Permit v CITY OF TIGARD ELECTRICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: ELC2015-00489
T f GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/24/2015
Parcel: 2S109DB05900
Jurisdiction: TIGARD
Site address: 13293 SW HAZELCREST WAY
Project: Sequoia Heights, Lot 7 Subdivision: SEQUOIA HEIGHTS Lot: 7
Project Description: Power Line Electric is completing the electrical work under MST2015-00008 and assuming responsibility for the
previous work.
Contractor: POWER LINE ELECTRIC INC Owner: LENNAR NORTHWEST INC
8403 SE SHERRETT ST 15060 SW 133RD AVE
PORTLAND, OR 97266 TIGARD,OR 97224
PHONE: 971-645-3807 PHONE: 360-258-7900
FAX:
FEES
Quantity Description Date Amount
3093 sf Permit Fee-Elect(per 06/24/2015 $338.14
Specifics: dwelling unit)
1 ea Limited Energy 06/24/2015 $75.00
Type of Use: SF 1 ea 12%State Surcharge- 06/24/2015 $49.58
Class of Work: ALT Electrical
Type of Const:
Occupancy Grp:
Total $462.72
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. Yo may obtain a copy of the ru irect questions to OUNC by calling 503.232.1987 or 1.88000,332.,2344.
Issued 8y: Permittee Signature: . -- `*,�JM
OWNER INSTALLATION ONLY v
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 I OR O► lI( I I .I ()NI 1
City of Tigard Received NAMIMI permit No.:
14 •
13125 SW Hall Blvd.,Tigard,OR 97223 PI, • ew
1 ' Phone: 503.718.2439 Fax: 503.598.1960 Date : Other Permit:
B
11%. \I:1) Inspection Line: 503.639.4175 Date Ready/By: B See Page 2 for
Internet: www.tigard or.gov Notified/Method: BIM Supplemental Information
TYPE OF WORK J PLAN REVIEW
New construction El Addition/alteration/replacement Please check all that apply(submit 2 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
0-4/1-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
❑Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑Addition of new motor load of ❑`A", `E","1-2",`I-3",
Job no.: Job site address: l -�p 2 ` ' �� _,, ,,�L\ 100HP or more. occupancy.
13 L 1 7 SYV [w\L-GLCG�.`�\� ❑Six or more residential units. ❑Recreational vehicle parks.
City/State/ZIP: ❑Health-care facilities. ❑Supply voltage for more than
�,�� L ❑Hazardous locations. 600 volts nominal.
Suite/bldg./apt.no.: Project name: ❑Service or feeder 600 amps or more
Cross street/directions to job site: De SC
scription DYJI.E
I Qty. I Fee. r_ Total I •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: S �;� �lee_1��'�t Lot no.: 1,000 sq.ft.or less 168.54 /67‘,51.1 4
Ea.add',500 sq.ft.or portion l 33.92 /G/100 I
Tax map/parcel no.: Limited energy,residential
DESCRIPTION OF WORK (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) I 75'00 7- �� 2
`7h ���� Renewable Energy , ❑ See Page 2
I Oo(5---CX 3 Cf(3 X- --(-1 Services or feeders installation,alteration,and/or relocation
❑'PROPERTY OWNER I U TENANT 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Name:
401 amps to 600 amps 200.34 2
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:( ) I 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
intended for sale.lease.rent,or exchange,according to ORS 447.449,670,and 701. 401 amps to 599 amps 168.54 2
Owner signature: Date: Branch circuits—new,alteration,or extension,per panel
APPLICANT 1 ❑ CONTACT PERSON • A.Fee for branch circuits with
above service or feeder fee,
Business name: each branch circuit 7.42
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 2
City/State/ZIP: 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:Vo V;N.,e e,G `c " ., Signal circuit(s)or limited-energy See
panel,alteration,or extension. Page 2 2
Address: Qt\Q7> • «., Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
City/State/ZIP: vo, ` 0'4'- l
Investigation(I hr min) 66.25/hr
Phone:(col) C,J�5�-srsj Fax:( ) Industrial plant(1 hr min) 78.18/hr
-
v\ 1 Inspections for which no fee is
CCB Lic.: t •°'�b Electrical Lie.: C. v o q Suprv_Lic.:5 30 j S specifically listed('h hr min) 90.00/hr
Suprv.Electrician signature,required: (1:2-- -
ELECTRICAL PERMIT FEES
/� 1 _ Subtotal: /3, ITF
Print name: lr/�,', r .. P_ LO r �(' "7Z' te: N. Zy.‘S Plan review(25%of permit fee):
Er t[�Rfd State surcharge(12%of permit fee):
5:f--
Authorized signature: v` TOTAL PERMIT FEE: GIG) ,
Print name: `4.-4- This permit application expires if a permit is not o wined within 180
�t� `��� Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1\Ruilding\Permits\ELC_PennitApp F1,R_ERE doe Rev 05/21/2013 440-46151(11/05/COM/WEB
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
13293 SW HAZELCREST WAY, TIGARD, OR,
97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00489
David Young
Change in electrical contractors.
Violation Summary:
Inspector Contractor