Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019-00493
TLG. R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/25/2019
Parcel: 1 S 133AC 12400
Jurisdiction: Tigard
Site address: 10860 SW HUNTINGTON AVE
Project: MCGEE Subdivision: HAWKS BEARD TOWNHOMES Lot: 42
Project Description: (1)branch circuit to connect NC unit.
Contractor: OWNER Owner: MCGEE,ANNA M
ANNA MCGEE 10860 SW HUNTINGTON AVE
10860 SW HUNTINGTON AVE TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-307-1081 PHONE: 503-307-1081
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 07/25/2019 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/25/2019 $6.74
Type of Use: SFA 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 enter. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co. • •- es or direct questions to OUNC by calling 503. 2 987 or 1.800.332.2344.
Issued By: Permittee Signature: 44�y
✓z'
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 RECEIVED roll OFF 1( 1. l S 1: ON I.I
City of Tigard Received
OR 97223 JUL 2 2019 Date/B : tri APAI !.r
111 13125 SW Hall Blvd.,Tigard,
Plan Review
= Phone: 503.718.2439 ITY OF TIGARD Date/B : Related Permit#: n 6)/ •)1 t
Email: TigardBuildingPetmits@Tigard- 9, �n�L ❑❑11,// Ready Date/By: ® See Page 2 for
TIG ARD Inspection Line: 503.639.4175 Int .�OabdW.ii�atti=bf. �" Notified/Method: IfiMil Supplemental Information
TYPE OF WORK PLAN REVIEW
❑New construction Addition/alteration/replacement Please check all that apply(submit a sets of plans w/items checked):
❑Demolition ❑Other 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
Eland 2-family dwelling 0 Commercial/industrial 0 Accessory building
Multi-family ❑Master builder ❑Other: less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: I Job site address: I(� U 60 � v`�-fiat ,U 0 Addition of new motor load of system.
� V 1 ]OOHP or more. ❑"A","E","1-2","1-3",
[� ❑Six or more residential units. occupancy.
City/State/ZIP: 1J.J �� Z ?j ,��/ " ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:iliC 64
❑Hazardous locations. 0 Supply voltage for more than
600 volts nominal.
0 Service or feeder 600 amps or more.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I *
�j �ly,'/ Li New residential single-or multi-family dwelling unit.
t 1
Subdivision: ZA1e6 r rC/ T. 1-4 . I Lot#: Includes attached garage.
1,000 sq.11.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
A/C/f J � (with ne ge st)
Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
PROPERTY OWNERRenewable Energy 0 See Page 2
0 TENANT Services or feeders installation;alteration,and/or relocation
Name: /r,A AZ.-e--.• 200 amps or less 100.70 2
Address: liOte7 0 vW AWL-2 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 0 '1 2'Li?�lei-74 601 amps to 1,000 amps 301.04 2
Phone:(ejl 3 1,0 '' Over 1,000 amps or volts , 552.26 2
4 -64 - � 1 Temporary services or feeders installation,alteration,and/or
t/�
Email: !`fl(fYtr‘ yry/"�z, 4 J,yv'! . relocation
Owner installation: •'s installation-it being mad on property that I own which is not 200 amps or less 59.36 1
intended for sale,1-.s-`rent,or excpge ntto ORS 447,449,6 )tn4O 1., 7y 201 amps to 400 amps 125.08 2
��j' /,� l
Owner signature Date: 401 amps to 599 amps 168.54 2
0 APPLICANT 1 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: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit 1 56.18 54, i z 2
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only „ 67.84 2
CONT CTOR Pump or irrigation circle 67.84 2
t ��..,.r.��� r _..._. _ a 1 .,_� .--. _ -i .A -4-- ,-:a --s .._
til'Sfilegg name CXAArsSign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: panel,alteration,or extension. ❑ 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:( ) Investigation(1 hr min) 90.00/hr
Email:
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: l Electrical Lic.: I Suprv.Lic.: specifically listed('V hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: .5—C ,/D
—
Print name: Date: 0 Plan Review Required(25%of permit fee): —
�n I�'A'''',(J/,/ State surcharge(12%of permit fee): (.2_�7t]y
Authorized signature: ( ',t,r.A /I ` (� v" " - TOTAL PERMIT FEE: -/� � f This permit application expires if a permit is not obtained within 180
Print name: NIY �1u Date��25/1 days after it has been accepted as complete.
Datil
111 * Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
FEE SCHEDULE ,
.. '"
Description I Qty. I 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:
n 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 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/hr min)
WORK
�, �ONLY: 1 .'. � ELECTRICAL PERMIT FEES±
Fee for each commercial system: $75 00 Subtotal(Enter on Page 1):
3' * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n A• udio and Stereo Systems
❑ Boiler Controls
Fl C• lock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑
Instrumentation
❑ Intercom and Paging Systems
n 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_ELRERE.doc Rev 10/26/2017
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
10860 SW HUNTINGTON AVE, TIGARD,
OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2019-00493
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor