Permit CITY OF TIGARD ELECTRICAL PERMIT
= • COMMUNITY DEVELOPMENT Permit#: ELC2015-00108
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/23/2015
T EUAFtID Parcel: 2S102CD02611
Jurisdiction: Tigard
Site address: 9735 SW MCDONALD ST
Project: Schwindt Subdivision: TWALITY HILL Lot: 11
Project Description: (1)new 400 amp panel.
Contractor: OWNER Owner: SCHWINDT, CHRISTOPHER
CHRISTOPHER SCHWINDT PO BOX 80794
PO BOX 80794 PORTLAND, OR 97280
PORTLAND, OR 97280
PHONE: 503-810-6374 PHONE: 503-810-6374
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-201 to 02/23/2015 $133.56
Specifics: 400 amps
1 ea 12%State Surcharge- 02/23/2015 $16.03
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $149.59
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 may obtain a c py-eLih rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: t� Permittee Signature: if
OWNER INSTALLATION ONLY "T
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 ApplicatioaCENV
Cl of Tigard Received S !f . Permit No.: =>
`J g Date/By: (� t) /7 (�[��1›....""""601�
13125 SW Hall Blvd.,Tigard,OR 97223 8 Plan Review
■ A �7 �O"� Other Permit:
I Phone: 503.718.2439 Fax: 503.598.l9Q�3E fl Date/By:
i , \1 t Inspection Line: 503.639.4175 A�]la Date Ready/By: Juns Ea See Page 2 for
Internet: www.tigard-or.gov , FTiGA t�_�`lotified/Method: 1��j Supplemental Information
It TYPE ()Fiji irS' 71s` �S�V PLAN REVIEW
❑New construction ®Addition/alte •placement V Please check all that apply(submit 2 sets of plans w/items checked below):
❑Service or feeder 400 amps or more ❑Building over three stones.
❑Demolition ❑Other: 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: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system.
❑Addition of new motor load of ❑"A" "E" "l-2""1-3"
Job no.:n/a Job site address:9735 SW McDonald Street IOOHP or more. occupancy.
❑Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities. ❑Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: `r,111a'— ['Service or feeder 600 amps or more.
W FEE SCHEDULE
Cross street/directions to job site:SW Hall to McDonald,between Omara and Description I Qty. I Fee. I Total I
New residential single-or multi-family dwelling unit.
95th Includes attached garage.
Subdivision:Twality Hill Lot no.:11 1,000 sq.ft.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.:2S12CD-02611 —
Limited energy,residential
75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00
New service 400 amp panel residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
❑ PROPERTY OWNER I ® TENANT 200 amps or less 100.70 2
201 amps to 400 amps 1 133.56 133-56 2
Name:Stephen Kendrick 401 amps to 600 amps 200.34 2
Address:Same as site 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:(816)716-3657 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,leas ,rent, exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54
Owner signature: Date:?f Ze2//f Branch circuits-new,alteration,or extension,per panel
❑ APPLICANT ® CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee,
Business name:Clearway Reall, I.L( each branch circuit 7.42
B Fee for branch circuits without
Contact name:Christopher Schw indt service or feeder fee,first 56.18
branch circuit
Address:PO Box 80794 Each add'l branch circuit 7.42
City/State/ZIP:Portland,OR 97280 Miscellaneous(service or feeder not included)
Each manufactured or modular
67.84
Phone:(503)810-6374 Fax::( ) dwelling,service and/or feeder
Reconnect only 67.84 2
E-mail:chris @cds-enterprise.com Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting _ 67.84 2
Business name: Signal circuit(s)or limited-energy See
n^N' r panel,alteration,or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
City/State/ZIP: Additional inspection(1 hr min) 66.25/hr
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/
CCB Lie.: Electrical Lie.: Suprv.Lie.: specifically listed(%hr min) hr
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: 133.56
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee): 16.03
Authorized signature: TOTAL PERMIT FEE: 149.59
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.
1:1BuildinglPemrits\ELC_PemtitApp_ELR_ERE.doc Rev 05/21/2013 440-4615T(II/05/COM/WEB
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law requires residential construction permit applicants who are not licensed with the
Construction Contractors Board to sign the following statement before a building permit can be
issued. (ORS 701.325 (2))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed architect and engineer applicants,exempt from licensing under ORS 701.010 (7), need not
submit this statement.This statement will be filed with the permit.
Please check the appropriate box:
I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
VI P-
will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction
Contractors Board. If I change my mind and hire a general contractor, I will select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
l-1?t0 CM<a >L(/t.1inrr, ,,(4 C4E- .V',w Iza i.--/Y cc.c
Print Name of Permit Applicant
' Z/Z y /I—
Signature of Permit Applicant Date
Permit#: '��a0I UO WI
11
Address: 77 i Ski , DoweigI 1 , ,-f„.',,
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Issued by: Date: o2�j//3— t-i-V
This Copy for Permit Offices
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
9735 SW MCDONALD ST, TIGARD, OR, 97224
Residential - Electrical
115 Electrical service
PASS
ELC2015-00108
Herb Stabenow
Violation Summary:
Inspector Contractor
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
9735 SW MCDONALD ST, TIGARD, OR, 97224
Residential - Electrical
115 Electrical service
FAIL
ELC2015-00108
Herb Stabenow
Install approved ground clamp( marked cu h2o ) at the water pipe
Violation Summary:
Inspector Contractor