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Permit m ,t CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2015-00988 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/16/2015 Parcel: 2S111 DB06900 Jurisdiction: Tigard Site address: 15420 SW ALDERBROOK DR Project: BENNINGTON Subdivision: SUMMERFIELD NO.7 Lot: 392 Project Description: Service replacement and modifying(3)branch circuits. Contractor: PRO STAT SERVICES LLC Owner: BENNINGTON,WILLIAM& BEVERLY 8122 NE 91ST STREET 15420 SW ALDERBROOK DR VANCOUVER,WA 98662 TIGARD, OR 97224 PHONE: 360-521-5742 PHONE: FAX: 360-859-3749 FEES Quantity Description Date Amount 1 ea Services or Feeders-200 12/16/2015 $100.70 Specifics: amps or less 3 crt Branch Circuits w/Purchase 12/16/2015 $22.26 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 12/16/2015 $14.76 Electrical Type of Const: Occupancy Grp: Total $137.72 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 oth cable aw. Al work wi be done in accordance with approved plans. This permit will expire if work is not started within 18 uan or if wor is s pen for re the 1 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon ility Notifi a er. Th ru s o i 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the r s or direct questions to OU C by callin 3 98 1 0 Issued By: ce Signature. OWNER INSTALLATION ONLY Th ation is being made on property I own which is not intended for sale,lease or rent. OWNE ' SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF R.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. r � Electrical Permit Application �� OOONLY `J g �� Received �) //_ /� ' Ci o Tigard O( ((! Permit Dale/By- v 13125 SW Hall Blvd.,Tigard,OR 972 O�h Plan Review r Phone: 503.718.2439 Fax: 503.598 V Date/By: Related Permit#: Inspection Line: 503.639.4175 �� dy Dale/By: ��' M See Page 2 for Internet: www.tigat-d-oi-.gov O` �C`o1 tified/Method: o Supplemental Information TYPE OF NVORK ` PLAN REVIEW ❑New construction Addition/alteration/r Please check all that apply(submit 2 sets of plans w/items checke ): E] Demolition ❑Other: @j ❑Serv' e or feed 400 an s or more Building ov thre storie wl re lie av ble fa t u Marinas boa rds. CATEGORY OF CONSTRUCTION a cc 10. amp 0 vol F atin tildi ' and 2-family dwelling ❑Commercial/industrial ❑Accessory building I ss to to ,d ore d o ❑c m e ial- agric u al nips r I I latio u' i 's. ❑ Multi-family ❑Master builder ❑Other: ire ut . l s latio 150 An JOB SITE INFORMATION AND LOCATION En r' y:y gerse aatelyd ed S� d no t mot load f stem Job#: Job site address: J 001 'or re. Cit /State/ZIP. Six rm resi mialut s. occ a City/State/ZIP Hea a f rttes. Re reat nal v hicle rk . Hazar o ovations. ❑ pply 'oll e for nto tat Suite/bldg./apt.#: Project na1116'. cc or feeder 600 amps or more. 00 vol: ominal, Cross street/directions to job site:Vf-�i FEE SCHEDULE !1 Deseri tion Iv. Each Total `� New residential single-or multi-fancily dwelling unit. Subd' of# Includes attached garage. 1,000 sq.11.or less 168.54 Tax map/pare ei i. Ea.add'l 500 sq.ft or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 s� �{ (wish above sq.ft.) '� ✓ Limited energy,multi-family 75.00 2 residential(with above sq.fl.) PROPERTY OWNER TENANT Renewable Energy ❑ See Page 2 Services or feeders installation,alteration,and/or clocation Nacne: 200 amps or less 100.7( i u- Lau 201 amps to 400 amps 133.56 2 Address:` t 401 amps to 600 amps 200.34 2 City/State/ZII"�� 601 amps to 1,000 amps 301.04 2 Phone: Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteratio ,and/or Email: relocation wine ns ati is i al tion i- ig I c n pr crty at I I h i s n 200 amps or Tess 59.36 1 nten d o si , I se nt, e an ,a rd' g RS 4 6 nd 01 201 at to 400 amps 125.08 2 O t si ture• Dat 401 amps to 599 amps 168.54 2 ❑ APPLICANT CONTACT PERSON Branch circuits—new,alteration,or extension, cr anel A.Fee for branch circuits with Business train tTj2oabove service or feeder fee, each branch circuit 7'42 Contact name. 13.Fee for branch circuits without Address: Q service or feeder fee,first 56.18 branch circuit City/State/ZIP: Lach add]branch circuit 7.42 2 Miscellaneous(service or feeder not included Phone: ( ) Lach manufactured or modular dwelling,service and/or feeder 67'84 2 Email: a C/ 2 Reconnect only 67.84 CONTRACTOR Pump or irrigation circle 67.84 2 Business na Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: j I Hanel,alteration,o I ❑ See Page 2 _ City/State/ZIP. Each additional inspection over allowable in any of tl D above Additional inspection(I hr min) 66.25/hi- Phone: rPhone: ) E Investigation(I 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.: V Electrical Lie.: S rv. Lic. specifically listed('/hr min) v ELECTRICAL PERJS.ba Suprv. Electrician. nat re,required Print name: e' t ❑Plan Review Required(25%of pctState surcharge(12%ofpe1Authorized gnatTOTAL PERM This permit application expires if a permit is nottainedwithiS180 Print name: Eldays after it has been accepted as c plete. C Number of inspections allowed per permit. 1\I3uildinl,\I'ermits\ELC_PennnApp_ELR_ERE.doc Rea 06/17/2015 440-4615T(I I/05/CO\I/WE13 + I Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIAL WORK ONLY: FEE SCHEDULE Description QN•. Each Total 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 k\,a 301.04 2 ❑ 50.01 to 100 kva 552.26 2 Garage Door Opener* >100 k%,a(fee in accordance with OAR 915-309-0040) 552.26 2 ❑ 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: 66._2>Each additional inspection is _ /hr I charged at an hourly(I hr min) Inspections for which no fee is 90.00/hr specifically.listed('/hr min) COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES Subtotal(Enteron 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 I\Eoddme\Permits\I:LC_PerinitApp_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 15420 SW ALDERBROOK DR, TIGARD, OR, 97224 Residential - Electrical 199 Electrical ﬁnal PASS - No C of O ELC2015-00988 Chip Barnett Violation Summary: Inspector Contractor