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Permit CITY OF TIGARD ELECTRICAL PERMIT IN COMMUNITY DEVELOPMENT Permit#: ELC2015-00162 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/24/2015 Parcel: 1S134CB03100 Jurisdiction: Tigard Site address: 12330 SW SUMMER CREST DR Project: ROCHEFORT Subdivision: SUMMER HILLS PARK Lot: 30 Project Description: Moving(10)branch circuits and replacing(1)panel. Contractor: THUNDERBIRD ELECTRIC INC Owner: ROCHEFORT, RAY 11124 NE HALSEY#678 3875 GLENWOOD LOOP SE PORTLAND, OR 97220 SALEM, OR 97317 PHONE: 503-253-9934 PHONE: FAX: FEES Quantity Description Date Amount 10 crt Branch Circuits w/Purchase 03/24/2015 $74.20 Specifics: Service or Feeder 1 ea 12%State Surcharge- 03/24/2015 $20.99 Type of Use: SF Electrical Class of Work: ALT 1 ea Services or Feeders-200 03/24/2015 $100.70 amps or less Type of Const: Occupancy Grp: 1 Total $195.89 Required Items and Reports(Conditions) A This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes y other II.• able 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 ork is •-nded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. hose ru- are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or . 0.332.23' N").%.1 Issued By: '•rmittee Signature:..0-ZsGsrl./e-- - _ — 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 City of Tigard ��{�1� 3�� DR t° ! /S - ,►7 _ • 13125 SW Hall Blvd.,Tigard,OR 972 � j V Plan Review i Phone: 503.718.2439 Fax: 503.598.1 Date/B : Related Permit#: 1 Inspection Line: 503.639.4175 r{ Q1� Ready Date/By: EMI ® See Page 2 for TI G A R D Internet: www.tigard-or.gov C( 11 Notified/Method: Supplemental Information E OF WORK �► C►O0. �.} PLAN REVIEW ❑New construction Addition/alteration(4tadefiie 3'{x. rY.:'l•. ' Please check all that apply(submit 2 sets of plans w/items checked): \� i ❑Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: 'L���`�`� where the available fault current ❑Marinas and boatyards. � CATEGORY OF CONSTRCTCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings. U '-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: I J 3 30 5 4- ,'4,0,At*'f C,4Afr I00HP or more. ❑"A","E",°t-2","l-3", City r /�R ❑Six or more residential units. occupancy. ty /�� �/ ❑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: / 2/ 5 r FEE SCHEDULE Description I Qty I Each I Total 1 • New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. Tax map/parcel#: 1,000 sq.ft.or less 168.54 Ea.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential .,0 Y/t C//t Gu l 1f 9L ev- t 4 /L (with above sq.ft.) O 75.00 2 r G Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 200 amps or less ( _ 100.70 (007-0 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 1 ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel A.Fee for branch circuits with Business name: .J. - R 5 d�`�� above service or feeder fee, t� each branch circuit 10 7.42 74J,2o 2 Contact name: B.Fee for branch circuits without service or feeder fee,first 56.18 2 Address: branch circuit 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: r/H/f n,D'l/r if D 15G,•ec to 1 c /it G- Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy ❑ See Page 2 2 Address: //al N 6 O A es 6y panel,alteration,or extension. City/State/ZIP: /.rrt r I ' 2 Each additional inspection over allowable in any of the above / 7 Additional inspection(1 hr min) 66.25/hr Phone:(3-v7 ) 25.-7 7-9-Ay Fax:( ) Investigation(I hr min) 66.25/hr Email: Industrial plant(1 hr min) 78.18/hr 3-7 S�S Inspections for which no fee is CCB Lic.: 5/,f9 Electrical Lic.:1 C--jo 51G Suprv.Lie.:_,Zr/ r 1 specifically listed('A hr min) 90.00/hr ELECTRICAL PERMIT FEES Electrician signature,required: •% c ' 144., Subtotal: r,ty,rJ Print name: CA all T J<, trZ9V,,q Date:7 /7-j f ❑Plan Review Required(25%of permit fee): -- State surcharge(12%of permit fee): . "t Y Authorized signature: TOTAL PERMIT FEE: `` �j,3 This permit application expires if a permit is lot obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 04/21/2014 440-4615T(II/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 s Fee for all residential systems combined: $75.00 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 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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/3 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: [1 A• udio and Stereo Systems ❑ B• oiler Controls ❑ C• lock Systems ❑ Data Telecommunication Installation ❑ F• ire Alarm Installation ❑ HVAC ❑ Instrumentation [l Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical El N• urse Calls [l Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations L\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 12330 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final FAIL ELC2015-00162 David Young Provide access for inspection, lock box on front door. 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 12330 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final FAIL ELC2015-00162 David Young Kitchen plugs each side of stove not energized. Plugs on island not energized, gfi not working. Dining plug by garage door not energized. Provide arc fault breaker for new branch circuit down stairs. Bedroom?OESC 210.12(a) Protect new wiring in basement alley at less than 8' from floor. OESC 334.15(b) Outlet by door to alley in laundry to be gfi protected. OESC 210.8(A)(10) 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 12330 SW SUMMER CREST DR, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final PASS - No C of O ELC2015-00162 David Young Corrections done. Violation Summary: Inspector Contractor