Permit (2) CITY OF TIGARD ELECTRICAL PERMIT
✓t • COMMUNITY DEVELOPMENT ELECTRICAL
ELC2020-00141
-FIG A R O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2020
T
Parcel: 1 S134BD05500
Jurisdiction: Tigard
Site address: 11550 SW GLENWOOD CT
Project: POTTRATZ Subdivision: ENGLEWOOD NO.2 Lot: 143
Project Description: Panel replacement.
Contractor: ELECTRI TECH Owner: POTTRATZ, LOUIS A&JULIA E
PO BOX 106 SCAPPOOSE 11550 SW GLENWOOD CT
SCAPPOOSE, or 97056 TIGARD, OR 97223
PHONE: 503-455-8533 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/11/2020 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 03/11/2020 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 1-0090. m ob in a co ybf tl es or direct questions to OUNC by calling 503.232.19 or 1.800.332.2344.r '
joi
Issued By: / Permittee Signature:
Ii
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 0F4ICI I NI ON IA
City of Tigard
13125 SN Wall Hhd I1gat1.ON v72_
Plan Rts,e. .- I
g Phone 503 71 S_2434 ) Hate Hs Heisted Pemut° _..—
Ernatl rigardBuild n I niutser l igmd-ot gs t r I r i , F Ready Date HN I,r'° 0 5re Page 2 fur
1 1. i t Instavum Lmc. 5-03 o7v 4175 Interim `Wheal-et- • 1 .onte'l Meth“,/ i T Supplemental inhere anew
TYPE OF WOR4ITYOFTMGAtRD ( PLAN REVIEW
❑NC*cOnstruettnn 0 Addition'alteragsWeisl dF iSr Neste heck all dui apply ttubmit I set*ofp4ns ss penis:he.iedl
0 Seni.e.,t'ceder-Ion amps or mart ❑Bmldmg .ear Imre.torro.
0 Demolition 0 Other .aloe t-e a.aitabk tauh..anus Q Mamas and M.ar)aed.
CATEGORY OF CONSTRUCTION moo. 1 toan.amps el 140 snits or 0 tkuring twtkiusgs
0 i• and_'family dwelling ❑t ommercial industrial 0 Ascesssr5 building
less Hi round.of metes N)a,rt at oinine ctabuse agricultural
amp.tare as other to tallatw.m ruttrengs
❑Multi-family 0 klaslet builder 0 Uthcr ❑rare 6.trnp 0 Irrauttatntn or 150 KVAnr
JOB SiTE INFORMATION AND LOCATION Q I-reactra.,...lent largo separately tempt
t�� ,t� CDArrdttron of MS,ma,tlu xu xr
d of item
-ash a_ �site�reSS /I ?J)4f Liti(�I Ga<o (/- I 100141,RP a more 0.h. ..I • • 1 t.
QSot or 1410re retialcartal mob rupanc
C •Stave ZIP: ' "�Y ❑Rcueans rial ehr:k parks
'�" '�'I�•b+:; t1 •�( u � 1 ❑Health care furht�
b!7►�7"' `-1 ❑Watalloue bustard 0 Surph<oluge for more than
Suitcbtdg. apt n: l kst+jalat-iuunc ���: iT/1rg�y -- ti$t.:hs rx'mrnal
_,._ ❑dais let a feeder dXi amps or mar
Cons street directions to job sire: FEE SCHEDULE
-----..----__-- n arrontw I tan. I Lada 1 tens 1 •
New reideatial dingle-or tistaliThinaily dwelling antt.
Subdisision• rot P. Includes attached garage.
1.000 sq ft m Less 164.54 4
Tas map parcel- Es atkrl 500 ha ft or portion 33.42 1
DESCRIPTION OF WORK I I imttad cncrio.residential 75 Or) 2
,�g,� frith abuse s4.ft.l
f�G µ(r:/ 4ta� _ I.maul mugs.muht-famih 'S.tY) 2
residential(ash mice s .ft.1
Renewable Emma See Page 2
❑ PROPERTY OWNER 1 ❑ TENANT Sersites or feeders insinuation,slteration,and/or relocation
,N4tne r tc { 4-144c;- 200 amps or less 1 100.70 Imo.�' '
:ilt amps 1.•4(?<i amps 1 133.56 ( '_ {
11 1
.. _.-.__...—_._L_ --__ -. —. ---_ — 401 amp,io 6+N.'r amps. fi0.3a
ltty;State LIP jit/itee, Pt- It�' ." `� ^_ 641i an pas to1�Yal amiss tl/I.IW
Phone: t T'y 1 g.�/,t� -r,.e, (her 1 1Y)4 amps ot setts 552 26 2
,2e `- `�/ M Temporal services or Emden instaiktka,alteration,and/or
Emil. T1'rl 1,6 �-) K +'tom,I'ry t""4" relocation
Owner installatioa: This installation is being made on property that I own which is not 200 amp,is less i 59.36 1
intended for.ale,lease.rtmt.or exchange.according to ORS 447.444,670.and 71)1 201 amps to 400 amps 125.05 2
Owner-agnature:____� _ Date: 401 amps to 5') amps _ 165.54 2
CAPP1l!CANT ❑ CONTACT PERSOc Branch tare°its-sear,akteruie or natation,per panel
IA Fee fee Nana circuits hair
Business name arose sera ice or feeder tee. .42
each branch circus
Contact name. H.pee fro branch circuits walrus/ II
sera arc or feeder tee.first 56 Ile
Adds: branchrcu anch cis
City -- ~ Each add'Itesnchctrcwt '.42 2
StatnZlP.
---- ---.__-- Miscellaneous(senice or feeder awl Waded)
Phone: t I Each manufactured or rnalulat 6784 '
duelling,was ride and ut keels
Email- Rmrcu t nil} 67.84
. s
CONTRACTOR Pump or inlgalwn sleek 67.S4 2
Business name' Sign or outline fighting 67 S4 2
` ❑ See Parr 2 '
— �� a___._____.._____._—_ Signal ciounrsl or limited-energy
Address. O �n a0 panel,alteration,or uthashx4
/ /9705C, Each additional Inspection over allowable la any of the above
City StateeZlP: Sc,. 05e_ / 0 R I I Arldiuonal inspectsmi t l hr mini I 4 66'5 hr
_ ---._`-- —_ ! TI
9t hr
Phone:i5c31 455-$J In.calga l I hi rem
—^
— - Industriall plant t I hr mini '8i IS,Ar
Email-
QrC } dyne C r) Q.+t CnWt, inpectitls fr..'uhwh no ter is I
I wl,Nn h,
Tall Lic 2t 3z 0 R ttccmcuie..CA2'1 62.125
ELECTRICAL PERMIT FEES
Sups.Llostnci an signature,required .�lL/ ..� _J Subtotal J /6(),70
I Print name Er i c.. god"A Q.S ! 1 Date.'3-I�- O Plan Res der Required t25°.of permit fees.
.._.__ Z. — Slate wrcharge i 12°.of permit feel. t lob-d
_ -- _-- TOTAL PERMIT FEE ;,1p2. �rt
Authontexi signatutC _ __----. Tali permtl applk.m..tapir..ira wroth h aol obtained within the
Print rare dram after Ir has here aerptrd a,compkl.
Date
.-- —_�.__..___--_____—_—.----._—�'_' ___�_�. -- -_.__ • \umtnr,LI nFpit lb.n.AN01.cd per perms
i4..a, '.. t1HIW41.
Electrical Permit Application FOR OFFICE ISI.O\l.,
Cl ofTigard Received
RECEIVED ate/B : / ,.., -_ _ „
1114 'I 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review
i Phone: 503.718.2439 Date/B : Related Permit 8:
Email: TigardBuildingPermits@Tigard-or.gs 6 Ready Date/By: ® See Page 2 for
T I G A R D Inspection Line: 503.639.4175 Internet: +1*• iiarefo. Notified/Method: WWII Supplemental Information
TYPE OF WOR�1 ITYOFF TIGARD PLAN REVIEW
❑New construction ElAddition/alteraliOy'1 8t70BiVISIQ N Please check all that apply(submit 2 sets of plans w/items checked):
['Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 I-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
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: 4/ 5i / c Wvc z„ . J�l� 100HP or more. ❑"A" "E" "1-2" "1-3"
0 Six or more residential units. occupancy.
City/State/ZIPI /// ))�� Z
`�' (yip ��Z 0 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: 11 alailine: ed ZIg tri-- ❑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 Oty. 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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
75.00 2
J (with above sq.ft.)
1ftn.17SD thL Mi Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
1 200 amps or less 1' 100.70 /a-l.'70 2
Address: ,-!it 9' tv L'z
' ciI' P Oirl 201 amps to 400 amps 133.56 t 2
401 amps to 600 amps 200.34 2
City/State/ZIP: '-'.14 40 6- 1 rL 1 601 amps to 1,000 amps 301.04 2
Phone:(•z ) 1 p,-a"�p Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:rc ef54' Age( ,pt►'t- 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 El CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: C_, _ S.
4�n1 above service or feeder fee, 7 42 2
C r�`a' each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit
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
CONTRACTOR . Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Signal Address: panel,alteration,oor extension. ❑ See Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:( ) Investigation(I 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.Liu.: specifically listed(/s hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: ic)O. 70
Print name: Date: ❑Plan Review Required(25%of permit fee): —
State surcharge(12%of permit fee): 41%_(f Y
Authorized signature: TOTAL PERMIT FEE: f/d•Z,
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.
P\BuildingTermits\ELC_PermitApp_ELR_ERE.doc Rev 10/26,2017 440-4615T(1 l/05/COMWEB
Electrical Permit Application—City of Tigard .
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Description I Qttv. I Each I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: s 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 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)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Subtotal(Enter on Page 1):
$75.00
Fee for each commercial system: * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ 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
1:Ttailding\Permits\ELC PermitApp_ELR_ERE.doc Rev 10/26/2017
CITY OF TIGARD ELECTRICAL RESTRICTED ENERGY PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2020-00141
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2020
f fCa'AIt•L7 9 Parcel: 1S134BD05500
-
Jurisdiction: Tigard
Site address: 11550 SW GLENWOOD CT
Project: POTTRATZ Subdivision: ENGLEWOOD NO.2 Lot: 143
Project Description: Panel replacement. 3/24/20:REPRINTED to add(3)branch circuits for heat pump,furnace,and tankless water
heater.
Contractor: ELECTRI TECH Owner: POTTRATZ, LOUIS A&JULIA E
PO BOX 106 SCAPPOOSE 11550 SW GLENWOOD CT
SCAPPOOSE,or 97056 TIGARD, OR 97223
PHONE: 503-455-8533 PHONE:
FAX:
FEES
Description Date Amount
Specifics: Services or Feeders-200 amps or less 03/11/2020 $100.70
12%State Surcharge-Electrical 03/11/2020 $12.08
Branch Circuits w/Purchase Service or 03/25/2020 $22.26
Type of Use: SF Feeder
Class of Work: ALT 12%State Surcharge-Electrical 03/25/2020 $2.68
Total Number of Systems:
Audio&Stereo: N
Security Alarm: N
Garage Door Opener: N
HVAC: N
Vacuum System: N
Other: N
Other Desc: Total $137.72
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 ma ob ' a roov of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.®
Issued By: Permittee Signature: V" w,/
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.
r
dormaJ
�L_cC � Hi—T�CH
March 24, 2020
Electri-Tech, Inc.
PO Box 106
Scappoose, OR 97056
Project: Electrical work at 1 1 550 SW GLENWOOD CT
Attn: Louis Pottratz
Electri-Tech Inc. has inspected the following circuits and made minor
corrections.
(1 ) Customer installed heat pump circuit
(2) Customer installed furnace circuit
(3) Customer installed tankless water heater circuit
Please add (3) branch circuits to Permit ELC2020-00141
Eric Haines
Electri-Tech Inc.
503-455-8533
CITY OF TIGARD ELECTRICAL PERMIT
•
a COMMUNITY DEVELOPMENT Permit#: ELC2020-00141
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/16/2020
TiG 4RD Parcel: 1 S134BD05500
Jurisdiction: Tigard
Site address: 11550 SW GLENWOOD CT
Project: POTTRATZ Subdivision: ENGLEWOOD NO.2 Lot: 143
Project Description: Panel replacement.
Contractor: ELECTRI TECH Owner: POTTRATZ, LOUIS A&JULIA E
PO BOX 106 SCAPPOOSE 11550 SW GLENWOOD CT
SCAPPOOSE,or 97056 TIGARD, OR 97223
PHONE: 503-455-8533 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/11/2020 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 03/11/2020 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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: ors>y , _ — 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.