Permit �� i:i, CITY OF TIGARD ELECTRICAL PERMIT
'` COMMUNITY DEVELOPMENT Permit#: ELC2015-00955
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/03/2015
Parcel: 2S110CB11700
Jurisdiction: TIGARD
Site address: 15166 SW HARVEYS VIEW AVE
Project: Southview Heights Subdivision: SOUTH VIEW HEIGHTS Lot: 5
Project Description: (1)branch circuit for a/c
Contractor: CITY ELECTRIC&SUPPLY CO Owner: STONE BRIDGE HOMES NW LLC
55568 SW SCHALTENRAND LN 4230 GALEWOOD ST, STE 100
SHERWOOD, OR 97140 LAKE OSWEGO, OR 97035
PHONE: 971-404-1714 PHONE: 503 387-7577
FAX: 503-625-305.2
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 12/03/2015 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/03/2015 $6.74
Type of Use: SF Electrical
Class of Work: ALT 1 ea Investigation Fee 12/03/2015 $90.00
1 ea Investigation 12%State 12/03/2015 $10.80
Type of Const:
Occupancy Grp: Surcharge
Total $163.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATT- •' ► -.on law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
952-00 /010 through OAR/52-1/ 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503 230.332.2344.
Iss •d By: . A Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Electrical Permit Applicatiot �, .,c ... :4 F OFFICEUSgONLY� 4 �k s �' :
+. t ' Received
r" City of Tigard ; .% f' a 1'i Permn ori: F_[C�Ar 'Dl')Q�$�
1 D:nc/Ilea
n 13125 SW 1-tall Blvd., Tigard,OR '�' 23 0 phi Review
21 Phone: 503.718.2439 Fax: 503.598.1960 LC Ic Ry: Oilier Peoria: /� _ '
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TIGARD Inspt:et: I.mc: 503.639.8 175 �i'% ' 4,*
.400��A , c RcadyeBy — .Iriris: E7 .cc ngc 2 or
_:�. Internet: www,Tigard-or gov
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� r'nnhed/Mrihal: TTIO Supplemental Information
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i item
1,1,;,,c cheek all that apply(submit 2 sets of plans whtcros checked below):
®New construction ❑Additionhdteratio
��33``�� ❑Service 01 feeder•00 amps of fume ❑Building over three stories.
❑I)emolltlon ❑Other: where the available fault cuneut 0 Marinas anti boatyards.
'°^
l' . •' ;6fi.,Eai.in `.(}Ir'a{"tmkrit,l eifiUN; - 7;.: ` '''.• •
r,, exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less toround,or exceeds 14 000
.,,,Sx,,* •r,.•.�x=..r-.a >. .- ..z - �•.-.r,:n Ls .'.g�,;•:'
g 0 Conunercial-use agricultural
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑ Multi-family D Master builder ❑Other: 0 Fire primp, 0 Installation of 150 KVA or
a=tea i, iti,s :,jj ;{,•, �,a w.,,.,..,, ,; ; z.. ❑Emergency system. larger separately derived system.
i', •-a .,r Ii')I3`I:lI 'etinOapart Vrild.IV;ANI.)gd.A-r1T14 '�r aa, �ti< 0,1'4 .1
.,:.'r�� ? `.., � .€ .�„�.,�: .._,.....,,.�� ,..,>..(,�, )(\ r :xFs?�„s �t�;t���a`3� 0Adtlilioncfncw �a ❑ '
-_a«..,. . molork load .,A.. ..F., .1.2.,..1.3„
Job no.: Job site address: r Ioonl'oi num< occupancy.
�/ l `� v" �� c �ItO 0 Alt"' ❑Six or more residential units. 0 Recrealinnal vehicleparks..
City/State/ZIP:Tigard,OR 97224 ❑Health-care facilities, 0 Supply voltage for more than
❑Hazardous locations, 600 volts nominal,.
Suite/bldg./apt.no..". Project name:Southview Heights 0 Service or feeder 600 amps or more. .
:a_. _
Cross street/directions to job site:SW 122"'t Ave&SW Beef Bend Rd pr.scr-;" /;;;-1',,,; ,:„:,-.:. :1-.:
ip,inrr M. I tae. ) 7r"tnl (`•
New residential single-or multi-family dwelling unit.
Includes attached garage.
•
Subdivision:Southview Heights Lot no.: 1.000 sq.ft,or less 168.54 4
Ba.4(1'1 500 sq.fl,or portion 33.92 ,
Tax map/parcel no..,:'' Limited energy,residential 75.00 2
: ., rf.
Falf` ;�z, -,`; i`egif'SSGIi1Nrt"O riiORKt' 72, Owilhahovcsc It)
F _� :1w � z ... a a�'' ,- '<s f` Limited energy,multi-family
_ 0) 1St p� 44- ��///� residential(with above sq,IL) 75,00 2
Renewable Energy ' ":'❑ See Pa'ge"2:u�-::. �„':mtt
Services or feeders installation.alteration,and/or relocation
F,.: a ^ ,.. a.,.* .,,. a',-_` / 200"m
s or less 100,70 f
a `0 tilt : R ^f 1V I RiVil .x: . 'i:x' ' 7 *At`tT <<;¢;s, h P
:i 7 ., x ,�• >s!;. :�.a.:r ir ,:,f fat r.,¢>'.xg ,,r< . h ,., ,W... 201 amps to 400 amps 133.56 2
Name:Stone Bridge Homes NW, LLC '401 amps to 600 amps 200,34 2
Address:4230 Gatewood St,Suite 100 601 amps to 1,000 amps 301,04 "2 '
Over 1,000 amps or volts 552.26 2'
City/State/ZIT': Lake Oswego,OR 97035 Temporaryservices or feeders installation,alteration,and/or
Phone:(503)387.7577 Fax:(503)387.7615 relocation
200 amps or less 1 59.36 ':
Owner installation:This installation is being made on properly that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps l0 599 amps 168.54 _ 2.
Owner signature: Date: Branch circuits-new,alteration,or extension, per panel
°:u�;:,�S�x.. .r�� � :*' 4:10-124970100444$2.41P �r, A.Feu for brutch circuits irx/r
k .,x44 zi' :� :,rK 144:41..4 M %.(�..t; '' . ' (it
'� above service or feeder fee,
Business name:same as above
each branch circuit 7'42
B.Fee for branch circuits without
Contact name:Deirdre Britt service or feeder tee,first 56,18 . r4*/7 2
branch circuit
Address: Each add'I branch circuit 7,42 2.
Miscellaneous(service or feeder not included)
City/State/ZIP: `
Each manufactured or modular 67.84 2
Phone: dwelling_scrvicc and/or tcedcr
ihone:( ) fax::( )
Reconnect only 67.84 2:
L-mail:dbritt n„stonebrklgehomesnw.com Pump or irrigation circle 67.84 2
-'-54 ,F-ri , == '_ « �,:< .,zg t fir. tf r2i.1 ` ;.I .wt ;z. ,. s4 v. 5,tl
. , ux,.s,«, _ �a�,F,> a...�, ,��=,�....._ _�., .�n�.�.:�.._.. 4� �»>���ea-:-._����,e,,� Sign or outline lighting 67,84 2
13usiness Halite: City Electric Signal cucuit(s)t,r Iimited-.nergy See
. _Hanel,alteration.or eStenston. Page 2
Address: 55568 SW Schaltenbra nd Ln Each additional inspection over allowable itt any of the above
(
Additional inspection(I lir min) rI 66.25/hr
City/Stale/ZIP:Sherwood,OR 97140 Investigation(I hr min) I66,25!hr
Phone:(971)404.1714 Pax:(503)625.3052 hulusti pal plant(I hr inin) I_78.18/hr
Inspections for udiich no ace is
90.00/hr'
CCB I,ie,: 42422 1 Electrical 1.ic.: 26-289C Supra'. Lie,: 35925 speeilieclh listed(I"hr min)
ELECTRICAL PERMIT FEES :
Su(mv. I It:ctricinn signature. required: (-7_,,...., �- Subtotal: 54'-f g'ii
Print Plan tevico:(2?';S,of permit Ice}: •�
I tint name: Chuck Friesen � Date: �.._.....
_--...__.._ill State;wchvi gcalx'.r oIpermit feel
tip 7
Authorized sir'nalure: `I / i TUI Al.PCRt\•11'1 I'I:..v ! girf•o0
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-I his permit appliranon espn'r,it a permit is mol uhl:unctl within IAO I
IIIA I1note: ll�l Ltnc: .,s. ii r.. n,u m. d.w to { O
V`e 111
ell
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i nor,a:_aP,,n n.;l L: ,..nuiala, Lti 1'<: :I,: K:•: :7t:7n;, •I.!•, lrl'It t:,i::r:t7.i:l lli i
Electrical Permit Application—City of Tigard
Page 2—Supplemental information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RC5.115.'Nf A[WO K ONS':, 1;_ ,.., 4 ' ✓ _
_ .. � i?L•;lirSGilirDUi:! ��:,��': -, '. ' ;
Fee for all residential systems combined ... $75.00 Description 1 rnV. T tree ° I `rota' f-
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
n Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
n Burglar Alarm Wind generation systems in excess of 25 kva:
25.01 to 50 kva 301.04 2
® Garage Door Opener* 50.01 to 100 kva 552.26 2. ,
>100 kva(fee in accordance with
OAR 918-309-0040) 552.26 2
® Heating,Ventilation and Air Conditioning
System* Solar generation systems in excess of 25 kva:
Each additional kva over 25 7.42 3
F. Vacuum Systems* >100 kva-no additional charge 0.0 3
n Each additional inspection over allowable in any,of the above:
Other: Each additional inspection is 66.25/hr 1
charged at an hourly(I hr min) -
Inspections for which no fee is 90.00!hr
�» - -r z , . „T 4pecifcally listed('/:hr min)
s {fit �y�/�-?'refT,{�'(' WOT�� :t7a757 ° li. .kr�1, ,:, .. c... at,ii�s �rixi j�i�-tai juT rKE;5:�Wa.,
,tif 0�,,it'�q!j•'I�::A�..?v.�b".1114°,L"�s.� � G`_'. ,,�§��:".'�iis<i��.n!. .�as%��Fi'ai:.:.$�ik .'63.:':i ln�v`�'s°$;
Fee for each commercial system $75.00 Subtotal:
(SEE OAR 918-309-0000) Plan review,if required(25%of permit fee):
State surcharge(12%of permit fee):
Check Type of Work Involved: TOTAL PERMIT FEE:
This permit npplicntion e.pires if a prnnit is not obtained within 180
nA• udio and Stereo Systems days after it has been accepted as complete.
• Number of inspections allowed per permit.
n Boiler Controls
n Clock Systems
n D• ata Telecommunication Installation
[� Fire Alarm Installation
(— I-NAC '
n Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
n M• edical
17 Nurse Calls
n O• utdoor Landscape Lighting*
Protective Signaling
n Other
'Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I`•,auild- fermi\ELC_Perr Ap_ELR_ERE doe Rev 05/21/7013