Permit (99) CITY OF TIGARD ELECTRICAL PERMIT
111COMMUNITY DEVELOPMENT Permit#: ELC2019 00577
Date Issued: 09/03/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111CC11800
Jurisdiction: Tigard
Site address: 10445 SW HIGHLAND DR
Project: Steele Living Trust Subdivision: SUMMERFIELD NO.4 Lot: 169
Project Description: (1)sub panel and(6)branch circuits for a 315 sq.ft.accessory structure.
Contractor: OWNER Owner: STEELE LIVING TRUST
ROBERT&JOAN STEELE/STEELE LIVING BY STEELE, ROBERT L&JOAN M TRS
TRUST 10445 SW HIGHLAND DR
10445 SW HIGHLAND DRIVE TIGARD, OR 97224
TIGARD, OR 97224
PHONE:
PHONE: 503-849-1768
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 09/03/2019 $100.70
Specifics: amps or less
6 crt Branch Circuits w/Purchase 09/03/2019 $44.52
Type of Use: SF Serviceoor Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 09/03/2019 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
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
95.2-001-0010 throu•h OAR 952-001-0090. You may obtai - opy of :rules or direct questions to OUNC by calling ajar or,.800/3 .', 4.
Permittee Si nature:
Issued By: �i_«_ ... �..��• g �
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 ONLI
City of Tigard \, Date/B cICEIIIMEEPAMMI
u 13125 SW Hall Blvd.,Tigard,OR 97223 "plan Review "'
' 2 Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#: ..5z-; lite._et,/ >,
Inspection Line: 503.639.4175 SEP 3 2019 Ready Date/By: H See Page 2 for
k li
Internet: www.tigard-or.gov Notified/Method: M Supplemental Information
CITY OF TIGARD
TYPE OF WO \/ ION' PLAN REVIEW
U ID I r,G I� Please check all that apply(submit 2 sets of plans w/items checked):
0 New construction ®Addition/alteratlo rep acement
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.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
❑ 1-and 2-family dwelling ❑Commercial/industrial ®Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
o Addition of new motor load of system.
Job#: Job site address:10445 SW Highland Drive 100HP or more. ❑"A "E","l-2 "1-3",
City/State/ZIP:Tigard,OR 97224 ❑Six or more residential units. oc cr nal vehicle arks.
❑Health-care facilities. ❑ P
Suite/bldg./apt.#: Project name: ❑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:Durham Road to SW Summerfield Drive FEE SCHEDULE
SW Summerfield Drive to SW Highland Drive Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision:Summerfield No.4 Lot#:169 Includes attached garage.
Tax map/parcel#:2S111CC11800 1,000 sq.ftor less 168.54 4
Ea.add'1500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Install power feed to accessory building panel.Wire accessory building for
(with above sq.ft.) 75.00 2
Limited energy,multi-family
75.00 2
lighting,heater and two circuits of recepticles residential(with above sq.ft.)
Renewable Energy 0 See Page 2
►t PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name:Steele Living Trust,dated October 26,2009 200 amps or less I 100.70 a(T; '7D 2
Address:10445 SW Highland Drive 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP:Tigard,OR 97224 601 amps to 1,000 amps 301.04 2
Phone:(503)849-1768 Fax:( ) Over 1,000 amps or volts 55226 2
'C Temporary services or feeders installation,alteration,and/or
Email: ST 2 616-2 0 l'YI 5»w aeo,.l 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 lea i t,or+xch� .�,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: 74��. , ' A _ Date: 91 2.0/q 401 amps to 599 amps 168.54 2
APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with n
Business name: above service or feeder fee, //���
each branch circuit 7.42 %"J,,5-
2
Contact name:Robert L.Steele B.Fee for branch circuits without
sAddress:10445 SW Highland Drive braot feeder fee,first 56.18 2
g branch ce
circuit
City/State/ZIP:Tigard,OR 97224 Each add'l branch circuit _L 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)849-1768 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67'84 2
Email:steele_652@msn.com Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
_tSusmGSs uatue. — —- - __ - -- -Stgirar auttinettglittng 67:34
—
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension. g
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
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('/z hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: /ct 5'1,?
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): /7 r73
gn TOTAL PERMIT FEE: 6
Authorized si ature: /if))
This permit application expires if a permit is not obtained within 180
Print name: Robert L.Steele Date: 09/03/2019 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Pemtits\ELC_PemiiApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB