Permit CITY OF TIGARD ELECTRICAL PERMIT
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11111 "
• . COMMUNITY DEVELOPMENT Permit#: ELC2015-00501
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2015
Parcel: 2S110DD10100
Jurisdiction: Tigard
Site address: 15725 SW HIGHLAND CT
Project: Alexander Subdivision: SUMMERFIELD NO.6 Lot: 317
Project Description: Replace main panel&(6)branch circuits.
Contractor: APOLLO ELECTRIC LLC Owner: ALEXANDER, LINDA E
PO BOX 80783 15725 SW HIGHLAND CT
PORTLAND, OR 97280 TIGARD, OR 97224
PHONE: 503-421-1691 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 06/29/2015 $100.70
Specifics: amps or less
6 crt Branch Circuits w/Purchase 06/29/2015 $44.52
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 06/29/2015 $17.43
Electrical
Type of Const:
Occupancy Grp:
Total $162.65
Required Items and Reports(Conditions)
I
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 acc pproved 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. ATT ION: Oregon la uire you to follow the rules adopted by the Oregon Utility Notification Center. Those rules set forth in OAR
952-001- 10 through OAR 952-0 - 090. o .y obtain a copy of the rules or direct questions to OUNC by calling 503.23. 7 or 1.880''2 2�/
IssuSd By: j / 4, / Permittee Signature: 3 4Ar/117_-P-
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:
CONTRA , •STALLATION ONLY
SIGNATURE OF SUPR.ELEC' � �/�"�' Date: j
�.
PV /�
LICENSE NO. 7 /,02 3 5
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 ()Ill( If I .l ()N1
City of Tigard RECEIVED Received
Date/B C a a� Perm #: Z4.cJ5 00 5v/
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Date/B
71
= Phone: 503.718.2439 Fax: 503.598.1960 JUN 9 Related Permit#:
Inspection Line: 503.639.4175 2015 Ready Date/By: ruris. ® See Page 2 for
TIGARD InterrleC www.tigard-or.gov CITY Notified/Method: Supplemental Information
TYPE OF§I 1ROI tG p �D PLAN REVIEW
❑New construction ®Addition/alteration/replacement roN PLAN Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories.
CATEGORY OF CON3TRIif'I[OIN where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or ❑Floating buildings.
0 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural
❑Multi-family ❑Master builder ❑Other: amps for all other installations. buildings.
JOB SITE INFORMATION AND LOCATION ❑Fire rgenc. ❑larger separately of 150 derived
K V A or
❑Emergency system. larger separately derived
Job#: I Job site address: 15725 SW HIGHLAND CT ❑Addition of new motor load of system.
100HP or more. ❑"A""E""1-2^ "l-3"
City/State/ZIP:TIGARD OR. ❑Six or more residential units. upancy.
❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:ALEXANDER ❑Hazardous locations. ❑Supply voltage for more than
Cross street/directions to job site: ❑Service or feeder 600 amps or more. 600 volts nominal.
FEE SCHEDULE
Description I Qty. I Each I Total I •
New residential single-or multi-family dwelling unit.
Subdivision: I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea•add'I 500 sq.ft.or portion 33.92 1
Limited energy,
REPLACE MAIN PANEL FPE TO NEW MAIN BREAKER PANEL,KITCHEN, ,residential
75.00 2
(with above sq.ft)
DINING FAM.RM 6 CT. Limited energy,multi-family
75.00 2
residential(with above sq.ft.)
Renewable Energy ❑ See Page 2
❑ PROPERTY OWNER I ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less I 100.70 100.70 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:( ) I 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 I ❑ CONA� gOrl Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:APOLLO ELECTRIC above service or feeder fee, 6 7 42 44.52 2
each branch circuit
Contact name:RICK STREIFF B.Fee for branch circuits without
Address:P.O.BOX 80783 branch or feeder fee,first 56.18 2
branch circuit
City/State/ZIP: PORTLAND,OR.97280 Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder n included)
Phone:(503)421-1691 I Fax::( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email:rick.apolloelectric @gmail.com
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:APOLLO ELECTRIC j _ Sign or outline lighting 67.84 2
Address:P.O.BOX 80783
Signal circuit(s)alteration,or limited-energy xn . ❑ See Page 2 2
panel,alteration,or extension.
Each additional inspection over_allowable in any of the above
City/State/ZIP: PORTLAND,OR 97280 Additional inspection(1 hr min) 66.25/hr
Phone:(503)421-1691 I Fax:( ) Investigation(I hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:rick.apolloelectric@gmail.com 70)7 /c,4 4(., Inspections for which no fee is
90.00/hr
CCB Lic.: 183120 7/10/10 Electrical Lic.: 4-3 4c .n• ..Lic.: 4123S specifically listed(A hr min)
/,, ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: /!� ` Subtotal: 145.22
Print name: RICK TAYLOR hj�fff"' Date: 6/26/15 ❑Plan Review Required(25%of permit fee):
719/v State surcharge(12%of permit fee): 17.43
�c TOTAL PERMIT FEE: 162.6 Authorized signature: r/\
This permit application expires if a permit is not obtained within 180
Print name: Date: 6/26/15 days after it has been accepted as complete.
I:1Building\Permits/ELC_PermitApp_ELR_ERE.doe Rev 06/17/2015 440-4615T(I i/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
15725 SW HIGHLAND CT, TIGARD, OR, 97224
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2015-00501
Jeff Grove
Violation Summary:
Inspector Contractor