Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: ELC2011 -00357
TIGARD 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
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Parcel: 2S110CB10200
Jurisdiction: TIGARD
Site address: 15408 SW ARLINGTON TER
Project: Arlington Heights No. 3, Lot 90 Subdivision: ARLINGTON HEIGHTS NO. 3 Lot: 90
Project Description: Install solar photovoltaic system.
Contractor: LAUGHLIN ELECTRIC LLC Owner: TIMBERLAND HOMES INC
3 MONROE PARKWAY STE P PMB205 12670 SW 68TH AVE #300
LAKE OSWEGO, OR 97035 TIGARD, OR 97223
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PHONE: 503 - 620 -8860
HONE: 503 - 449 -7389
FAX: 503 - 639 -0077
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 06/28/2011 $100.70
Specifics: amps or less
1 crt Branch Circuits w /Purchase 06/28/2011 $7.42
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12% State Surcharge - 06/28/2011 $12.97
Electrical
Type of Const: 108 Investigation Fee (Equals 06/30/2011 $108.12
Occupancy Grp: Permit Fee)
13 ea Investigation 12% Surcharge 06/30/2011 $12.97
Total $242.18
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 (); You may obtain a cop e rules or direct questions to OUNC by calling 503.232.1987 or 8I 32.2344.
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Issued By: r - Permittee Signature: 1 0121 ' I '
- A01
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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.
' lectrical Permit Application RECEI E . FOR OFFICE USE ONLY
111 City of Tigard JU 2 $ Re Date /By: (P Ad ceived %- // �`�=OK
q 0 PermitN i/A -e0 5,5-7 13125 SW Hall Blvd., Tigard, OR 97223 201 i
g Plan Review (l
17 Ph one: 5 03.718.2439 Fax: 503.598. T L O 20 ft o Other Permit 61�`fr 7�
196 O F I Date /By:
1 _ I A R l� Inspection Line: 503.639.4175 l � f i 1.lryi'1 {,� Date Ready /By: o tuns: 10 See Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified /Method:li 4 / Supplemental Information
TYPE OF WORK d ,�-n/ tT S PLAN REVIEW
® New construction ❑ Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ 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 ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
® i - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor lgad of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: k --4Os 5J O � t���n 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 'J1-. (,- Doi.0.) t 0 . 9 27-3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description ' I Qty. I Fee. I Total i *
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: q 0 1,000 sq. ft. or less 168.54 4
Ea. add'I 500 sq. ft. or portion 33.92 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi- family 75.00 2
Photovoltaic installation residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less X 100.70 100.70 2 /
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 133.56 2
Nme: °T'1 yA( �,(„ (cps S l 10\e— , 401 amps to 1, 0 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Address: ("2,1/1 d 7,1... (4.13'E" C ik3O0 Over 1,000 amps or volts 552.26 2
City/State /ZIP: 1--1(7 01 (7a. g'"? 7 2 3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (' l 8eao Fax: ( ) 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Owner installation: This installation is being made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 168.54 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with /
® APPLICANT ' ❑ CONTACT PERSON above service or feeder fee X 7 42 7.42 2
each branch circuit
Business name: LiveLight Energy, LLC B. Fee for branch circuits without
service or feeder fee, first
Contact name: Molly Stradley branch circuit 56.18 2
Each add] branch circuit 7.42 2
Address: 1815 NW 169 Place, Suite 4020 Miscellaneous (service or feeder not included)
City/State/ZIP: Beaverton, OR 97006 Each manufactured or modular 67.84 2
dwelling, service and/or feeder
Phone: (503) 682 - 2168 Fax: : ,(503) 690 - 4399 Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
E - mail: molly@livelightenergy.com
Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s) or limited - energy
Business name: Laughlin Electric LLC panel, alteration, or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: 3 Monroe Parkway, Suite #205 Additional inspection (I hr min) 66.25/ hr
• City/State /ZIP: Lake Oswego, OR 97035 Investigation (1 hr min) 66.25/ hr
Industrial plant (I hr min) 78.18/ hr
Phone: (503 ) 449 -7389 Fax: ( ) inspections for which no fee is 90.00 / hr
specifically listed (1/4 hr min)
CCB Lic.: 165763 Electrical Lie.: C 6 Suprv. Lic.: 5097 S ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 108.12
le..... Plan review (25% of permit fee):
Print name: Grant Laughlin Date: f _ ( I L I State surcharge (12% of permit fee): 12.97
l � TOTAL PERMIT FEE: 121.09
Authorized signatu 11 r, , i f, I 1 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Molly Stradley Date: I 5/ r( • Number of inspections allowed per permit.
1: \Building \Permits \ELC- PermitApp.doc 07/01/10 440- 4615T(1 t /05 /COM /WEB