Permit 11111 q CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC201500342
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/11/2015
Parcel: 1 S 136CA02208
Jurisdiction: Tigard
Site address: 7960 SW THORN ST
Project: TORGERSON Subdivision: MARG TERRACE Lot: 8
Project Description: Panel replacement.
Contractor: OWNER Owner: TORGERSON, BRADLEY W
BRAD TORGERSON 7960 SW THORN ST
7960 SW THORN ST TIGARD,OR 97223
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 05/11/2015 $100.70
Specifics: amps or less
1 ea 12%State Surcharge- 05/11/2015 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 sus•-••ed for more the 180
days. ATTENTION: Oregon law requires you to foil e rules adopted by the Oregon Utility Notifi ••n C= ter. Those„--- are set forth in OAR
952-001-0010 through OAR 952-001-0090. You may obtai y o ules or direct questions to OUNC by calling 503.232. •87 or 1.8'. 2.2344.
Issued By: `,�.ti _ y��� Permittee Signature:
OWNER INSTALLATION ONL
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.()R (a 1.1( l I "Sr O v l 1
City of Tigard G G�,�v D tBy: /l /5—al/- Permit#: E_-.1„„C„..42,0 I 5--- �3 ,Z
13125 SW Hall Blvd.,Tigard,OR 97223 RG •lan Review
I Phone: 503.718.2439 Fax: 503.598.1960 i 1 7.0 .ate/By: Related Permit#:
Inspection Line: 503.639.4175 MPI 1 •• Date/By: Juria: 0 See Page 2 for
1 l i' \i.l' Internet: www.tigard-or.gov G i''• -1 ethod: �rr Supplemental Information
■
` ^ �i► .
i
❑New construction I:. Addition/alteration/re.v., ill" Please check all that apply(submit j 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.
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 ❑Other: ❑Fire pump. ❑Installation of 150 KVA or
❑Emergency system. larger separately derived
+++•�•�� '�A ❑Addition of new motor load of system.
Job#: Job site address:
�cf 6Q Sc. ' -r
` rt or 1ooHPormore. ❑"A" "E" "l-2""1-3"
Clty/State/ZIP: 7 7 o Six or more residential units. occupancy.
O / Z Z 3 ❑Recreational vehicle parks.
0 facilities. P
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:
Description Qty. Each Total •
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'1500 sq.ft.or portion 33.92 l
Limited energy,residential
75.00 2
(with above sq.ft.) •
eyel /-7f64.7erke_A, Limited energy,multi-family 75.00 2
residential(with above sq.ft.)
Renewable Energy ❑.See Page 2
Services or feeders installation,alteration,and/or relocation
Name: r T rg ersal 200 amps or less / 100.70 / , 2
Address: / ` CC 201 amps to 400 amps 133.56 2
7 (�o J w U r J . 401 amps to 600 amps 200.34 2
City/State/ZIP: O 1 ,, c1/l.Z 3 601 amps to 1,000 amps 301.04 2
Phone:(503 ) &6 p - bcf 35 I Fax:( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: f,\o h`1 P�CC Gm�1 I , C_GY✓) relocation
Owner installatw .installs This installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,re t,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
Branch circuits—new,alteration,or extension, •er panel
A.Fee for branch circuits with
Business name: .ry `LS Ci/�9tle above service or feeder fee,
i/" each branch circuit 7.42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 2
branch circuit
Each add'l branch circuit 7.42 2
City/State/ZIP: Miscellaneous(service or feeder not included)
Phone:( ) 1 Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name: OrkN`/e,(-- Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy ❑ See Page 2 2
panel,alteration,or extension.
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(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: Electrical Lic.: Suprv.Lic.: s ificall listed %hr min 90.00/hr
Suprv.Electrician signature,required: Subtotal: -70
Print name: Date: ❑Plan Review Required(25%of permit fee): --
State surcharge(12%of permit fee): (2 or
Authorized signature: TOTAL PERMIT FEE: //01
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.
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc 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 a •
Fee for all residential systems combined: $75.00 I Each -I Total I
�' Renewable electrical energy systems:
s:
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
with OAR 918-309-0040) 552.26 2
❑ 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 6625/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/,hr min)
COMMERCIAL WO ELECTRICAL P
Subtotal(Enter
Fee for each commercial system: $75.00 Page 1):
Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
El Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
El Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
El Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1:\Building\Permits\ELC_PennitApp_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
7960 SW THORN ST, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00342
Jeff Grove
Violation Summary:
Inspector Contractor