Permit (40) n CITY OF TIGARD ELECTRICAL PERMIT
114
COMMUNITY DEVELOPMENT Permit#: ELC2016-00256
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 03/31/2016
Parcel: 2S102DB00203
Jurisdiction: Tigard
Site address: 9301 SW HILL ST
Project: Neubo Subdivision: BURNHAM TRACT Lot: 7
Project Description: (1)service and(8)branch circuits for panel change,kitchen remodel and convert baseboard heat to cadet heaters.
Contractor: QUALITY PLUS FRAMING&ELECTRICAL Owner: NEUBO, CRAIG&KRISTY
16037 SW BOWMEN LN 18418 OLD RIVER LANDING
SHERWOOD, OR 97140 LAKE OSWEGO, 04 97034
PHONE: 503-477-0704 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 03/31/2016 $100.70
Specifics: amps or less
8 crt Branch Circuits w/Purchase 03/31/2016 $59.36
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 03/31/2016 $19.21
Electrical
Type of Const:
Occupancy Grp:
Total $179.27
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= applicable law. ;foil/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 wor2 is s pended for,' ore the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Ce '-r. •-e les are forth in OAR
952-001-0010 thr gh R 952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.19.7 or .800. . .2344
t /
Issued By: Permittee Signature: /A—
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.
Electrical Permit Applicat* n �1 OI2 t)Fhl( I. t I.t)NI.1
City of Tigard 1 C El V j Received E /�i/L��I{rri�� Permit 5:E`+-4•r�/ ,'ea p/S4
Rete iv C
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
. . Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit i!:
Inspection Line: 503.639.4175 MAR 3 1 ;/n16 Ready Date/By: Juris: ® See Page 2 for
I I t 1 R I> Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE O*. ()F 11VAKD PLAN REVIEW
❑New construction r.Additio I C Please check all that apply(submit 2 sets of plans w/items checked):
U Lrtt/'I° � � ' `( 0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or 0 Floating buildings.
1`'.j-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14.000 0 Commercial-use agricultural
amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: _1 30 t (4.. f( a 100HP or more. ❑"A , E 1 2","I-3",
City/State/ZIP: /� x1/4_ ❑Six or more residential units. occupancy.
Y /G�r� Qf� Recreational vehicle parks.
❑Health-care facilities. ❑
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: . ,FEE SCHEDULE
Description I Qty. I Each I.,: Total I
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
1,000 sq.ft.or less 168.54 4
Tax map/parcel#: Ea.add'I 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
QQraka_ �,,�\ _ / (with above sq.ft.) 75.00 2
1 C�YIQ 1Z t^ L1M3�C/� Limited energy,multi-family
75.00 2
/t 1 ,� !J 1' c 5 residential(with above sq.ft.)
�C�'`�'"� Op H v C'L� tW�++�C Renewable Energy 0 See Page 2
0 PROPERTY OWNER 1 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less / 100.70 2
201 amps to 400 amps 133.56 2
Address:
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) 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
0 APPLICANT I 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with 7/
Business name: above service or feeder fee, {� 7 7 .42 /"2
each branch circuit
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit 56.18 2
City/State/ZIP:
Each add'I branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) 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: Ql1e,xt u5 �t�Qwv:as " L'C
� Vt (. g
Sign or outline lighting 67.84 2
�'
(�� Signal circuit(s)or limited-energy
Address: I/O 37 IYK`t-t.. -k— Lc...v,c_ panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: , h q /�d Each additional inspection over allowable in any of the above
t cwzd 71 Additional inspection(I hr min) 66.25/hr
Phone:(1I ) ) 477- o7c l Fax:( ) Investigation(1 hr min) 90.00/hr
Industrial plant(I hr 78.18/hr L 4-,�k� Q k-vwki(i CGi� Inspections for which no
fee is
specifically listed '/2 hr min) 90.00/hr
CCB Lic.: q (‘•�i Electrical Lic' Op_ Suprv. Lie.: 57‘s � y ( '
ELECTRICAL PERMIT FEES
Suprv. Electrician signature,required: Subtotal: i olo_
Print name: 1 Date: /-- ( — I b 0 Plan Review Required(25%of permit fee):
�V V cY v G c
State surcharge(12%of permit fee): /"/�w
. W
TOTAL PERMIT FEE:
Authorized signatur : ' q-
This permit application expires if a permit is not obtai ,. at� n :1
Print name: 6,tt 1�s (2,e Date: 3(3, days after it has been accepted as co ,. •. a
fs
Number of inspections allowed per permit. /7._. :
I:Building Permits ELC PermitApp ELR_EREdoc Res 06 17 2015 440-4615T(I I 05('OM WEB
0
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
ritESTOENTIAL WORK'ONLY: et 4 DVLE w
-Description I Qis Each I 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
552.26 2
with OAR 918-309-0040)
n 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:
n Other: Each additional inspection is
66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('h hr min)
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Pagel):
*
(SEE OAR 918-309-0000) Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1 Building Permits 1 LC PennitApp ELR ERI doc Rec 06 17 2015