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Permit o CITY OF TIGARD ELECTRICAL PERMIT f S . COMMUNITY DEVELOPMENT _" Permit#: ELC2013-00684 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/13/2013 Parcel: 25111 DB11000 Jurisdiction: Tigard Site address: 15345 SW OAKTREE LN Project: OLTEAN Subdivision: SUMMERFIELD NO.10 Lot: 598 Project Description: (5)branch circuits for kitchen remodel. Contractor: LIGHTING ELECTRIC LLC Owner: OLTEAN, STEPHEN V PO BOX 890 FLANAGAN, MAUREEN WOODBURN, OR 97071 15345 SW OAKTREE LN TIGARD,OR 97224 PHONE: 971-338-8989 PHONE: FAX: FEES Quantity Description Date Amount 5 crt Branch Circuits wo/Purchase 11/13/2013 $85.86 Specifics: Service or Feeder 1 ea 12%State Surcharge- 11/13/2013 $10.30 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $96.16 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 m, •. ,'n a of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344, Issued By: 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. Electrical Permit Application FOR OFFICE USE ONLY City of Tigard ViCIE1140 DateBea /3 rj� Permit No.: _ :� q 13125 SW Hall Blvd.,Tigard,OR 9722 Plan Review Phone: 503.718.2439 Fax: 503.598.19 Date/By: Other Permit: mem f 3_tx)(to 40 Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for :FIG/1 h l) Notified/Method: Supplemental Internet: www.tigard-or.gov wi i l 2013 pp emental Information TYPE OF WORK �/ ICS" PLAN.REVIEW ❑New construction Addition/alteratio 1'gaCtn�1� Please check all that apply(submit 2 sets of plans w/items checked below): ®1NG DIN O° ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: v`�, 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 El Master builder El Other: 0 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","l-3", Job no.: Job site address: f ool1P or more. occupancy. -{ ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: 1 53('S SL) �qlr\ lr .c l C4_`D Ti / / �� ❑Health-care facilities. ❑Hazardous locatis. ❑Supply voltage for more than 600 volts nominal. Suite/bldg./apt.no.: Project name: CAR.5:i v\ ❑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.: 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 K -tlimV- cc,.-04 residential(with above sq.ft.) Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or relocation 0 PROPERTY OWNER ❑ TENANT _200 amps or less 100.70 2 �v 201 amps to 400 amps 133.56 2 Name: /p�Ic ,--ro h q,1q IT-) 7.qevr. Q I.kc\ 401 amps to 600 amps 200.34 _2 Address: is 3 Li r— 3(„) 09 tti -rte,Q 41.,..e 601 amps to 1,000 amps 301.04 2 J ""t Over 1,000 amps or volts 552.26 2 City/State/ IP: i O�f� Temporary services or feeders installation,alteration,and/or Phone:( ) ` Fax:( ) relocation — 200 amps or less 59.36 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,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2 Owner signature: Date: Branch circuits–new,alteration,or extension,per panel ❑ APPLICANT I CONTACT PERSON A.Fee for branch circuits with /� above service or feeder fee, 7 42 2 Business name: T i_ (1 G m o�G1 each branch circuit B.Fee for branch circuits without Contact name: // service or feeder fee,first 1-.q � branch circuit 56.18 ,,(r 2 Address: 1'`_) 60,A 10t(1 Each add'I branch circuit LI 7.42 c,1,(p8 2 City/State/ZIP: T. r� (}. Z� Miscellaneous(service or feeder not included) l ✓ 1 r 2. Each manufactured or modular 67.84 2 Phone:(503 ) 9 '1L, Z7 $D Fax: :( ) dwelling,service and/or feeder Reconnect only 67.84 2 E-mail: -1"Z-R.ziv,0 Ai ® 71-Loo,40,,,E Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: �,1 Signal circuits)or limited energy See L I��� v13 c.et panel,alteration,or extension. Page 2 2 Address: Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr City/State/ZIP: Investigation(1 hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: I Ct ' 6-5z, Electrical Lie.: e GiO N Suprv.Lie.:3s35 c. specifically listed(%3 hr min) ELECTRICAL'PERMIT FEES . Suprv.Electrician signature,required: Subtotal: 75, y60 Print name: 090`\h C'. rs;g� Date: It -49 • Plan review(25%of permit fee): -! `� State surcharge(12/0 of permit fee): Yt). A Authorized signature: TOTAL PERMIT FEE: 4 6, . h. 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. I.\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 44046151(1 I/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 El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 ❑ Burglar Alarm 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(V5 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 1:\Building'Permits\ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 Location: Record Type: Inspection Type: Comments: Inspection Date: Record ID: Result: City of Tigard 13125 SW Hal Blvd. Tigard, OR 97223 Tel: 503.718.2439 15345 SW OAKTREE LN, TIGARD, OR, 97224 Residential - Electrical 199 Electrical final 2014-01-03 (null) ELC2013-00684 PASS - No C of O Violation Summary: Inspector Contractor