Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2020-00070
T f G ARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/04/2020
Parcel: 2S114BB20800
Jurisdiction: Tigard
Site address: 10285 SW KENT CT
Project: Berube Subdivision: RIVERVIEW ESTATES NO.2 Lot: 52
Project Description: (3)branch circuits for switches,lighting and GFI in bathroom.
Contractor: ABS ELECTRIC LLC Owner: BERUBE, JONATHAN &ALYSHA
752 DIVISION ST 10285 SW KENT CT
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503-888-7676 PHONE:
FAX: 503-257-6168
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 02/04/2020 $71.02
Specifics: Service or Feeder
1 ea 12%State Surcharge- 02/04/2020 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
Required Items and Reports(Conditions)
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spe .4ty Codes and all othe pplicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days I issuance, or if work s suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notifi tion Center. Tho e 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 ca ' 32.1987 or 1.800 3 . 44.
Issued By: ��� y�f-t ---T"`L- Permittee Signature: ; iii ` (\
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 FOR OFFICE USE ONLY
City of Tigard FER 4 2020 Date/By:•4 t/, 4 Permit lgic.2c-/.Q 661O'7 D
;1 - 14 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 I1 Y OF TIGARD Date/By: Related Permit#:
Inspection Line: 503.639.4175 • l ll1_.DING DIVISION Ready Date/By: Juris: El See Page 2 for
TIGARD, Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN 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 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 El Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
4t-/
y amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
aZi l- c]- ❑Addition of new motor load of system.
t�✓ S �`J Job#: Job site address: looxP or more. ❑
''j ❑Six or more residential units. occupancy.
City/State/ZIP:
7_/ cNA ,,, f � / Z? El Health-carefacilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑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'1500 sq.ft.or portion 33.92 1
DESCRIPT ON OF WORK Limited energy,residential
A �� - (with above sq.ft.) 75.00 2
��i/(re Stu/C1K''� rNl Can-/'/ROI 1 J� A,-,)- Limited energy,multi-family
1 % [�cJ�. Eft tJ /1• • / / 4 13 residential(with above sq.ft.) 75.00 2
b G,,(��'1 (� �.1�llt L ' Renewable •
Energy ❑ See Page 2
ROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: &-12.t tIS 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:( ) 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 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
❑ APPLICANT 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 1 56.18 2
Address: branch circuit
City/State/ZIP: Each add'I branch circuit Z 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
. 4- # s; it :r ;! , ,. Pump or irrigation circle 67.84 2
Business name: -�j p_ � / Sign or outline lighting 67.84 2
1/4-1 ,
' `-� �-fi L Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: 7c�- ; Sty ^� panel,alteration,or extension.
City/State/ZIP: Q C ) 7O fs z.
Each additional inspection over allowable in any of the above
v ( Additional inspection(1 hr min) 66.25/hr
Phone:( 3, ;,� '�7z7h Fax:( ) Investigation(1 hr min) 66.25/hr
ail: ) e tlU. Cr), Industrial sp forant which hr no) 78.18/hr
C , / Inspections for no fee is
CCB Lie.:l5-gg 7 Electrical L /2, 'c Suprv.Lit,/„j0 specifically listed(Y2 hr min) 90.00/hr
PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 7/, 0_2_
Print name: r' 1e LI ' Date: ❑Plan Review Required(25%of permit fee):
' I State surcharge(12%of permit fee): ?', $ -
TOTAL PERMIT FEE: `.�
Authorized '_nature:'-., IVY — � ��� S 7
This permit application expires if a permit is not obtained within 180
Print name: w�!:, t)/ i'7,, i days after it has been accepted as complete.
* Number of inspections allowed per permit.
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 Descriptian Q�. Each Total
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
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n Other: Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000) •
•
Check Type of Work Involved:
❑ Audio and Stereo Systems
LI Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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