Permit CITY OF TIGARD ELECTRICAL PERMIT
I C OMMUNITY DEVELOPMENT Permit #: ELC2013 -00723
T [GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2013
Parcel: 25111 CA11600
Jurisdiction: Tigard
Site address: 9773 SW OAKS LN
Project: Nealon Subdivision: SATTLER PARK Lot: 1
Project Description: (1) branch circuit for fireplace insert
Contractor: OLIVERS PRECISION ELECTRIC COMPANY Owner: NEALON, FOREST
17035 SW HIGH HILL LN 34680 NE KRAMEN RD
BEAVERTON, OR 97007 NEWBERG, OR 97132
PHONE: 503 - 887 -3134
HONE: 503 - 579 -7747
FAX: 503 - 579 -5907
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo /Purchase 12/10/2013 $56.18
Specifics: Service or Feeder
1 ea 12% State Surcharge - 12/10/2013 $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 i '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 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. TTENTION: Oregon la eq • s_ you to follow the rules adopted by the Oregon Utility N. cation C=�er. Those rules are set forth in OAR
952 -0 -0010 through OAR 95 01 -0090. ou may obtain acoop of the rules or direct questions to OUNC by calling 50 . ' . • •f or 1.800.332.2 .4
Iss By: P t .44.4.---0 ,( Permittee Signatur ��i�,ai _r ' % -• 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
C
SIGNATURE OF SUPR. ELEC' \
,, )..1' C A D7---49---,'---.__ 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.
Dec 06 13 11:21a Oliver's PrecisFA 5035795907 p.2
Electrical Permit ApplicatiotbEC 9 2013 R D
l-I• c)FH.:4 I t'I: t
City of Tigard Da*IB Received Permit No.: �[- ao/ g -OP 7.
i
14
Dat : (� �/
13125 SW Hall Blvd., Tigard, OR TIGARD Plan Review Other Perron: Nf_t / 5 -ex 770c/ Phone: 503.718.2439 Fax: 503. = OF DatuBv:
fBy. Supplemental e 2 Information
A
Inspection te ne: Line: 5 03. Date Ready
-39.41 7sB UILDING DIVIS Notified/Method: Method: hub Page 2 for
T I G
Internet: www.tigard-or.gov Notified/Method:
TYPE OF WORK PLAN REVIEW
Please check all chat apply (submit 2 sets of plans winem checked below):
I ❑ New construction ® Addition /alteration replacement ❑ Scrvice or feeder 400 amps or more ❑ Building over three stories.
. C Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION cceceds 10,000 amps at I50 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
E 1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building amps for all other installations. buildings.
❑ Fire pip. ID installation of 150 KVA or
❑ Multi family ❑ Master builder 173 Other: o Emergency system. larger separately derived system.
JOB SITE LNFORMATION AND LOCATION 0 Addition of new motor load of ❑ "A ", "E" "I -2 ", "1 -
10011P or more. occupancy.
Job no.: f Job site address: 9773 SW Oaks Lane ❑ Six or more residential units. ❑ Recreational vehicle parka.
❑ Healthcare facilities. ❑ Supply voltage for more than
City'StateiZEP: Tigard, OR 97224 0 Hazardous locations 600 volts nominal, .
['service a feeder 600 amps or room.
Suit eJbldg /apt no.: Projectname: FEE SCHEDULE
Cross street/directions to job site: Dme, iiiw. 1 Qtr. I Fee. I Total t '
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: `Lot no.. 1,000 sq. ft. or less 168 S 4 Fa. add'1500 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
one circuit for fireplace insert residential (with above sq. ft )
Renewable Energy ❑ See Page 2
Services or feeders installation. alteration, and/or relocation
200 amps or less 100.70 2
El PROPERTY OWNER ❑' 201 amps to 400 amps 133.56 2 +
Name: 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301 04 2
Over 1.000 amps or volts
Address: 552.26 2
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation Phone: ( ) Fax: ( ) 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 i 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps i�•� 2
Owner signature: Date: _ Branch circuits - new, alteration, or extension, er panel
CONTACT PERSON A. Fee for branch circuits with
❑ APPLICANT ❑ above service or feeder fee, 7.42 2
each branch circuit
Business name: B. Fee for branch circuits sirhout
service or feeder fee, first I 56.I 8 56.18 2
— Contact name: branch circuit
Address: Each add'1 branch circuit 7 2
Miscellaneous (service or feeder not indnded)
City(S[ate1ZLP: Each manufactured or modular I 67 84 12
dwelling, service and/or feeder ! I
Phone: ( ) I Fax: ( ) Reconnect only 67 84 2
E -mail:
Pump or irrigation circle 67.34 2
CONTRACTOR Sign or outline lighting 67.84 2
Signal circuit(s1 or limited - energy See
Business name: Oliver's Precision Electric panel, alteration. or extension. I Page 2 I 2
Address: 17035 SW High Hill Lane Each additional inspectioa over allowable in any of the above
Additional inspection (1 hr min) 66.25/ hr
City State /ZIP: Beaverton, OR 97007 investigation (1 hr min) ' 66.25 /hr
t
dusrial plant (I hr min) 78.18/ hr
Phone: (503)574 - 7747 Fax: (503 )579 - 5907 i n -
Inspections for which no fee is 90.00/ hr
CCB Lic.: 186112 I Electrical Lie.: 34 - 521C 1 Suprv. Lic.: 25395 specifically listed t'hhrmin)
/ 7i ' ELECTRICAL ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ;' / -' Subtotal: 56.18
v✓
D 12/6/13
Plan review (25% of permit fee):
Print name: Wm Oliver State surcharge (12% of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
Authorized signature:
This pewit application expires if a permit is at obtained within 180
l
Print name: 1 Date: days after it 1ms been accepted as complete 1Gi \Vt!
• Number of inspections allowed per permit
t.1&:ildinglermils ELR_ERE.doc Rev OSI2 1,2013 440 Cm N051O0 SWm
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9773 SW OAKS LN, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
2013-12-18 00:00:00
ELC2013-00723
PASS - No C of O
Violation Summary:
Inspector Contractor