Permit CITY OF TIGARD MECHANICAL PERMIT
1 . COMMUNITY DEVELOPMENT
Permit#: ELC2015-00462
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/15/2015
TIGARD Parcel: 2S 111 C 008300
Jurisdiction: Tigard
Site address: 15875 SW SERENA CT
Project: #42239 Subdivision: KERWOOD ESTATES Lot: 4
Project Description: Replace panel and add(4)branch circuits
Contractor: OWNER Owner: MCCLAUGHRY, RYAN&AMY
AMY&RYAN MCCLAUGHRY 15875 SW SERANA CT
15875 SW SERENA CT TIGARD, OR 97224
TIGARD, OR 97224
PHONE: 503-939-7145 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Services or Feeders-200 amps or less 06/15/2015 $100.70
Type of Use: SF Branch Circuits w/Purchase Service or 06/15/2015 $29.68
Class of Work: ALT Type of Const: Feeder
Occupancy Grp: 12%State Surcharge-Electrical 06/15/2015 $15.65
Stories:
Investigation Fee 06/15/2015 $90.00
Investigation 12%State Surcharge 06/15/2015 $10.80
Fuel
Fuel Types:
Gas Pressure:
Total $246.83
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 copy of the rules
or direct qu- •OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued ;y: / Permittee Signature: 7t.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.( //NNY Gvurrf 'YY//
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 Applicag CEIVEP FOR OFFICE USE ONLY
City of Tigard 1tecei cd //n /5 /r�
b II'nI Date/By: l.t' J /`� � /� Permit No.: LC /5--Op (Q f-,
III 01 13125 SW Hall Blvd.,Tigard,OR 9722} 15 2015 Plan Review
= Phone: 503.718.2439 Fax: 503.598,19r60' tt�� Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 CITY OF 1 fl At\V Date Ready/By: luris: Ed See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
1-414SIltl'
TYP O PLAN REVIEW
❑New construction ®Addition/alteration/replacement Please check all that apply(submit 1 sets of plans w/items checked below):
❑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.
less to ground.or exceeds 14.000 ❑Commercial-use agricultural
El I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building 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 system.
❑Addition of new motor load of ❑"A","E","I-2 "I-3",
Job no.: Job site address: 15875 SW Serena Ct IOOHP or more. occupancy.
❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP:Tigard,Oregon 97224 ❑Health-care facilities. ❑Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Durham Description I qty. I Fee. I Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.ft.or less 168.54 4
Ea.add'I 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION OF WORK (with above sq.ft.)
Limited energy,multi-family 75.00 2
REPLACE ELECTRICAL PANEL AND ADD 4 NEW CIRCUITS residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
Services or feeders installation,alteration,and/or relocation
® PROPERTY OWNER ❑ TENANT amps s or less I 100.70 100.70 2
201 amps to 400 amps 133.56 2
Name:AMY& RYAN McCLAUGHRY 401 amps to 600 amps 200.34 2
Address: 15875 SW Serena Ct 601 amps to 1,000 amps 301.04 2
Over 1,000 amps or volts 552.26 2
City/State/ZIP:Tigard,Oregon 97224 Temporary services or feeders installation,alteration,and/or
Phone:(503)939-7145 Fax:( ) relocation
200 amps or less 59.36 1
Owner installation:This installation is being made on property that 1 own which is not 201 amps to 400 amps 125.08 2
intended for sale,leas- rent,or excha ge,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: i 4,. II _A,,,i„ Date: r/-0-866 Branch circuits—new,alteration,or extension,per panel
❑ APPLIC•1 T ❑ CONTACT PERSON A.Fee for branch circuits with
above service or feeder fee, 4 7 42 29.68 2
Business name: each branch circuit
•
B.Fee for branch circuits without
Contact name: service or feeder fee,first 56.18
branch circuit
Address: Each add'I branch circuit 7.42
City/State/Z1P: Miscellaneous(service or feeder not included)
Each manufactured or modular 67.84
Phone:( ) Fax: :( ) dwelling,service and/or feeder -
Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84 2
CONTRACTOR Sign or outline lighting 67.84 2•
Business name: ("3600 t Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
City/State/ZIP: Investigation(1 hr min) 6(il31fir 9•11.0O
Phone:( ) Fax:( ) 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('V,hr min)
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal:
Print name: Date: Plan review(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT FEE: 6, g 3
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,Penults,.ELC_PermitApp_ELR_ERE.doc Rev 05/21/2013 440-46151(1I/0S/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
15875 SW SERENA CT, TIGARD, OR, 97224
Record Type: Record ID:
Residential - Electrical ELC2015-00462
Inspection Type: Inspector:
115 Electrical service Jeff Grove
Result:
PASS
Comments:
Violation Summary:
Inspector Contractor