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Permit CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit #: ELC2013 -00266 'T I G AR 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 05/09/2013 Parcel: 1 S 133DD03700 Jurisdiction: Tigard Site address: 12566 SW BRIDGEVIEW CT Project: Topp Subdivision:'ILLAGE AT SUMMER LAKE PARK NO Lot: 76 Project Description: (1) branch circuit for electrical vehicle charging station Contractor: SOLARCITY CORPORATION Owner: TOPP, STEVEN W AND 6132 NE 112TH AVE LIU, SHI -YI PORTLAND, OR 97220 12566 SW BRIDGEVIEW CT TIGARD, OR 97223 PHONE: 971 - 279 -9655 PHONE 971- 285 -7374 FAX 866 - 810 -7656 FEES Quantity Description Date Amount 1 crt Branch Circuits wo /Purchase 05/09/2013 $56 18 Specifics: Service or Feeder 1 ea 12% State Surcharge - 05/09/2013 $6 74 Type of Use: SF 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 Center Those rules are set forth in OAR 952 - 001 -0010 through OA 2-001- 090 You A` may obtain a copy of the rules or direct questions to OUNC by calling 503 232.1987 or 1 800 332 2344 � Issued By: LC�tXX� hl U.1 Permittee Signature: #P/ Li ( / IO 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. To Pape 3 or 3 2013 -05 -08 16 56 40 GMT 18665922249 From Mollie Krell RECEIVED Electrical Permit Application FOR OFFI t t Sr: ONLY II City of Tigard MAY 0 8 2013 Received S 13 ° 13125 SW Hall 61vd. Ti OR 97 DatdB . gdrd Ti �D� Plan Review • Phone: 503.716.2439 Fax: 503�F 11GC11W DataB : Other Permit • c tilfn Inspection Line: 503.639.417 DIVISION Dam Bead) 'BY: lark Ea See Page 2 for Internet www.tigard or.gov Notified/Method: 1 ( (a Supplemental Information . TYPE U' WORK P4,0i 1tEVIEW ❑ New construction g Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or mere ❑ Building over three stories. ❑ Demolition ❑ Other where the mailable 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 ❑ Emergency system. larger separately derived system JOB SITE, INFORMATION AND LOCA'!'1oN 0 Addition of new motor load of ❑ "A ",' "E", "1-2", '1-3", Job no.: Job site address: 125 `' g / )6 , , , I 100/1P or more. occupancy. ❑ Six or more residential units. El Recreational vehicle parks. Cily`Stale/Z1P " /� ( ❑ Health -can facilities. ❑ Supply voltage for more than ` 1 G �t L ^L - . - 13 Hazardous locations. 6 00 volts nominal ❑ S ervice or feeder 600 amps or more. Suite/bldg. /apt. no.: J 'r ject nan)e: .� b 5 � P FEE SCHEDULE Cross street/directions to job site: Deuriptton 1 Qty. 1 Fee. 1 Total _ J_ New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. fl. or less 168.54 4 Tax ma !steel no.: Ea. add'1500 sq ft. or portion 33.92 1 map /parcel Limited energy, residential DESCRIPTION OF WORK (with above sq. fl 75.00 2 .) S C Limited energy, multi-family 2 s tQ r o , residential (with above sq. ft.) +T )T \ ` Services or feeders installation, alteration, and/or relocation C r[, { , (I U O -h A-t 700 amps or less 100.70 2 , ' '12D PROPERTY OWNER. , fff CI 'TENANT 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 Name: -1 t 601 amps to 1,000 amps 301.04 _ 2 Address: r!5 (r7(.Q Sva flGkii,o,L3 Over 1,000. amps or volts 552.26 2 ■ � llll(( � 77 Temporary services or feeders installation, alteration, and/or -- l l City /State/ZIP: kp t) 02.. ) ). 3 relocation , 200 amps or less 59.36 1 Phone: (/7( ) _ 7 9 Fax: ( ) 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 —I ® CONTACT PERSON , above service or feeder fee, 7 42 2 each branch circuit Business name: SolarCity Corporation B. Fee for branch circuits Without service or feeder fee, first s6.16 64 r fg 2 Contact name: If\A © , \ ( Vk{'-e l \ branch circuit Each add'l branch circuit 7.42 2 Address: 6132 NE 112 Ave Miscellaneous (service or feeder not included) City/State/'L1P: Portland + OR 97220 Each manufactured or modular 67.84 2 dwelling„ service and/or feeder Phone: (971) 5 Fax:: 866 &e ,2,91-11 Reconnect only 67.84 2 Pump or irrigation circle 67.84 2 E -mail: \K4-&"t- t 4P> 'g6\ tarn 1 `�- -� Sign or outline lighting 67.84 2 CONTRACI';oR 1 ., Signal circuit(s) or limited - energy Business name: SolarCity Corporation panel, alteration, or extension. Pegc 2 2 Each additional inspection over allowable In any of the above Address: 6132 NE 112'" Ave Additional inspection (1 hr min) 6625/ hr City/State/ZIP: Portland, OR 97220 Investigation (I hr min) 6625/ hr Industrial plant (1 hr min) 78.18 / hr Phone: ( .6)f 5 '76 Fex: (866) • . , f 44 Inspections for which no fee is 90.001 hr — specifically listed (''A hr min) CCB Lie.: 180498 Electrical Li • C562 Suprv. Lie.: 5201S „ ELECTRICAL• PERMIT FEES ' , Suprv. Electrician signature, required: , fee): #.. i 2 ` /.�� Plan review (25% of permit fee): Print name: Derek Cropp 4 Date: State surcharge (12% of permit fat): 0 jam' l TOTAL PERMIT FEE: (p a . 1?--- Authorized signature, Q �(-f41 I , This permit application eeplres if a permit Is not obtained within 180 days after it has been accepted as complete. Print name 0 / . - op - Date: ii )Q 13 a Number of inspections allowed per permit. 1. amraing Permits ELt rermnApp noc U 440.4615T(11 05 COM WEB To I°ago 1 of 3 2013 -05 -08 18 55 40 GMT 18885922249 Flom Molly Krell FAX COVER SHEET TO COMPANY FAX NUMBER 15035981960 FROM Mollie KreII DATE 2013 -05 -08 16:55:06 GMT +00:00 RE Steven Topp, Electical permit and CC AUTH. COVER MESSAGE Sincerely, Mollie Mollie Krell I Permit & Inspections Coordinator I SolarCity I T: 971-201-5278 I mkrell@ solarcity. com <mailto:mkrell @soiarcity.com> I www.solarcity.com WWW EFAX COM