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Permit (81) CITY OF TIGARD ELECTRICAL PERMIT g COMMUNITY DEVELOPMENT Permit#: ELC2016-00236 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/28/2016 Parcel: 2S110DC01000 Jurisdiction: Tigard Site address: 11075 SW MEADOWBROOK DR 4 Project: Summerfield Subdivision: WILLOW-BROOK-FARM Lot: 17 Project Description: (1)branch circuit for dryer vent in lower unit. Contractor: MCCAMMON ELECTRIC CORP Owner: SUMMERFIELD ASSOCIATES, LLC 5086 IKE MOONEY RD BY HSC REAL ESTATE SILVERTON, OR 97381 1500 SW FIRST AVE STE 1020 PORTLAND, OR 97201 PHONE: 503-559-8466 PHONE: FAX: FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 03/28/2016 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 03/28/2016 $6.74 Type of Use: MF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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 thr gh OA 2-001-I•'4. You may obtain a copy of the rules or direct questions to OUNC by calling 503.2 .198 or 1.8 0.332.2344 Issued By: Permittee Signature: k' i 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: b'///� LICENSE NO. 177. Tw 5 < 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 ApplicatiolnoECEIVED F011 0141( i l til O\1.1 �l V Received s ,I City of Tigard Date/B : i �10 �J Pennit#: Lu)O I V-OO.. .1114 g 13125 SW Hall Blvd.,Tigard,OR 97223 p Plan Review Phone: 503.718.2439 Fax: 503.598.1960MAR 2 8 2016 Date/B : Related Pennit 4:H ,7 .azo-oo,9 j Inspection Line: 503.639.4175 CITY OF TIGARD Ready Date By: loris. ® See Page 2 for I It, 1 Internet: www.tigard-or.gov Notified/Method: Supplemental Information :�,; ':y 7 TYPE OF ING DIVISION PLAN REVIEW ❑New construction Is.Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): 0 Service or feeder 400 amps or more ❑Building over three stories. ❑Demolition ❑Other: where the available fault current 0 Marinas and boatyards. ?,',,: :..7.:'''-,' , CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings. ❑ I-and 2-family dwelling ElCommercial/industrial ElAccessory building less to ground,or exceeds 14.000 ❑Commercial-use agricultural amps for all other installations. buildings. '.Multi-family ❑Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or .SITE INFORMATIONAND LOCATION 0 Emergency system. larger separately derived ❑Addition of new motor load of system. Job#: Job site address: / MOWN" I1 075 5 w . E1tt Z. 100HP or more. ❑ E ..1 13• /! n Q 2-211 ❑Six or more residential units. occupancy. City/State/ZIP: I 1 ©I` L 70 Health-care facilities. 0 Recreational vehicle parks. L Suite/bldg./apt.#: If Project name: r^.r,,MR, C(/ZLi/( 7" 0 Hazardous locations. Supply voltage for more than 1 L�Y�I'�' 600 volts nominal. 0 Service or feeder 600 amps or more. Cross street/directions to job site: A v(2._it el.a l (L p1 FEE SCHEDULE Description I Qty. I Each I Total 1 * New residential single-or multi-family dwelling unit. Subdivision: ctifv141 02-F/CrZi) Lot#: Includes attached garage. 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add.'500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential /� ��/ I (with above sq.ft.) 75.00 2 hp � � t C v� �O���rfi� vN�/7 Limited energy,multi-family residential(with above sq.ft.) 75.00 2 Renewable Energy 0 See Page 2 t.PROPERTY OWNER I 0 TENANT Services or feeders installation,alteration,and/or relocation Name:-CUYVI/yI eleF/EZI /4Moc-/41-65 L LC. 200 amps or less 100.70 2 J 201 amps to 400 amps 133.56 2 Address: tit 76" Sy.J /$10001 f g e-OOK j)(2., 401 amps to 600 amps 200.34 2 City/State/ZIP: '71 6 O . 9 7 2.2-g 601 amps to 1,000 amps - 301.04 2 Phone:(,5U ) 68 -18?/ Fax:( ) Over 1,000 amps or volts 552.26 2 Temporary services or feeders installation,alteration,and/or Email: relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 59.36 1 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps _ 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 APPLICANT ❑ CONTACT PERSON Branch circuits-new,alteration,or extension,per panel tigA.Fee for branch circuits with Business name: f c(4-MM OJ) e CT/21 t✓ 1Ivt above service or feeder fee, 7.42 o each branch circuit Contact name: pd.1/1_0 MG C4MmQ/%/ B.Fee for branch circuits without 1 �� 56.18 service or feeder fee,first �_�. 2 Address: .c0 66 /k' //IM ooi's/G� A 0, branch circuit City/State/ZIP: 5(L e(2.70N i Q q 73 Each addi branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(50 Z) 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: S/,'714 C Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy 0 See Page 2 2 Address: 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 Industrial plant(I hr min) 78.18/hr Email: - Inspections for which no fee is CCB Lic.: Ai 1z C7 Electrical Lic.: e (€2.5- Suprv. Lie.: 4L specifically listed(�/z hr min) t 90.00/hr ) _ ELECTRICAL PERMIT FEES Suprv. Electrician signature,required: �Ly,, �, �02 fj Subtotal: g(�•1C Print name: c. b�1S ��"" Date: 3-- 2 5- /,(, ❑Plan Review Required(25%of permit fee): �- JState surcharge(12%of permit fee): ee•7 yAuthorized signatuc77)7. G TOTAL PERMIT FEE: �j �— �� /� This permit application expires if a permit is not obtained within 180 Print name: M( Cue. 0.,\.. Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I.Building Permits ELC Permit.App ELR__ERE doe Rec 06 17'_015 440-4615T(I 105 COM WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: A. OI ONLY. FEE SCHEDULE Description Qtv. 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 n 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 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 n Heating, Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 111 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 I charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed(1/2 hr min) F Q I a hCG WORK ONLY: ELEC1` At"PERMIT FEES e commercial system: $75.00 Subtotal(Enter on Page I): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n Data Telecommunication Installation n Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems n Landscape Irrigation Control* n Medical n Nurse Calls n Outdoor Landscape Lighting* ❑ Protective Signaling n Other: Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I Building Permits FLC PermitApp t-LR_ERF doc Re%06 17 2015