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Permit rt CITY OF TIGARD ELECTRICAL PERMIT 11111 • COMMUNITY DEVELOPMENT Permit#: ELC2015 00651 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 //i, Date Issued: 08/17/2015 Parcel: 2S110DD02800 Jurisdiction: Tigard Site address: 10580 SW CENTURY OAK DR Project: Olsen Subdivision: SUMMERFIELD Lot: 35 Project Description: Panel replacement and installation of(1)branch circuit. 9/28/15,REPRINTED to add(3)additional branch circuits. Contractor: OWNER Owner: OLSEN, BOB BOB OLSON 10580 SW CENTURY OAK DR 10580 SW CENTURY OAK DR TIGARD,OR 97224 TIGARD,OR 97224 PHONE: 503-453-7831 PHONE: 503-245-3923 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/17/2015 $100.70 Specifics:, amps or less 1 crt Branch Circuits w/Purchase 08/17/2015 $7.42 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 08/17/2015 $12.97 Electrical Type of Const: 3 crt Branch Circuits w/Purchase 09/28/2015 $22.26 Occupancy Grp: Service or Feeder 0 ea 12%State Surcharge- 09/28/2015 $2.68 Electrical 45 Misc Administration Fee 09/28/2015 $45.00 Total $191.03 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. ATTENT : Oregon la requir- you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001 roug OAR 952-001-••.• • m/, obtain a copy of the rules or direct questions to OUNC ' ''"!;1! ..32.1987 or 1.800.332.2344. /// Issue By: , . ,4 �.� Permittee Signature: �� l 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. CITY OF TIGARD ELECTRICAL PERMIT 11111 r' COMMUNITY DEVELOPMENT Permit#: ELC2015-00651 T!GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/17/2015 Parcel: 2S110DD02800 Jurisdiction: Tigard Site address: 10580 SW CENTURY OAK DR Project: Olsen Subdivision: SUMMERFIELD Lot: 35 Project Description: Panel replacement and installation of(1)branch circuit. Contractor: OWNER Owner: OLSEN, BOB BOB OLSON 10580 SW CENTURY OAK DR 10580 SW CENTURY OAK DR TIGARD, OR 97224 TIGARD, OR 97224 PHONE: 503-453-7831 PHONE: 503 245-3923 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/17/2015 $100.70 Specifics: amps or less 1 crt Branch Circuits w/Purchase 08/17/2015 $7.42 Type of Use: Service or Feeder Class of Work: 1 ea 12%State Surcharge- 08/17/2015 $12.97 Electrical Type of Const: Occupancy Grp: Total $121.09 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 se forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy e rules or direct questions to OUNC by calling 503..223 . 987 0 .80 .332.2344. Issued By: Permittee Signature: / � 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 Received $-SO't 13125 SW Hall Blvd.,Tigard,OR 97223 *� NI g g Plan Review _: 111=121 Phone: 503.718.2439 Fax: 503.598.1960 'V Date/B Inspection Line: 503.639.4175 c'1,� �Ii�ly Date/By: Juris: See Page 2 for TIGARD Internet: www.tigard-or.gov Aw ii`` `` �lbllt' s`c ethod: 6 Supplemental Information TYPE OF WORK . ` �v�(�'�`�1� ` PLAN REVIEW ❑New construction ❑Addition/alteration/replactmen t,,? Please check all that apply(submit/sets of plans wiitems checked): ❑Demolition ❑Other: ❑Service or feeder 400 amps or more ❑Building over three stories. � where the available fault current ❑Marinas and boatyards. CATEGORY OF CONSTRUCTi 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 ❑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 Job#: Job site address: 6 L� c„,,,-..,,,,t ✓,'2 ❑Additioo moew motor load of system. I �0�7 �'f� / �I� ry 100HP or more. ❑••A„ ••E„ ••l_2•,,••l_3„ City/State/ZIP' ! / G / Pam! 72-2-Y, ❑Six or more residential units. Recreational ❑Health-care facilities. ❑Rr vehicle parks. Suite/bldg./apt.#: I Project name: A..-5a/./j �_,, , ❑Hazardous locations. ❑Supply voltage for more than ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Descripl ion I Qtv. 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 Ea.add]500 sq.ft.or portion 33.92 I DESCRIPTION OF WORK a Limited energy,residential ANC/ - Cl- ith above sq.ft.) 75.00 2 /lfNC iefLQ!Yle-A- creel ,-h/ //ea7�f}>� / / C,Ytc.t,`j., Limited energy,multi-family 75.0(1 _ residential(with above sq.ft.) Renewable Energy ❑ See Page 2 ❑POPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: J �� Lej�/�-• 200 amps or less ( 100.70 Jyj 2 +� �^ 201 amps to 400 amps 133.56 2 Address: /D��D lJ 44) L'rz 0 -00,4 tip/, /./✓ 401 amps to 600 amps 200.34 2 City/State/ZIP: /7 a,9._z, pne^ q 2 2.Q.4 601 amps to 1,000 amps 301.04 2 Phone:(!5 p9 n y.,---3—?8 7 I Fax:( ) Over 1,000 amps or volts 552.26 2 /� Temporary services or feeders installation,alteration,and/or Email: bA 1,1.5,,,./ �� ,j n"_. c,„r„ 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 ren,o exc , ge,a • ding to ORS 447,449,670,an 01 201 amps to 400 amps 125.08 2 Owner signature: j/ Date: 8 /2 /�^ 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: t /I,12 cl s 647)`C above service or feeder fee, each branch circuit 7.42 -7. i ,. Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 branch circuit City/State/ZiP: Each add'I branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) I Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 Email: Reconnect only 67.84 _ CONTRACTOR Pump or irrigation circle 67.84 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: ❑ 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:( ) I Fax:( ) investigation(1 hr min) 90.00/hr , Email: Industrial plant(I hr min) 78.18/hr Inspections for which no fee is 90,00/hr CCB Lic.: I Electrical Lie.: 1 Supra. Lie.: specifically listed(i4 hr min) ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: /U', 19, Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 1 .Z Cr? Authorized signature: TOTAL PERMIT FEE: /2 f J q This permit application expires if a permit is not obtained,sithin 180 Print name: Date: days after it has been accepted as complete. - • Number of inspections allowed per permit. 1:\Building\Permps\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615TO1/05/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 Qt). I Each b lal I Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 5 kva or less 100.70 Check Type of Work Involved: 5.01 to 15 kva 133.56 '- [1 Audio and Stereo Systems* 15.01 to 25 kva 200.34 Wind generation systems in excess of 25 kva: _ n Burglar Alarm 25.01 to 50 kva 301.04 50.01 to 100 kva 552.26 ❑ Garage Door Opener* >100 kva(fee in accordance with OAR 918-309-0040) 552.26 ❑ 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 charged at an hourly(1 hr min) Inspections for which no fee is 00.00/hr sprciticalh listcd t':hi mini COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES 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: U Audio and Stereo Systems n Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation Fire Alarm Installation ❑ HVAC ❑ Instrumentation n Intercom and Paging Systems Landscape Irrigation Control* Medical Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:,BuildingTermits'E1.C_PermitApp_ELR_ERE.doc Rev 06/17/2015 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 10580 SW CENTURY OAK DR, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00651 Jeff Grove Violation Summary: Inspector Contractor