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Permit CITY OF TIGARD ELECTRICAL PERMIT " '! Permit#: ELC2015-00814 COMMUNITY DEVELOPMENT 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/08/2015 T 1GAAI7 Parcel: 2S104AA04100 Jurisdiction: Tigard Site address: 12670 SW KAREN ST Project: Arid LLC Subdivision: BELLWOOD Lot: 25 Project Description: Replace 150 amp with 200 amp service. Contractor: OWNER Owner: ARID LLC-CHRIS STOCKS 4800 E HUMMINGBIRD LN PARADISE VALLEY,AZ 85253 PHONE: PHONE: 602-478-8888 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 10/08/2015 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 10/08/2015 $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 suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificatio Cen*in hose rules are set forth in OAR 952-001-0010 throug e'R•• '1-0.90. You may obtain a copy of the rules or direct questions to OUNC by calling 503.j 32 •�' •r '.:10.3.2 ••4. IW I 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 503.639.4176 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 RECEIVE FOR OFFICE 1 ",I t 1\1 1 City of Tigard Received,A /s Permit a:ELt!to26/� -Ddb'/Y I : • 13125 SW Hall Blvd.,Tigard,OR 97223 OCT 8 Z 5 Plan Review Related Permit 4: Phone: 503.718.2439 Fax: 503.598.1960 Inspection Line: 503.639.4175 Ready Date/By: Juris: ® See Page 2 for TIGARD Internet: www.tigard-or.gov (j'I'%19i,` F,1(' I i' Notified/Method: Supplemental Information TYPE OF WdRK PLAN REVIEW _ . . _ . ❑New construction ® Addition/alteration/replacement r Please check all that apply(submit 2 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. CATEGORY OF CONSTRUCTION • 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 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 ❑Addition of new motor load of system. Job#: Job site address: 12670 Sw Karen 1o01IP or more. ❑"A","E", '1-2 'I-3", ❑Six or more residential units. occupancy. City/State/ZIP:Tigard,OR 97233 ❑Recreational vehicle ❑Health-care facilities. parks. 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:SW Scholls Ferry Rd&SW 121"Ave FEE•SCHEDULE- Description I Qty. 1 Each I Total 1 • New residential single-or multi-family dwelling unit. Subdivision: Bellwood Neighborhood Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 (with above sq.ft.) Remove and replace 150amp Electrical with 200amp service. . 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:Arid LLC ' s 4 /*mile_ (C C .�C,AQ/,S 5 th S 200 amps or less X 100.70 2 Address: 12670 SW Karen,Tigard,Or 97233 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard,OR 97233 601 amps to 1,000 amps 301.04 2 Phone:(602)478-8888 Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: "2/0 LL((0 A,AN,, C4'rY; 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: bo/s/mss 401 amps to 599 amps 168.54 2 ® APPLIC ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel I A.Fee for branch circuits with Business name: S ' above service or feeder fee, 7A2 2 -�QM"f �`J 4��`� each branch circuit Contact name: B.Fee for branch circuits without service or feeder fee,first Address: branch circuit 56.18 2 City/State/ZIP: Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:( ) Fax: :( ) Each manufactured or modular dwelling,service and/or feeder 67.84 2 Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name: Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy See Page 2 2 Address: panel,alteration,or extension. Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Phone:( ) 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.: Electrical Lic.: Suprv. Lic.: specifically listed('A hr min) _ .• ELECTRICAL PERMIT FEES - Suprv.Electrician signature,required: Subtotal: 100.70 Print name: Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): 12049 Authorized signature: TOTAL PERMIT FEE: .43:49 /JZ 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, ,-7F Electrical Permit Application–City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: ai-=M,V=- �. �; _ �... �: Description .- .. I Qty.l Each .Total i • Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 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 552.26 2 with OAR 918-309-0040) ❑ 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 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(V hr mm) rains EC iew_t.PEsrr: >ES ; ,w 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: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other: Total number of commercial systems: — *No licenses are required. Licenses are required for all other installations 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 12670 SW KAREN ST, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal FAIL ELC2015-00814 David Young Add all new branch circuits to permit. No inspection done. Violation Summary: Inspector Contractor 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 12670 SW KAREN ST, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00814 David Young Corrections complete. Violation Summary: Inspector Contractor