Permit UPI p
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2014-00545
C $ Date Issued: 09/23/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 1
Parcel: 2S1 11 C 605500
IMAM Jurisdiction: Tigard
Site address: 15215 SW 100TH AVE
Project: AHO Subdivision: 2001-006 PARTITION PLAT Lot: 2
Project Description: (1)branch circuit for A/C unit. 10/16/14: Reprinted permit to include(1)additional branch circuit.
Contractor: OWNER Owner: AHO, JONATHAN E
JONATHAN AHO 15215 SW 100TH AVE
15215 SW 100TH AVE TIGARD,OR 97224
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 10/16/2014 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 10/16/2014 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 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 c or direct questions to OUNC by calling 503.232.1987 or 800.332.2344.
t'"--- ,...(..„...,
Issued By: `r., - Permittee Signature: ��,"
-�J
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 i of mil( r t .i ON 1
City of Tigard R _�
Tigard,13125 SW full Blvd.,Ti
B OR �� Plan Review
• Phone: 503.718.2439 Fax: %•\Dt fate/ft : Related Permit e:
Inspection Line: 503.639.4175 0�� Ready DatidBy: B See Page 2 for
i I v,",t;t' Internet: www.tigard-or.gov fy I Ni bod: Supplemental Information
�rS�[ i N
TYPE OF WOIR� 4. 1 .,"� Y�.A1�T R1LVI1t VY ;
❑New constriction Addition/alterati a Please check all that apply(submit j sets of plans w/items checked):
Other:
❑Demolition iDemolition ` ❑Service or feeder 400 amps or more ❑Building over three stories.
• where the available fault current ❑Marinas and boatyards.
CATEGORY OF C ON exceeds 10,000 amps at ISO volts or ❑Floating buildings.
- / less to ground,or exceeds 14,000 ❑Commercial-use agricultural
•
'0 I-and 2-family dwelling ❑Commercial industrial ❑Acce •
'ii amps for all other installations buildings.
❑Multi-family ❑Master builder ❑Other: ' ❑Fire pump ❑Installation of ISO KVA or
JOB SITE INFORMATION AND LOCATION ❑Emergency system larger separately derived
Job#: Job site address: /� ❑Addition of new motor load of system.
LS2(S Sw IOU - ,41Je" 10011P or more ❑ A, E 1_2 , 1.3
City/State/ZiP: -,t . 4 ❑Six or more residential units. ❑�eational vehicle parks
c{d�/ C'9 [� R 7 �� ❑Health-care facilities
Suite/bldg./apt"#: ', tt Project name: ❑Hazardous locations. ❑Supply voltage for more than
! 600 volts nominal
❑Servnce or frcder 600 amps or more.
Cross street/directions to job/site: `c,,,4/ 4s. .�..)�-- qr IJ e,-, FEE SCHEDULE
�'tn de r'/ r'19
7 Dmrriwbo -Tam I r,li I raw j
,, ,c-� 1.+� r �'r"a i ' New residential single-or multi-family dwelling unit.
Subdivision: I Lot ti: Includes attached garage.
fax map/parcel#: 1,000 sq.it or less 168.54 14
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
J. 2,2 0 34.-5e Q______ ie kfr' e t.imited energy,muhi-family
-AY-cci---cit„si i a ' 75 00 2 GG// (( residential(with above sq.ft.)
0 OPERT OWNUt R` f 1t ! ( ti)i-i's.
TENANT L� r Renewable Energy ❑ See Page 2 i.2
Services or feeders installation.alteration,and/or relocation
Name: ,1,A,,t 44,t,,r,,..., A 200 amps or less 100.70 2
Address: 1 C )1.3" S G.. t o p'b- A Vie 201 amps to 400 amps t 33.56 2
,/ 401 amps to 600 amps 200 34 2
City/State/ZIP: ,.�.cb,;.Pdi Q P. 'i 71'9 601 amps to 1.000 amps 301.04 2
Phone:(So 3)4'o? D.9 S a. Fax:( ) Over 1,(X)0 amps or volts 552 26 2
Temporary services or feeders installation,alteration,and/or
Email: ,c,,, ...Jet 1 di 01 d.. C 1 c-,ill relocation
Owner installation:This insta'tiation is being made on property that I own which is not 200 amps or less 59.36 I
intended for sale,let se,rent,or exch e,according to ORS 447,449,671),and 701- 201 amps to 400 amps 125.08 2
Owner signature: ` �� .____.._. Date: _1)).3/1 7 401 amps to 599 amps 168.54 2
❑ APPLICANT I ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel _
A.Fee for branch circuits with
Business name: each branch service or feeder fee, 7.42 2
Contact ntune: B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address: branch circuit .gyp,
City/State/"Lip:
Each add'I branch circuit i I 7,42 -7..'1� 2
Miscellaneous(service or feeder not included) _
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
imail' Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67,84
Signal cir ult(s)or limited-energy
Address: panel,alteration,or extension ❑ See Page 2 2
City/State/ZIP:
Each additional inspection over allowable in any of the above
Additional inspection(I hr min) I I 66.2>/hr )
Phone:( ) Fax:( ) Investigation(1 hr min) 66 25/ht
Email: Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee d
specifically listed h hr mm) 90001 hr
CCB Lic.: Electrical Lic.: Suprv. Lic.: pe' (' _
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: _ Subtotal- Th,,L '
Print name: Date: ❑Plan Review Required(25%of permit tee):
State surcharge(12%of permit fee): G-7,1
TOTAL PERMIT FEE ' ' -
Authorized signature: ,�-
This permit application expires if a permit is not obtained within ISO
Print name Date: days after it has been accepted as complete.
• Number of inspections allowed per permit ¢
t`rnuildmg�Prrmitt.ELC PcanitApp,_FLR_ERF dots Rev O4/2t/2014 440-461ST(I I/OS/COM/WEB ty 71-)-3
1 315eIc.
CITY OF TIGARD ELECTRICAL PERMIT
1111 • COMMUNITY DEVELOPMENT Permit#: ELC2014-00545
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/23/2014
Tic,'�� g Parcel: 25111 CB05500
Jurisdiction: Tigard
Site address: 15215 SW 100TH AVE
Project: AHO Subdivision: 2001-006 PARTITION PLAT Lot: 2
Project Description: (1)branch circuit for A/C unit.
Contractor: OWNER Owner: AHO, JONATHAN E
JONATHAN AHO 15215 SW 100TH AVE
15215 SW 100TH AVE TIGARD, OR 97224
TIGARD,OR 97224
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 09/23/2014 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/23/2014 $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 - 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.'•y of the ru•s or direct questions to OUNC by calling 503.232.1987 or . 00.332.2344.
Issued By: - r— 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
Received /j Permit#: C
City of Tigard Date/By: °l r�� I i 1.5/ le u�AO/Lf 66 4 t�
13125 SW Hall Blvd.,Tigard,OR 9 Plan Review
': I Phone: 503.718.2439 Fax: Date/13y: Related Permit#:
1
Inspection Line: 503.639.4175 t��� Ready Date/By: kris: 0 See Page 2 for
I I c'.\R II Internet: www.tigard-or.gov p \ Notified/Method: ��e Supplemental Information
TYPE OF WOR ` PLAN REVIEW
❑New construction Addition/alterati Please check all that apply(submit 2 sets of plans w/items checked):
fie' ❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: AG�:.,1 where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONS SHe PION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
A 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
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
❑Addition of new motor load of system.
Job#: Job site address:\,52 is SL., (pv e, 100HP or more. ❑"A","E","t-2","l-3
City/State/ZIP: ❑Six or more residential units. occupancy.
t., _,,-67/ es,R R 7)7 ❑Recreational vehicle parks.
7 ❑Health care facilities. ❑Supply voltage for more than
Suite/bldg./apt.#: a j A Project name: 4 h , ❑Hazardous locations. 600v volts nominal.
/ ❑Service or feeder 600 amps or more.
Cross street/directions to job site: `0o' d- 4 H er- u r-II o w FEE SCHEDULE
de d� / Description I Qty. I Each I Total
Vi o�SfA t.�, 9 .c-.-' +, ' New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
Add (with above sq.ft.) 75.00 2
t I 3c.2 0 -5e)'retc, t,<'{'c V f t 4.. Li p"e 4-e> Limited energy,multi-family 75.00 2
Ac �NI residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation _
Name: dNq 4'L w, +A� 200 amps or less 100.70 2
Address: `5'I S- S(N [ d 0 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: .4_,b,p1 o p, Gj 7-2)1/ 601 amps to 1,000 amps 301.04 2
Phone:(So 3)4' 7—2 9 .S 2 Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: 'p,,,y a110 0 keti I r co hi relocation
Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,le. e,rent,or exch.A e,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:
...a._., —
Date: //a-31/z/ 401 amps to 599 amps 168.54 2
❑ APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7'42 2
Contact name: B.Fee for branch circuits without
service or feeder fee,first ) 56 18 t 2
Address: branch circuit 1
City/State/ZIP: Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Signor outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension. g
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 66.25/hr
Email: Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(Y2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 6.7'1
Authorized signature: TOTAL PERMIT FEE: L(Lh q),
This permit application expires if a permit is not obtainal within 180
Print name: Date: days after it has been accepted as complete.
' Number of inspections allowed per permit.
1:\Building\Permits\ELC_PermitApp_ELR_ERE.docx Rev 04/21/2014 440.4615T(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
Description I Qty. I Each I Total I •
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kvaorless 100.70 . 2
5.01 to 15 kva 133.56 2
El Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
El Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min) •
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
ELECTRICAL PERMIT FEES
COMMERCIAL WORK ONLY: Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 • Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
El Audio and Stereo Systems
❑ Boiler Controls
El Clock Systems
El Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
El Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PermitApp_ELR_ERE.docx Rev 04/21/2014