to 400 amps 133.56
Address: ,--
401 amps to 600 amps 200.34 2
City/State/ZIP:
601 amps to 1,000 amps 301.04 __2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2 Entail: 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 I
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
3 1%.1,-1,ruttANTE: !,,U5, : ,:!: wc::[1,:f.;:c::7!:i,:,E.i,E;:yea.NrAcri,::0..k.*iii,t4.:.i4,,,::::h,,,,ii: 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
Address: 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:
IReconnect only 67.84 2
04$7140T,43.-*%.,,:: ; :re; 8ti,1',:':;01iiiii:Aii& l'0!."':i Pump or irrigation circle 67.84 2
Business name: E7 Etkg 6 t,6C1X IC I tie, Sign or outline lighting 67.84 2
Address: 0 soy. 3 g ci i Signal circuit(s)or limited-energy
panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: DONN i-D 1-7 0 2-•C) Each additional inspection over allowable in any of the above
...1 Additional inspection(I hr min) 66.25/hr( 3) (jirg .--I 351-, Fax:(5-1)3) is,ig- ii ag Investigation(1 hr min)
90,00/hr
Email: 12FK4 ITS e, (2,E,Ain,„Ecrif I c. c.,),y) Industrial plant(1 hr min) 78.18/hr
Inspections tar which no fee is
90.00/hr
CCB Lie.: "7".041, 1 C Electrical Lie.: 2.11 -107c Suprv.Lic.:. :9,..s-9_..5 specifically listed(1/410 tnin)
---- ji*gtt4te:A.t.4:k.gli4:11'-0,0g.:-;!'iT'Suprv. Electrician signature,required:
Print name: c-,--kr,,z," „c),..,e,ke
, ..,_,e_. ./ ....1.,41._ ___........ Subtotal:
ate: -oct......ckin 0 Plan Review Required(25%of permit fee):
— State surcharge(12%of permit fee):
....._
Authorized signature:,, TOTAL PERMIT FEE:
,
i - This permit application expires if a permit is not obtained within ISO
•‘
Print name: kw a 1,-)4 er, Date:/...?-/3//q days after it has been accepted as complete.
i * Number of inspections allowed per permit.
1:11uilditlatIlormilaTLC_Ilor niilApp_IFIRJREdot: Rev 06/17/2015 440-461ST(I I/05/COKI/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK SCUÔULE
Fee for all residential systems combined: $75.00 Description Q . 3 Cod; I Total
Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved:
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15,01 to 25 kva 200.34 2
Wind generation systems in excess 425 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
552.26 2
with OAR 918-309-0040)
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(I hr min)
Inspections for which no fee is
90.00 hr
specifically listed(11z hr min)
COMMERCIAL.WORICONLVi, . tWpocAt mow PEES
Subtotal(Enter on Page I):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
Fl A• udio and Stereo Systems
Boiler Controls
E Clock Systems
[1:1 Data Telecommunication Installation
—1 Fire Alarm Installation
H• VAC
CI Instrumentation
El Intercom and Paging Systems
Ej Landscape Irrigation Control*
I— M• edical
I I Nurse Calls
U Outdoor Landscape Lighting*
U Protective Signaling
Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:',RuildineertniisTi,C2ennit App_alt_Elt E dee Rev OW1712015
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00469
T I( A R f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/10/2019
Parcel: 2S 101 DB00616
Jurisdiction: Tigard
Site address: 13355 SW 76TH AVE
Project: NESSETH Subdivision: ROLLING HILLS Lot: 21
Project Description: Relocating meter for garage addition,replacing main electrical panel,relocating circuit for A/C unit,and adding(6)
branch circuits.
Contractor: OWNER Owner: NESSETH,JERRY S&TRACY J
JERRY NESSETH 13355 SW 76TH AVE
13355 SW 76TH TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-686-0793 PHONE:
FAX:
FEES
Quantity Description Date Amount
2 ea Services or Feeders-200 07/10/2019 $201.40
Specifics: amps or less
6 crt Branch Circuits w/Purchase 07/10/2019 $44.52
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 07/10/2019 $29.51
Electrical
Type of Const:
Occupancy Grp:
Total $275.43
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: Ore.•. 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 c'' -001-0090. - ma o' .in- opy of/rules or direct questions to OUNC by calling 503.23 or 1.:%•.3: .2344.
...
Issued By: illi/V �. WA 4.! -ermiftee Signature: _f_ 4 Arr.
OWNER INSTALLATION ONLY Vy-
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 k ! .s/ �;, FOR OFFICE I SF ONI,I
.City of Tigard J U L DateB : Milir7 L,l i 'ermit ft: "00 y
" 13125 SW Hall Blvd.,Tigard,OR 97223 G Received
Plan Review
Phone: 503.718.2439 Fax: 503.598.1969-,Tyn -, 2.,..1 DateB : ji``
Inspection Line: 503.639.4175 Q, .. `' Ready Date/By: Juris: El See Page 2 for
T I G A R D g-.Li i-o':,:,L;'. r!V'i�1 Notified/Method: Supplemental Information
Internet: Line:www.tigard-or.govpp
. . .1:14'..k-PF*ORI ' . ,. PI,AN"'.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.
❑Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
CATEGORY OF,CONSTRUCTION STRUCTION'' exceeds 10,000 amps at 150 volts or 0 Floating buildings.
® 1-and 2-family dwelling 0 Commercial/industrial ❑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
TOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address:13355 SW 76th Avenue
100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP:Tigard,OR 97223 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name:Nesseth Electric Panel 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:SW Varns Street. FEE SCHEDULE
Description I Qty. 1 Each I Total
New residential single-or multi-family dwelling unit.
Subdivision:Rolling Hills Lot#:21 Includes attached garage.
Tax map/parcel#:2S101DB00616 1,000 sq.ft.or less 168.54 168.54 4
Ea.add'!500 sq.ft.or portion 33.92 1
DESCRIPTIONWORN :, y Limited energy,residential
Relocate Meter for garage addition.Replace Main Electric Panne!
(with above sq.ft.) 75.00 2
Limited energy,multi-family 75.00 2
New circuits for garage addition.Relocate circuit for AC Unit residential(with above sq.ft.)
Renewable Energy 0 See Page 2
P1tOPERTY:OWNER . ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name:Jerry Nesseth 200 amps or less 100.70 100.70 2
Address: 13355 SW 76th Avenue 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97223 601 amps to 1,000 amps 301.04 2
Phone:(503)686-0793 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: relocation
Owner installation:This installatis is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,le. - - r o S_•___according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner sign. .t-. Date: –7//0// , 401 amps to 599 amps 168.54 2
4e®- Branch circuits–new,alteration,or extension,per panel
�" �� � "PEaI A.Fee for branch circuits with
Business nn e: above service or feeder fee, 7 42 44.52 2
each branch circuit
Contact name:Jerry Nesseth B.Fee for branch circuits without
serAddress: 13355 SW 76th Ave branchce i feederstfee,first 56.18 2
branch circuit
City/State/ZIP:Tigard,OR 97223 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)686-0793 Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:jerry@oregonadventures.org Reconnect only 67.84 2
co ., . .. Pump or irrigation circle 67.84 2
Business name: t>(,ipt,r Sign or outline lighting — -- 67.84 –/--
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(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: ,,,,specifically listed(%2 hr min)
Suprv.Electrician signature,required: Subtotal: 313.76
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 37.65
Authorized signature: TOTAL PERMIT FEE: 351.41
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_PermitApp ELR ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESMENTIAL WOE ONLY,
FEE sc aH t uLl DeEach
Fee for all residential systems combined: $75.00 sC Qty• I I Total I =
3' Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70
5.01 to 15 kva 133.56 2 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 lova(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ 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
specifically listed(Y:hr min)
� T rte vas
COMMERCIAL WORK.ONLY:; Subtotal(Enter on Page 1).
Fee for each commercial system: $75.00
(SEE OAR 918-309-0000) ' Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
Fl Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015