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Permit -114. CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2015-00882 Date Issued: 11/02/2015 tlEIGAft.D 13125 SW Hall Blvd ,Tigard OR 97223 503 718 2439 Parcel: 2S103BB06800 Jurisdiction: Tigard Site address: 12442 SW 122ND AVE Project: Tapia Garcia Subdivision: BROOKWAY Lot: C Project Description: (4)branch circuits for relocating lights,receptacles and switches in kitchen,bedroom,and garage Contractor: OWNER Owner: TAPIA, SERGIO SERGIO TAPIA GARCIA 12442 SW 122ND AVE 12442 SW 122ND AVE TIGARD, OR 97223 TIGARD, OR 97223 PHONE. 503-481-3408 PHONE FAX FEES Quantity Description Date Amount 4 crt Branch Circuits wo/Purchase 11/02/2015 $78 44 Specifics: Service or Feeder 1 ea 12%State Surcharge- 11/02/2015 $9 41 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $87 85 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 hose rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a co.• - . miles-or direct questions to OUNC by calling 503 23 987 or 00 332 2344 r 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 oNL\ Received 114 oCity of Tigard \`t Date/B• Permit Al. _ •IS a q 13125 SW Hall Blvd.,Tigard,OR 97223 1ti�' Plan Review G 1--•- Phone: 503.718.2439 Fax: 503.598..19 0 Ct.\ D ate/B Related Permit/ P i ! = • `� TIGARD Inspection Line. 503.639.4175 ` �` Ready Date/lay ® See Page 2 for r, Internet: www.ligard-or.gov r '0-J Notified/Method _ Supplemental Information w TYPE OF WORK NV i*W. 1 PLAN REVIEW ❑New construction ddition/alteration/replacem IP @`'lc Please check all that apply(submit 2 sets of plans whtems checked). arc .. ��D� ❑Service or feeder 400 amps or more ❑Budding over three stories ❑ Demolition ❑Other: }�1AB �a� where the available fault current ❑Marinas and boatyards CATEGORY OF CONSTRU exceeds 10,000 amps at 150 volts or ❑Floating buildings and 2-family dwelling ❑Commercial/industrials 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: e_ 100111'or more r 2-4711 z 50) /Z? ei • 0 City/State/ZIP: Six or more residential amts occupancy i ❑Recreational vehicle parks J, 7 7 Z ❑I leallh-care facilities P< Suite/bldg-/apt.#: Project name: ! //JJ f ❑llarardous locations 0 Supply voltage for more than 7- Ii /�`p�'��^�/ 'P� ❑Service or feeder 600 amps or more 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description I 9n, I Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. 1,000 sq It or less 168 54 4 Tax Wrap/parcel#: Ea add.'500 sq ft or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75 00 2 (with above sq It.) I e,to ra•f•t /`1-9 k 1-5 12/a5c ovt-r S(1)%j e) Limited energy,multi-family 75.00 2 residential(with above sq ft.) Renewable Energy ❑ See Page 2 ❑ PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation Name: 5C-ICI /D / a/0 f rt ��r� 200 amps or less 100 70 2 Address: 4/9.7 y1 eJ // _201 amps to 400 amps 133 56 2 /Z 5�L/ 1 7? /7 Ve 401 amps to 600 amps 200 34 2 City/State/ZIP: fj yo y J O ' '77 -7. 3 601 amps to 1,000 amps 301.04 2 Phone: (5 63 ) S/ 7 r-G I Fax' ( ) Over 1,000 amps or volts 552 26 1 / Q Temporary services or feeders installation,alteration,and/or Email: Cn?i'/tc.f r;41( .e7ci e iQ tr C v. t^O %/14 _ relocation Owner installation:This instal atiOn is being made on property that I own which is not 200 amps or less 59 36 1 intended for sale,lease,r, exchange.according to ORS 447,449,6710,an 701./// 201 amps to 400 amps 125.08 2 Owner signature' Date: // Z /AS 401 amps to 599 amps 168 54 2 ❑ AP LICr1NT ❑ CONTACT PERSON / Branch circuits new,alteration,or extension,per panel A Fee for branch circuits with Business name: above service or feeder fee. 7.42 each branch circuit Contact name. B Fee for branch circuits without service or feeder fee,first 1 56.18 56,tX 2 Address: branch circuit _ City/State/ZIP: Each add'I branch circuit a� 7.42 22,. 2 Miscellaneous(service or feeder not included) Phone: ( ) Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email: Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67 84 2 Business name: d LO N) Lam- 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 mm) 90.00/hi Industrial plant(I hr min) 78.18/hr Email: • Inspections for which no fee is 90.00/hr CCB Lie.: Electrical Lie.: Suprv. Lie.: specifically listed('L•hr min) ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: Subtotal •"1Y. /pi Print name' Date: ❑Plan Review Required(25%of permit fee)' — G� State surcharge(12%of permit fee). y, II Authorized signatur TOTAL PERMIT FEE: 7, /`0 This permit application expires if a permit is not raid within ISO Print name: ,/ le Date: // /'Z // days after it has been accepted as complete. of i i d (/ /! * Number of inspections allowed per permit I\Buildme\Permits\EI-C_Pern p_Ii I.R_ERE doe Re,06/17/2015 440.4615T(I I/O5/CO\1/WE13 Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description 1 Qty. 1 Each 1 Total Fee for all residential systems combined: $75.00 Renewable electrical energy systems: 2 Check Type of Work Involved: 5 kva or less 100 70 5.01 to 15 kva 133.56 2 H Audio and Stereo Systems* 15.01 to 25 kva 200 34 2 Wind generation systems in excess of 25 kva: H 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 with OAR 918-309-0040) 552 26 2 H 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: n Other: Each additional inspection is 66.25/hr charged at an hourly(1 hr inn)) Inspections for which no fee is 90 00/hr specifically listed('/hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Fee for each commercial system: $75.00 allowed al per permit on Page I) * Number of inspections allowe per permit (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems n Boiler Controls ❑ Clock Systems H Data Telecommunication Installation H Fire Alarm Installation n HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* H Medical H Nurse Calls n Outdoor Landscape Lighting* H Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I\13uddmg\Primus\ELC_PermnApp_ELR_ERE doe 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 12442 SW 122ND AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal FAIL ELC2015-00882 David Young Not ready for ﬁnal inspections, need rough in inspections. 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 12442 SW 122ND AVE, TIGARD, OR, 97223 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00882 Chip Barnett Violation Summary: Inspector Contractor