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Permit ,o CITY OF TIGARD ELECTRICAL PERMIT ili COMMUNITY DEVELOPMENT Permit#: ELC2015-00854 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/12/2015 Parcel: 2S 1128809900 Jurisdiction: Tigard Site address: 14385 SW FANNO CREEK LP Project: Dalton Subdivision: COLONY CREEK ESTATES NO.3 Lot: 81 Project Description: (1)branch circuit for replacing NC Contractor: WESTERN HEATING&COOLING INC Owner: DALTON, DANNY ERVIN&SHIRLEY J 50618 COLUMBIA RIVER HWY 14385 SW FANNO CREEK LOOP SCAPPOOSE, OR 97056 TIGARD, OR 97224 PHONE. 503-543-5599 PHONE: FAX: 503-543-3693 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 11/05/2015 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 11/05/2015 $6.74 Type of Use: SF Electrical Class of Work: ALT 1 ea Investigation Fee 11/05/2015 $90 00 1 ea Investigation 12%State 11/05/2015 $10.80 Type of Const: Surcharge Occupancy Grp: Total $163.72 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 95090 You may obtain a copy of the rules or direct questions to OUNC by calling 503.232 1987 or 1 800 332.2344 / Issued By: . " ,erZ_ Permittee Signature: 2AJ f9--/i0G/6977 '/V 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. Oct. 13. 2015 11 : 16AM western Heating & Cooling, Inc, No. 0210 . P. 1 Electrical rermiet A,pplicanon FOR OFFICE:USE(ml.v . . City of Tigard ������ Date/B / /_ ..tilt, Permit lc T, 00,er7 I - v 13125 SW Hall Blvd.,Tigard,OR Plan Re-view Phone: 503 718 2439 Fad, 503.598.1960 Date/By Related Penult o, Inspection Line 503.639.4175 Ready Datc/By �.r uas, H See Page 2 for TId,Aan OCT 13 2015 �� ,. Internet: www.tigard-or.gov Notified/Method't/(j/�/�J Supplemental Information• • 'F,r-..7.' ['.•*(fail':• . ..>. -._. _ .'1 t•h_ tsj 11'17,,,'1 116'N '?r'. t•❑New construction 1rii Additio =s i '4 PXQ 'N'IS IO M Please check all that apply(submit;sets of plans w/[tams checked) Other: ❑Service or feeder 400 amps or more ❑Building over three stones ❑Demolition where the available fault current ❑Marinas and boatys ds. _'• (?:%`' ,'"‘:j)1..,''', ( ;.'/t':©yY[ L U_"i:'i i'((i' .1 exceeds 10,000 amps at 150 volts or ❑Floating buildings•Its 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 ❑Commercial-use agricultural A amps for all other installations buildings • Multi-family ❑Master builder ❑Other: ❑Fire pump. ❑Installation of 150 KVA or ,;•)l.j.rt-i q_. iii,1 01!f4;,/Cit1i(!';:) ,.`,:WI:: IL J)).-r: ir.:4`� ['Emergency system, larger separately denved ❑Addition of new motor load of system. Job#: Job site address: ''.5 S� so ••- - • I00HP or more ❑"A","E","i•2'•,"1-3". City/State/ZIP: ❑Six or more residential units occupancy ! e7 C� D� q 7 as F ►`t ® ❑ltecreattonal vehicle arks ❑Health-care ficihties, P Suite/bldg/apt.4: I Project name: 1,0 1}G 0 ❑Hazardous locations ❑Supply voltage for more than ❑Service or feeder 600 amps or more 600 volts nominal, I Cross street/directions to job site: I irtq-, t; _.i t,= ;" ,ie. Description Ore. East 1 j.:::,..-_;.::.::•:.-. ...:::Total New residential single-or multi-family dwelling unit. Subdivision' Lot#: Includes attached garage. 1 Tax map/parcel 4: 1,000 sq ft or less 1 168 54 4 __ portion 3 1 ... Ea. sq or pottio 3 92 �^': Limited energy,rosldenris 75 00 __ ^ — (with above so g) 2 u �* r ►� C L► Limited energy,multi-family - residential(with above sq ft) 7 ,00 2 Renewable Energy 0 See Page 2• 1' :.(c.:1 -T -- Seri,„o feeders installation, an or relocation IIMMII ► r 200 amps or less 100 70 2 Address: i- I yr.-�� 201 amps to 400 amps 133.56 2 �Y' ) ) Cc€L L \ 401 amps to 600 amps 200 34 2 Cit)/State/ZIP: 7 j CO I-! 0� Jl.7, 11 601 amps to 1,000 amps 301.04 - 12 Phone:613 ) -,)a li Fax:( ) Over 1,000 amps or volts 552,26 12 I Email: Temporary services or feeders installation,alteration,and/or relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59 36 I l 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670.and 701. 201 amps to 400 amps 125 08 I 2 I Owner signature: Date: 401 amps to 599 amps 168 54 L 2 ' 17_11 A ti,iKM;1 J ---_Eli.(fr-11 �� 0i 41i; Branch circuits-new,alteration,or extension,per panel -.. A Fee for branch circuits with Business name: / MOWN N 1 n 1_ a0� ne above service or feeder fee, 7 40 2 Contact name: n each branch circuit I9 p 0 B Fee for branch circuits without Address: '-p i (1, / service or feeder fee,first 1 56.18 ,) 2 I . i C' . i, .4 branch circuit 1 City/State/ZIP: .z( ilt_'.2 ` ` /-Xl5.6 1 Each add'I branch circuit 7 42 I 12 ` ` Miscellaneous(service or feeder not included) 1 Phone: 03 ) Fax-:(r ) Each manufactured or modular �� � �� 67 84 2 dwelling.service and/or feeder Email: 6 j _ I __- 'S ��11L!ggf --_ Reconnect only 67 84 2 L l: �t:'i?�Itfi:`�r;/{c[(oi4� • -.. 71 Pump or irrigation circle 67 84 I IT j• 1332EMIMEIFff t r / `i n' Sign or outline lighting I 67.84 I 12 Cr • Address: / 1 i Signal circuits)or limited-energy ❑ gee Page 2 2 L 0111(1 -11 A I<J-r,-( , 1JJ) panel,alterattoll1 or extension. City/State/ZIP /1 j "0 / Each additional inspection over allowable in any of the above Additional inspection(1 lir mm) 66 25/hr I Phone:* > ) .b `7 (.5 AEI Fax:(a).3) 5-13.. Investigation(1 hr torn) 90 00/hr I Email. �. Industnol plant(1 hr min) I 78 18/hr •• .el / -d ■ r•r v F Inspections for which no fee e is I 1 CCB Lic.: 7(g 7 A- ) EleotricalLic.:*J l e_ Supnv.Lic.: s.ccifrcal•'listed(%hr min Su rv.Electricians.� re u " ', 7 ?lJ c5i.1:;�,r,tal.,i.?';� ,,Judie.1,7:1.6. p required: /de- / • 7 _ - � ---- . Subtotal 5 ,, ��{` , Print name: /.. 1(\f Date. ' . ''.,1-� ❑Plan Review Required(25%of permit fee): !!•�, j - State surcharge(12%of permit fee): I td•19-1 Authorized signature: i`d ' ( 'V 1 2y1 TOTAL PERMIT FEE. I Lis, t `4 This permit application expires if a permit is not obtained wit in 180 Print name. k r 1 Eh. / (cc- Date:�16 -. 5 1.J days after it has been accepted as complete f ' Number of inspections allowed per permit /-0 Q Y PAD 11Buddins\PermUs\ELCPer!WtAp ELR-ERE doc Rev 06/17/2015 440-4615T(11/05/CO7`1/WEB /Nj 7 G / �_ 6 Oct. 13. 2015 11 : 16AM western Heating & Cool ing, Inc. No. 0210 P. 2 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 14385 SW FANNO CREEK LP, TIGARD, OR, 97224 Record Type: Record ID: Residential - Mechanical MEC2015-00408 Inspection Type: Inspector: 699 Mechanical final David Young Result: FAIL Comments: No electrical permit on file, no minor label posted on site for ac re- connect. Electrical permit required from city of tigard for ac re-connect, no minor label allowed for work done without permit, Investigative fee to be paid for electrical work done without permit prior to any further inspections._ Violation Summary: /•� Inspector Contractor Debbie Adamski From: Debbie Adamski Sent: Tuesday, October 27, 2015 9:39 AM To: djnelson @westernheating.com Cc: #Building Permit Technicians Subject: Dalton, 14385 SW Fanno Creek Lp, ELC2015-00854 Attachments: Dalton, ELC2015-00854.pdf Darcy, I wasn't sure if anyone had notified you that this permit is ready to be issued once the fees have been paid. The fees due on this permit are $163.72. A copy of the fee schedule is attached. This fee can be paid online through our web site. Here is the link: http://www.tigard-or.gov/city hall/online permit counter.php. Once this page opens go to the quick link list on the lower right hand side of the page and click on "Online Payments". When the fee is paid we receive a notification and we will issue and email the permit to you and you will be able to request the inspection. Debbie Adamski Senior Building Permit Technician City of Tigard I Community Development 13125 SW Hall Blvd., Tigard, OR 97223 503-718-2450 DISCLAIMER E-mails sent or received by City of Tigard employees are subject to public record laws If requested, e-mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law E-mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule " 1