Permit 1111 CITY OF TIGARD 1 ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PM Permit#: ELC2013-00613
TIGARD A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2013
Ii.
Parcel: 25111 DC01500
Jurisdiction: Tigard
Site address: 15940 SW ALDERBROOK CIR
Project: Dufort Subdivision: SUMMERFIELD NO.8 Lot: 76
Project Description: Replace service panel,add(5)branch circuits. 2/23/15 Reprinted permit to show change of contractor from Neel
Electric to Dreamhouse Electric.
Contractor: DREAMHOUSE ELECTRIC LLC Owner: DUFORT, PATRICIA M
221 SW MOONRIDGE PL 15940 SW ALDERBROOK CIR
PORTLAND, OR 97225 TIGARD,OR 97224
PHONE: 503-519-6711 PHONE:
FAX: 503-648-9723
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/14/2013 $100.70
Specifics: amps or less
5 crt Branch Circuits w/Purchase 10/14/2013 $37.10
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 10/14/2013 $16.54
Electrical
Type of Const: 45 Misc Administration Fee 02/23/2015 $45.00
Occupancy Grp:
Total $199.34
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• the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: Permittee Signature: EP__
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.
e ... 23. 2015 1 : 11PM `T�j'� No. 4629 P. 3
Electrical Permit Application E��E� hilt (II I It 1, 1 '1 tl\l 1
Received
City of Tigard Date/B : Permit No.:
13125 SW Hall Blvd.,Tigard,OR 94 2 3 2015 Plan Renew
'� ' Phone: 503.718.2439 Fax: 503.59E-1960 Plan R Other Permit
` ~
T I,..,, RI, inspection Line 503.639.417ti I Y OF 1 IGARD Date Ready/13y: kris' r ® Sec Page 2 for
Internet: www.ligard-or,ov i MAified/Method: Supplemental Information
❑New construction ®Addition/altcration/replacement Please cbcck all that apply(submit 2 sets of plans wfrtems checked below)
DSc/vice or realer 400 amps or more ❑Bui(dine owe three scoria.
fl Demolition ❑Other: where the available fault current ❑Marinas and boatyards_
• CATBOORil Ov'.ct PNbI'(RII ...1x� exceeds 10.000 amps at 150 volts or 0 Floating building.
_'.. 5� a-.•:.3 ' D'f: ::'`'%:: less to ground,or e<ceedi 14,000
0 Commeaeral-use?gncuhur:d
® I-and 2-family dwelling ❑Cammcrciallindustriol ❑Accessory building amps for all other installations. buildings.
El Multi-family ❑Master builder ❑Other: OFrre Pump. ❑Installation of 150 KVAor
❑Emergency system. larger separately derived system.
JOB SIl'$ oittoR ATIUr1 AND 14C T Q .">.`; ❑Addition of any maim load of
Job no.: Job site address: 15940 SW Alderhrook Circle 1ceor or more. 1> x
❑Sia or more residential units. ❑Rearatiooal vehicle parks.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities ❑Supply voltage for more than
❑Haurdous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Dufort Update ❑Service or feeder 600 amps or more_
Cross street/directions to job site:Durham to Alderbrook Dr. Dncdptina 1 Qty. I Fee I Total i
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: _,,Lot no.: 1,000 sq.It or less 168.54 4
Ea.add'1 500 sq.Ii.or portion 33.92 1
Tax map/parcel no.:
Limited energy,residential 7500 2
DSXCRIPTION'.OI>tilt "`• 'Y-:"`' ::` (with above sq.ft.)
Limited energy,multi-family 75.00 2
Replace service panel,add S circuits • residential(with above sq.ft.)
Renewable Energy _ Q See Page 2
Services or feeders i nstall a tion,_alteration,and/or relocation
200 amps or less 100.70 2
®
PItOPIRR'1Y OWNER' ?'''.0: ,. ,'.• 201 amps to 400 amps 133.56 2
Name Patricia Dufort 4101 amps to 600 amps 200.34
Address. 15940 SW Alderbrook Circle 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:7'Igard,OR 97224 Temporary services or feeders Installation,alteration,and/or
Phone:(N/A) Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: _ Date: _ Branch clrculla-new,alteration,or extension,per panel
' '° A.Fee for branch circuits with
APPLTCA1rl1' I.:. y _'` `- ._ �. above service or fader fa,
Business name:Timberland Homes,Inc. each branch circuit 7.42 2
- B.Fee for branch circuits without
Contact name:Steve Brown service or feeder fee,lust 56.18 2
branch circuit
Address: 12670 SW 68th Ave.,Suite 300 Each add'1 branch circuit 7,42 2
City/Statel21P:'Tigard,OR 97223 Muccllancoua(service or feeder not included)
Each manufactured or modular 67.84 2
Phone:(503)620-8860 Pax::(503)598-9081 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:steve@timberlandhomes.net Pump or irrigation circle 67.84 2
' CON7ILACl'OR: • • .`f_. ,, : Sign or outline lighting 6714 2
Business name:Dreamhouse Electric LLC Signal circuit(s)or limited-energy See
- panel,alteration.or extension. Page 2 - 2
Address:221 SW Moonridge PI Each additional inspection over allowable in any of the above
Additional inspection(t hr min) 66.25/hr r
City/StateIZtP:Portland,OR 97225 Investigation(I ht min) 66.25/hr _
Phone:(503)519-6711 Fax:(503)648-9723 Industrial plant(I lu-min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 196726 Electrical Lie.: C848 �i Suety.Lie.: 45605 sQeciI 11 r listed hr min)
Suprv.Electrician signature,required: l./Vul � - all9)!� -
Subtotal
Print name. Chris Mahoney Dale: 2/23/2015 Plan review(25%of permit fee):
.- State surcharge(12%of permit fee):
Authorized signature: 04 TOTAL PERMIT FEE:
Print name: Chris Mahoney Date: 2/2,i/2015 This permit application erpira if a permit b not obtained within l80
y days alter it has been accepted as complete.
' Number of inspections allowed per permit.
1.1BuiltheePermits\ELC_PennitApp_IJ_LIte doe Rev 01131/2013 4404615T(I 1/05/COM/lVID
Feb. 23. 2015 1 : 10PM No. 0629 P. 2
Rite/
V//tr
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT p
Request for Permit Action 2.
. I 13125 SW Hall Blvd. •Tigard,Oregon 97223. 503-7 18-2439 • v1,
thuvr�I L,4xb
TO: CITY OF TIGARD OA
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits @tigard-or.gov
FROM: ❑ Owner Applicant ❑ Contractor ❑ City Staff
Check(V)one
REFUND OR Name:
INVOICE TO: (Business oe 1ndividuan 7/41./ iiii /4144461/ C•
Mailing Address: /,Z G `7 D SW (vii`fire, Su de 3tt)
City/State/Zip: /r1� ej 722 3
Phone No.: -O3 102-(9.- ' i)
PLEASE TAKE ACTION FOR THE ITEM(S)CHECKED (1):
❑ CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE(attach case fee schedule and provide explanation below),
rst REMOVE/REPLACE CONTRACTOR ON PERMIT(do not cancel permit).
Permit#: _ E U,.,Gl,2 013,'- 0l)(v /3
Site Address or Parcel#: / .S1 0 S '//b.f.6 7L Lure Li, 7-, '1 Z
Project Name: P(,l((JJ elf.UPeLLIC
Subdivision Name: Lot#:
EXPLANATION: r e f re) AIALe-iithq u..et, ',Li II 4,.
la1i1 --kejeb.
Signature: Date: /—/Z 3/l5
Print Name: j t /(,IL _
Refund Policy
I. The city's Community Development Director,Building Official or City Engineer may authorize the refund of
• Any fee which was erroneously paid or collected.
• Not more than 80/n of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 806/o of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the fonts of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
Route to Sys Admin: Date ,l )5—toy 7.. Route to Records: Date By
Refund Processed: Date By Invoice Processed: Date _ By
Permit Canceled: Date By Parcel Tag Added: Date By
I:\Building\forms\RcgPennitAction_092314.doc
Feb. 23. 2015 1 : 10PM No. 0629 P. 1
RECEIVE
n
FEB232015
T C'ITYUFTtGAkU
RLAt1TY'
S►0,
, V
.�—
HOMES INC .
12670 SW 68TH AVENUE, SUITE 300 TIGARD, OR 97223
(503) 620-8860 FAX (503) 598-9081
CCB # 141715
Fax Transmittal Cover Sheet
To: tvtt-ii ilk Date: '212-1,/l i'
Company: d-ct y e -f r:ii Fax No.
v
From: tetWic/}(ti[.. ..-- , TIMBERLAND HOMES, INC.
Rf/b � Li 2-Z �yrNi► Art-xfrtagrAgcOt -fire c
1
0
dut4tie c? i/ .d ezd.d Wu•l/�, -
is e vn� f Kul/ _the , 1 F App •
1-11144.0 .1
,..._ AzAja.,„----
This cover sheet is page 1 of 5 in this transmittal. If you do not receive all of
the pages, please call our office.
CITY OF TIGARD ELECTRICAL PERMIT
1111 12 COMMUNITY DEVELOPMENT Permit#: ELC2013-00613
T t G AR D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/14/2013
Parcel: 25111 DC01500
Jurisdiction: Tigard
Site address: 15940 SW ALDERBROOK CIR
Project: Dufort Subdivision: SUMMERFIELD NO.8 Lot: 76
Project Description: Replace service panel,add(5)branch circuits.
Contractor: NEEL ELECTRIC INC Owner: DUFORT, PATRICIA M
2931 REDFIR CT., NE 15940 SW ALDERBROOK CIR
SALEM, OR 97034 . TIGARD,OR 97224
PHONE: 503-701-6257 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 10/14/2013 $100.70
Specifics: amps or less
5 crt Branch Circuits w/Purchase 10/14/2013 $37.10
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 10/14/2013 $16.54
Electrical
Type of Const:
Occupancy Grp:
Total $154.34
Required Items and Reports(Conditions)
This ermit is issued subs- to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be one in accordance with -•.roved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
da s. ATTENTION: Oregon la -q =a you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95 -001-0010 thr.ugh OAR 952-s11 00 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 2.1'87 or ;1 I 32.2344.
Is ed y: — �p 1 f Permittee Signature: ,,,I. /
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. ` ��p
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.
ii
Electrical Permit ApplicationOCf Il 4 201 FOR OFFICE USE ONLY Q� gg
Date/B O� Permit No.; Ece /;!^
City of Tigard �q ! A� �p
III
• 13125 SW Hall Blvd.,Tigard,OR 7 :Y �S'( 0:Lc,,,,,,., r Plan Review
Phone: 503.718.2439 Fax: 50-541' $71 1 �� Date/B : Other Permit:
e�� �� -.� lr
TI G A R D Inspection Line: 503.639.4175 B Date Ready/By: Ju s: See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental information
TYPE OF WORK PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked below):
❑New construction Z Addition/alteration/replacement
❑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
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A","E","I-2","1-3",
I00HP or more. occupancy.
Job no.: Job site address: 15940 SW Alderbrook Circle ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name:Dufort Update ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:Durham to Alderbrook Dr. nesedptton I Qty. I Fee. l Total l
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
l Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
75.00 2
Replace service panel,add 5 circuits residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER I ❑ TENANT 200 amps or less I 100.70 /00.711 2
201 amps to 400 amps 13356 2
Name:Patricia Dufort 401 amps to 600 amps 200.34 2
Address:15940 SW Alderbrook Circle 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 55226 2
City/State/ZIP:Tigard,OR 97224
Temporary services or feeders installation,alteration,and/or
Phone:(N/A) Fax:( ) relocation
200 amps or less 5936 1
Owner installation;This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,leas nt, r exchang ,according to ORS 447,449,670,and 701.
r 401 amps to 599 amps 168.54 2
Owner signature: i j Date:/t// //3 Branch circuits—new,alteration,or extension,per panel
® APPLICANT • ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 5
7.42 3-7.16 2
Business name:Timberland Homes,Inc. each branch circuit
B.Fee for branch circuits without
Contact name:Steve Brown service or feeder fee,first 56.18 2
branch circuit
Address:12670 SW 68`s Ave.,Suite 300 Each add.'branch circuit 7.42 2
City/State/ZIP:Tigard,OR 97223 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84 2
Phone:(503)620-8860 Fax::(503)598-9081 dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:st eve @timberlandhomes.net Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2
Business name:Neel Electric,Inc. Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address:2931 Redfir Ct.NW Each additional inspection over allowable in any of the above
City/State/ZIP:Salem,OR 97304 Additional inspection(1 hr min) 6625/hr
Investigation(I hr min) 6625/hr
, Phone:(503)701-6257 Fax:( ) Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lie.: 194105 Electrical Lie.: C747 Suprv.Lie.: a.7�')5 specifically listed(Si hr min) 90A01 hr
i Suprv.Electrician signature,required: 1 j07/% ELECTRICAL PERMIT FEES
! Subtotal:
>
7. go
Print name: Mike Neel Date: 10/14/2013 Plan review(25%of permit fee):
" r State surcharge(12%of permit fee): 1�,Vil
Authorized signature: /1 1 � / ___,\�J TOTAL PERMIT FEE: 15y.3f,1
(
This permit application expires if a permit is not obtained within 180
Print name: Mike Neel Date: 10/14/2013 days after it has been accepted as complete.
. Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp_EtR_EREdoc Rev 0521/2013 4404615T(I 1/05/COM/WEB
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 Description I Qty. I Fee I Total I •
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
ElAlarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26 2
>100 kva(fee in accordance with 552.26 2
Heating, Ventilation and Air Conditioning
OAR 918-309-0040)
System* Solar generation systems in excess of 25 kva:
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
charged at an hourly(1 hr min) 66'25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed(2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
❑ Audio and Stereo Systems days after it has been accepted as complete.
* Number of inspections allowed per permit.
❑ 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
I:\Building\Permi ts\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15940 SW ALDERBROOK CIR, TIGARD, OR,
97224
Residential - Electrical
115 Electrical service
PASS
ELC2013-00613
Jeff Grove
Violation Summary:
Inspector Contractor