Permit y q CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC2014-00540
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2014
Parcel: 2S102CD00200
Jurisdiction: TIGARD
Site address: 13510 SW ASH AVE
Project: Aspen LO LLC Subdivision: FREWING'S ORCHARD TRACTS Lot: 25
Project Description: Replace existing devices and fixtures. Add lighting to basement and carport. (1)branch circuit.
Contractor: SERVICE FIRST PROPERTY MAINTENANCE&REPA Owner: ASPEN LO LLC
17413 WAKE ROBIN CIR PO BOX 25430
OREGON CITY, OR 97045 PORTLAND, OR 97298
PHONE: 503-258-7203
PHONE: 503-505-5647
FAX: 503-655-6317
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 09/25/2014 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/25/2014 $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 thr 52-00 •r90. You may obtain a copy of the rules or direct questions to OUNC by calling 5087 or 1.800.332.2344..
Issued By: _�.r.�/�iii _ — 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' \ems �t n nl/ -� Date:
LICENSE NO. 1-/?F3 S
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 Received 9 113 dt / Penult No.. 6.14.071/-4954i0
• 13125 SW Ball Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.59 Date/By: Other Permit: �ityljl�o/9
1 ° ,\ Inspection Line: 503.639.4175 C �0\bc Date Ready/By: Juris ® See Page 2 for
Internet: www.tigard-or.gov CC--� �� .s\ Notified/Method: Supplemental Information
TYPE OF WORK �J` o' er��. PLAN REVIEW
❑New const ruction 'gAddition/alteration/tt � rtl.t 's 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.
❑ Demolition ❑Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRU exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 ❑Commercial-use agricultural
-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
dgl_
Multi-family 0 Master builder ❑Other:
0 Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑'A", E", 'I-2","I-3",
Job no.: Job site address: a _ IOOHP or more. occupancy.
, Sre� S /n'+ l7��Y ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: 71343,040 0 Health-care facilities. ❑Supply voltage for more than
°ea ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑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 I
Tax map/parcel no.: Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family
75.00 2
R Lg C.))0s1- 9gy1 crs + Actu 2es t ND+o residential(with above sq.It.)
Renewable Energy _ ❑ See Page 2
L., n-ria (b 1 AsM ev"}` +,(',�RP�L,1" Services or feeders installation,alteration,and/or relocation
L2J, PROPERTY OWNER I�"" _ ❑ TENANT 200 amps or less 100.70 2
' 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
Address: 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP: Temporary services or feeders installation,alteration,and/or
Phone:( ) Fax:( ) relocation
200 amps or less 59.36 I
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
B.Fee for branch circuits without ��
Contact name: service or feeder fee,first ` 56.18 5t0•�7 2
branch circuit 1
Address: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Each manufactured or modular
Phone:( ) Fax: :( )
dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
•
CONTRACTOR Sign or outline lighting 67.84 2
Business name: 0 LQs Signal circuit(s)or limited-energy . See
panel,alteration,or extension. Page 2 2
Address: 11 y 13 if /A je� p Ieo Each additional inspection over allowable in any of the above
V y/` Additional inspection(1 hr min) 66.25/hr
City/State/ZIP:O f 6, 3 c44.., O R. `7704' Investigation I hr min
g ( ) 66.25/hr
Phone:(.5--.0.3).25-8..... 7.205 Fax:(503) 656"--603( 7 Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.:/6,27/ Electrical Lic.: (r(40,5— Suprv.Lic.:LI q 83 S specifically listed('/2 hr min) 90.00/hr
l 1 ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 5(p• 17
Print nam Date: /.2., Plan review(25%of permit fee):
°-(-� L Q- r :7`1 State surcharge(12%of permit fee): (p,'�S�
Authorized signatu •�//i/4 /�_ TOTAL PERMIT FEE: &9, _9 2-
'/' / This permit application expires if a permit is not obtained within 180
Print name// i/ Date:' _ days after it has been accepted as complete.
* Number of inspections allowed per pennit.
1iBuilding'Permits\EL.C_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(1I/05/COM/WEB