Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016-00034
. s 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 01/1
9/2016 Parcel: 2S111AD111AD11200
Jurisdiction: Tigard
Site address: 15055 SW 88TH AVE
Project: Chandler&Newville Inc Subdivision: SCHECKLA PARK ESTATES Lot: 47
Project Description: Reconnect only.
Contractor: OWNER Owner CHANDLER&NEWVILLE INC
20508 SW ROY ROGERS RD, SUITE 147
SHERWOOD, OR 97140
PHONE:
PHONE: 503-830-4793
FAX:
FEES
Quantity Description Date Amount
1 as ReconnectOnly 01/19/2016 $67.84
Specifics:
1 ea 12%State Surcharge- 01/19/2016 $8.14
Electrical
Type of Use: SF
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $75.98
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 Notifica ion Center. Those rules are set forth in OAR
952-001-0010 through O 52- 0 O. You may obtain a copy of the rules or direct questions to DUNG by calling . 32.1987 or 1. 44.
Issued By: Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease of rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.forthe next available inspection date.
This permit cam 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 Applicatio ECEIVED
Received
City of Tigard Dto`B -Permit NEGC
13125 SW Hall Blvd,Tigard,OR 97223 JAN 19 2016 Plan Revieo
Phone: 503.718.2439 Fax 503.598.1960JAN Related Peroral#:
Inspection Line: 503.639.4175 CITY OF tIGKRD Ready date,By: 7juns ® See Page 2for
Internet www.tigard-or.gov NotiOed'Methld: Supplemental information
TYPE OF PLAN REVIEW ��
❑New construction ❑Addition/alteration/replacement Please check all that apply(submit 2 sets ofplans w/items checked):
��// � ❑Service or feeder 400 amps or more Building over three stories.
C] Demolition pg,Other. Q GNt919 P /,/rOwe� [Iwhere the available fault current ❑Mamas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 sobs or ❑Floating buildings.
I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceed, 14.000 ❑Commercial-use agricultural
amps for all other installations. buildings.
E]Multi-family ❑Master builder E]Other: ❑Fire pump_ ❑Installation of 150 KVA of
- JOB SITE.INFORMATION AND LOCATI'O�N1 p,L ❑Emergency system, larger separately derised
�SaSS S{5/ �y r &, ❑Additonofnew motor load of system.
Addition
Job#: lob site address: IooItnrmore. ❑`n" E"" ,_ 1-3
^ ❑Six or more residential units, occupancy
Cloy/S[ffiC/ZIP: _
r Ar `•' 97 Z Z ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bidg./apt. I Project name: Hazardous locations, [I Supply Voltage tor more than
E]Service or feeder 600 amps or mare. 600 .Its nonunal
Cross street/directions tojob site: ruf .5 4 el f FEE SCHEDULE
/fo O f R N 0,41
`4 / /., Drscri rion 0. Fach Total
d (�P 7 New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.fl.or less 168.54 4
Tax map/parcel#: Ea.add 1 500 sq.it or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
e (with above sq.It.) 75.0(1 _
�ewx ACL Limited energy,multi-I'nmil
residential(with abovesq.ll,)
75.00 _
Renewable Eneray
PROPERTY OWNER ❑ TENANT ❑ See Pa e 2
Services or feeders installation,alteration,and/or relocation
Name: L ,4,A ,e7, 200 amps or less I(10.70
Address: 2d.�g <64 6 r� ) U t� �� '-01 amps to 400 amps 133.56 _
401 amps l0 600 amps 20034 _
City/State/ZIP: 601 amps to 1.000 amps 301 D4
Phone: (fp ) �>G r 7G '5 Fax: ( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
Email: k i c4. 6%A ✓t1/f y L 1•&,-A relocation
Owner installation:This instal A on is being made on property that I own which is not 200 amps or less 1 59.36 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.09
Owner signature: Date: 401 amps to 599 amps 168.54 1 1 2
APPLICANT 13 CONTACT PERSON Branch circuits—new alteration or extension per panel
A.Fee for branch circuits frith
Business name: `,4 A 4-- �, e 1'J V` �e A above sets ice or feeder fcc, 1.42
each branch circuit
Contact name: GN W � rv'6� B.Fee for branch circuits n nhmn
Address: Z(f,SV" /4,-7service or feeder ev:,firs) 56.18 0
AfVK p� � 6 .�/� M% Q � branch circuit
City/State/ZIP: >`i Q/WOG 0A 740 Bach add'[branch circuit 7.42 -
r� Miscellaneous service or feeder not included
Phone:(,$V3) 9-30— a74 3 Fax: :( ) Each manufactured or modular
/� //�� 67,84 '
Email: WC r 0(}v ` /t'1�1 r W� Reconnect
service and tisdur
Reconnect only 6284
CONTRACTOR Pump or irrigation circle 67,84
Business name: Sign or outline lighting 67,84 2
Address: Signal circuits)or limiltd-enSee Page 2
panel,alteration,or extension.
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(I hr min) 66.25/hr
Phone:( ) Fax: ( ) Investigation(I hr min) 90.00/hr
Email: Industrial plant(I hr min) 78 lsi'tr
Inspections for ohich no fee is 90,00/hr
CCB Lic.: Electrical Lic.: Suprv. Lic.: s -ificalllisted(': hr min
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal:
Print name: Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee):
Authorized signature:
TOTAL PERMIT FEE: <,
this permit application expires if a permit is not obtained within IAO
Print namc: O 4 �; r.A�4/I Date. / -let- /6 days after it has been accepted as complete.
' Number of inspectmns allowed per penmt.
I.Puildu,Panne I L( PPImhA, FI R 1-RI'dem Re,n6 I Illy 440.46157111 05(1),\I"I It
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
"._. .. '1Sd`ib�'=u- ��r•,tf.,S� _ Dexri tion b. Ea h Tolvl '
Fee for all residential systems combined $75.00 Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 00.70 -
5.01 to 15 kva 133.56 2
F] Audio and Stereo Systems* 15.01 to 25 kva 20os4 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
❑ Garage Door Opener* 50.01 to 100 kva 552.26
>I00 kva(fee in accordance 5K,26
kith OAR 915-309-00401 -
❑ Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Hach additional kva ova 25 7.42 3
❑ Vacuum Systems* >100kva—no additional charge o.o 3
Each additional inspection over allowable in anv of the above:
❑ Other: fiach additional inspection is 66.25/hr I
charged at an hourly(I hr min)
Inspections for which no Ice is 90,00/hr
specifically listed('/n hr min)
-_.._. FAA TYICAL PERMIT FEES
coHIMERCUL WORK ONLY:
Subtotal(Enteron Pagc I):
Fee for each commercial system: $75.00 Number of inspections al lowed per permit.
(SEE TTR 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
1 nuihang Pcrnma CI r Peniir App I I R I RId- Ra OM1 1'2015