Permit 11111. q CITY OF TIGARD ELECTRICAL PERMIT
$ COMMUNITY DEVELOPMENT Permit#: ELC201500127
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/02/2015
Parcel: 2S111DD06500
Jurisdiction: Tigard
Site address: 15800 SW STRATFORD LP
Project: WIEBE Subdivision: STRATFORD Lot: 62
Project Description: (3)branch circuits for kitchen remodel.
Contractor: CRAINIC ELECTRIC CO Owner: WIEBE, SUE ELLEN REVOCABLE LIVIN
15812 SE BROOKLYN ST 15800 SW STRATFORD LOOP
PORTLAND, OR 97236 TIGARD,OR 97224
PHONE: 503-913-8005 PHONE:
FAX: 503-760-1787
FEES
Quantity Description Date Amount
3 crt Branch Circuits wo/Purchase 03/02/2015 $71.02
Specifics:, Service or Feeder
1 ea 12%State Surcharge- 03/02/2015 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty C nd all other ap.licable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of is anc , or if work is .spended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification enter. Those` les are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtain a co.440 e rules or direct questions to OUNC by callin 0 32.1987 or 1.800.3, .2344.
Issued By: �_—.. Permittee Signature: / 1:
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 1.01z 01.11( u: I ,,I (1�1.)
City of Tigard � Received d
;�
• 13125 SW Hall Blvd.,Tigard,ORE Plan Review ,
1 ' Phone: 503.718.2439 Fax: 503. v Date/B : Related Permit#:
Inspection Line: 503.639.4175 AP� A�Q Ready Date/By: El See Page 2 for
Internet: www.tigard-or.gov "` 0�-`\G Irs\O Notified/Method: Supplemental Information
TYPE OF WO -'G..- PLAN REVIEW
❑New construction ddition/alter I�Cement Please check all that apply(submit 2 sets of plans w/items checked):
❑Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition Other: where the available fault current ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
Multi-family ❑Master builder El Other: ❑Fire pump. ❑Installation of 150 KVA or
JOB SITE INFORMATION AND LOC 'HON ❑Emergency system. larger separately derived
Job#: Job site address: CO 'Ili ,- / ❑Addition of new motor load of system.
ti /5g O V y[ 91'1f�A'- irCi 100HP or more. ❑ A E„ l_2" l_3„
City/State/ZIP: rti C FT. f d 0, n( / ` . ❑Six or more residential units. occupancy.
`' ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCHEDULE
Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
(with above sq.ft.) 75.00 2
6) biroleil GI' rust/3 11t /r_M(fi7iLi. Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
❑ PROPERTY OWNER ❑ TENANT Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email:
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, lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
❑ APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: 5.41.r.u., as above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without 1
service or feeder fee,fist
Address: branch circuit 56.18 r ty 2
City/State/ZIP: Each add'l branch circuit ,?/ 7.42 141,Pi 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: t�g fit J N k C e t—C 1( C ` Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy El See Page 2 2
Address: (6/0 ,21 (� }—`H-f E L 52v panel,alteration,or extension. g
City/State/ZIP: A r Kam,# i( �� 6p 7 z 3 6 Each additional inspection over allowable in any otthe above
& ( 1 Additional inspection(1 hr min) 66.25/hr
Phone:(SQ 3) R1 -5 , g0 d ) Fax:( U ) Investigation(1 hr min) 66.25/hr
Email:Crawic e Qc,fr, c(3C 6 n,-0,1 -coy.
( Inspections for which no fee is
90.00/hr
CCB Lic.:I SG, J i z Electrical Lic.: 61 Suprv.Lic.: ct23 30 `1171 specifically listed(1/2 hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required. Subtotal: -7/_ej..
Print name: 0 J i_r f if U j, (f i 0 Date:Cc ,--,0,2 , if ❑Plan Review Required(25%of permit fee):
/ State surcharge(12%of permit fee): r.54
Authorized signature: ,7 rfl)I C TOTAL PERMIT FEE: -29 -y
n/ This permit application expires if a permit is not obtained within 180
Print name: q(14/rCt-- ( 4t `V\ C Date:0 3 _oZ .- I days after it has been accepted as complete.
• Number of inspections allowed per permit.
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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
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ 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
❑ 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 66.25/hr
charged at an hourly(1 hr min)
— Inspections for which no fee is 90.00/hr
specifically listed(/2 hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
•
(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
El Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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