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Permit CITY OF TIGARD ELECTRICAL PERMIT . COMMUNITY DEVELOPMENT Permit#: ELC2014-00368 T f G.AR n 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/02/2014 Parcel: 1 S133CD05700 Jurisdiction: Tigard Site address: 13648 SW FEIRING LN Project: DANES Subdivision: COTSWALD MEADOWS Lot: 55 Project Description: Reconnect only. Contractor: Owner: DANES, IOAN 13648 SW FEIRING LN TIGARD,OR 97223 PHONE: PHONE: 503-702-5829 FAX: FEES Quantity Description Date Amount 1 ea Reconnect Only 07/02/2014 $67.84 Specifics: 1 ea 12%State Surcharge- 07/02/2014 $8.14 Electrical Type of Use: SF Class of Work: OTR Type of Const: Occupancy Grp: Total $75.98 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 s pended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those r' - set forth in OAR 952-001-0010 through OAR 952-001-0090, You may obtain a co• of • . - - - questions to OUNC by calling 503.232.1987 or Issued By: —_ - - ••nature: ���•WNER 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 Received City of Tigard as DateB : �� , p PermitNo.:f --A-%t�„I_ ,6 !. 711 " 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review i Other Permit: Phone: 503.718.2439 Fax: 503.598.1 Q Date/ By:y. I I c.A K D Inspection Line: 503.639.4175 \�` Date Ready/By: inns: ® See Page 2 for Internet: www.tigard-or.gov J { 10 Notified/Method: Supplemental Information TYPE OF WORK CO It CO 1� PLAN REVIEW t � ' :,.. ❑New construction ❑A'• tion/alteration/respltic7 n t 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. ❑Demo •tion VP •ther: 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","l-2","l-3", Job#: I Job site address: 1 3648 SIX/ r'e1 ari 110 LC(Y1 p • 1ixor or eres. Recreational p 7 \J ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP: `r-q Q rd 0 Q t ! / 2_23 ❑Health-care facilities. ❑Supply voltage for more than �l ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.#: Project name: bq oleS ❑Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: minion.. l Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot#: 1,000 sq.ft.or less 168.54 4 Ea.add'I 500 sq.ft.or portion 33.92 I Tax map/parcel no.: Limited energy,residential DESCRIPTION OF WORK (with above sq.ft.) 75.00 2 Limited energy,multi-family p residential(with above sq.ft.) 75.00 2 Renewable Energy _ ❑ See Page 2 Services or feeders installation,alteration,and/or relocation R PROPERTY OWNER ❑ TENANT 200 amps or less 100.70 2 201 amps to 400 amps 133.56 2 Name: r®Q y) A - (C y)es 401 amps to 600 amps 200.34 2 Address: I 3 582 51X) Lip(Q nets 26Y- . 601 amps to 1,000 amps 301.04 2 Over 1,000 amps or volts 552.26 2 City/State/ZIP: l(Ua rd 0 R t 9 7 223 Temporary services or feeders installation,alteration,and/or Phone:(S,3) 702— 932`j 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: each branch circuit e5c fs'1'� 4s Q lo11V'`L B.Fee for branch circuits without Contact name: service or feeder fee,first branch circuit 56.18 2 Address: Each add'I branch circuit 7.42 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( ) Fax: :( ) dwelling,service and/or feeder Reconnect only 1 67.84 6 7. 7 2 E-mail: Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Business name: Signal circuit(s)or limited-energy See 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(I hr min) 66.25/hr Phone:( ) Fax:( ) Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv.Lie.: specifically listed(%hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: (p 7_V( Print name: Date: Plan review(25%of permit fee): State surcharge(12%of permit fee): T-iY Authorized signature: TOTAL PERMIT FEE: —7S:9y This permit application expires if a permit is not obtained within 180 Print name: „e�q n 94. 6q y es Date: O 7,9211 0ly days after it has been accepted as complete. 1 * Number of inspections allowed per permit. 1:\Building\Perils\ELC_PennitApp_ELR_ERE.doc Rev 04/21/2014 440.46151(11/05/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 Each I Total J 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 ❑ 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 OAR 918-309-0040) 552.26 2 ❑ Heating, Ventilation and Air Conditioning 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(I hr min) 66.25/hr 1• • Inspections for which no fee is 90.00/hr specifically listed(%hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system $75.00 Subtotal: (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ 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\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 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 13648 SW FEIRING LN, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final PASS - No C of O ELC2014-00368 Herb Stabenow Violation Summary: Inspector Contractor