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Permit CITY OF TIGARD ELECTRICAL PERMIT .111111 ar COMMUNITY DEVELOPMENT Permit#: ELC2016-00521 Date Issued: 06/23/2016 T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S134DC00900 Jurisdiction: Tigard Site address: 11631 SW 114TH PL Project: VAIL Subdivision: 114TH PLACE Lot: 1 Project Description: Replacing galvanized piping from fixtures to crawl space only,and replacing(1)water closet,(2)sinks,and(1) water heater. Contractor: OWNER Owner: VAIL,VALERIA ALEJANDRA&JESSE JESSE VAIL 18047 SW LOWER BOONES FERRY RD 18047 SW LOWER BOONES FERRY RD#125 #125 TIGARD,OR 97224 TIGARD, OR 97224 PHONE: PHONE: 503-523-8222 FAX: FEES Quantity Description Date Amount 9 crt Branch Circuits wo/Purchase 06/23/2016 $115.54 Specifics: Service or Feeder 1 ea 12%State Surcharge- 06/23/2016 $13.86 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $129.40 Required Items and Reports(Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma ••-'• , o.y of direct questions to OUNC by calling 503.232.1987 or 1.800,332.2344. 1111111 Issued By: ,_� -. _ .. . re: • �^ 41100 OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale,lease or rent. OWNER'S SIGNATURE Date: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.ELEC' Date: LICENSE NO. Call 503.639.4175 by 7:00 a.m.for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Electrical Permit Application FOR OFFICE USE ONLY . Received / mei rmit#: Received (O h�iiwl l C.-, ! �;—SII City of Tigard y 1 - q 13125 SW Hall Blvd.,Tigard,OR 97223 ',y Plan Review Related Permit#: AA. ��p' _� Phone: 503.718.2439 Fax: 503.598 19 ' Date/By: lee Page 2 for ' p Ready Date/By: Inspection Line: 503.639.4175 %\� Notified/Method /- Supplemental Information TI G A RD Internet: www.tigard-or.gov .g�1 ,. PT`I ZW ... , 'z OF; ©RI{� .. . FPl .s' ';n..+th>$: co ': .. ��.� ��'� '� � �,�., Please check all that apply(submit 2 sets of plans w/items checked): 0 DemolitioneW tistTUCtlori ®Addition/alteratiOrl/rep•. Y 1t ❑Service or feeder 400 amps or more ❑Building over three stories. r 'r Other �� ¢- t ,�' where the available fault current ❑Marinas and boatyards. 0 exceeds 10,000 amps at 150 volts or ❑Floating buildings. ' ; ,... A`1`��iQ�-.�}FO�ST� less to ground,or exceeds 14,000 ❑Commercial-use agricultural ® 1-and 2-family dwelling 0 Commercial/industr' ° IAccessory building amps for all other installations. buildings. ❑Multi family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or 1irU� BIE.IlR1YAT1©N AND LOGATI©1 . ... t 0 Emergency system. larger separately derived ❑Addition of new motor load of system. ❑..A„ Job#: l Job site address: 11631 SW 114th Place 100HP or more. occupancy. ❑Six or more residential units. ❑Recreational vehicle parks. City/State/ZIP:Tigard,OR 97223 0 Health-care facilities. Residence Remodel Vail 0 Hazardous locations voltage f❑Supply or more than Project name: 600 volts for t Suite/bldg./apt.#: I J ❑Sernce or feeder 600 amps or m/o�re ��[ Cross street/directions to job site:SW 114th Place&Tigard St. Descr,Pnon I Qty. I Each I Total I * New residential single-or multi-family dwelling unit. Lot#: Includes attached garage. Subdivision: 1,000 sq.ft.or less 168.54 4 Tax map/parcel#: Ea.add'l 500 sq.ft.or portion 33.92 1 411,..4. - OF WO zi A_., .�,"t Limited energy,residential 75.00 2 r,.;. -: (with above sq.ft.) Add Can Lights and Outlets Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Relocate Range Renewable Energy ❑ See Page 2 O EKT1t d ER ,x t [ 'EN fT ,.,~ _. Services or feeders installation,alteration,and/or relocation - ►a � 100.70 2 Nr F Jesse 200 amps or less Name: Vail 201 amps to 400 amps 133.56 2 Address: 11631 SW 114th Place 401 amps to 600 amps 200.34 2 1,000 amps 301.04 2 to City/State/ZIP:Tigard,OR 97223 601 amps Phone:(503)523-8222 I Fax:( 552.26 2 Over 1,000 amps or volts Temporary services or feeders installation,alteration,and/or Email: relocation 6 1 200 amps or less 59.3 Owner installation:This installation is being made on property that I own which is not p 125.0853 2 intended for sale,lease,rent,or exchange,according to ORS 447,449,670,a id 70° . 201 amps to 400 amps 168.54 2 Date: 6 ✓j 401 amps to 599 amps Owner signatureBranch circuits-new,alteration,or extension,per panel t ®0` I ' t$i ., .;El CO T C ,lt'1 I# k .. „ ' A.Fee for branch circuits with - above service or feeder fee, 7.42 2 Business name: Same as Above each branch circuit B.Fee for branch circuits without i Address: y��J Contact name: service or feeder fee,first 56.18,.t 1'i 2 branch circuit Each add'I branch circuit — er 7.42 .,p 2 City/State/ZIP: Miscellaneous(service or feeder not included) Each manufactured or modular 67.84 2 Phone:( ) Fax: :( ) dwelling,service and/or feeder Email: Reconnect only 67.84 2 ridethewaves@gmail.com 67.84 2 '- x ' a 1't cTO , , :_,_.. ,, '. t. - Pump or irrigation circle ����_� �-���� `� ����'���'� "'" ��� ���� � Sign or outline lighting 67.84 2 Business name:Same as Above Signal circuit(s)or limited-energy 0 See Page 2 2 panel,alteration,or extension. Address: Each additional inspection over allowable in any of the above City/State/ZIP: Additional inspection(1 hr min) 66.25/hr Investigation(1 hr min) 90.00/hr Phone:( ) I Fax:( ) Industrial plant(1 hr min) 78.18/hr Email: Inspections for which no fee is 90.00/hr Suprv.Lie.: specifically listed 'A hr min CCB Lie.: Electrical Lic.: p .. a t': t I � *'' ��� � �� Subtotal: Suprv.Electrician signature,required: Date: 0 Plan Review Required(25%of permit fee): Print name: State surcharge(12%of permit fee): /7, W �.7 ��.--- J� TOTAL PERMIT FEE: / () Authorized signature ( I This permit application expires if a permit is not o ained within 180 Date: 51241364'6- days after it has been accepted as corn lete. Print name: Jesse Vail * Number of inspections allowed per permit. I:\BuildingTermits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: RESIDENTIALWU ON Fee for all residential systems combined: $75.00 Description j Qty. Each I Total 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 ❑ 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 ❑ Heating, Ventilation and Air Conditioning with OAR 918-309-0040) 552.26 2 System* Solar generation systems in excess of 25 kva: Each additional kva over 25 7.42 3 El Vacuum Systems* >100 kva—no additional charge 0.0 3 El additional inspection over allowable in any of the above: Other: Each additional inspection is charged at an hourly(1 hr min) 66.25/hr 1 Inspections for which no fee is * 0 specifically listed(V5 hr min) 90.00/hr Fee for each commercial system: $75.00 ,.. _ Subtotal(Enter on Page 1): I (SEE OAR 918-309-0000) * Number of inspections allowed per permit. Check Type of Work Involved: ❑ Audio and Stereo Systems El Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation El Intercom and Paging Systems El 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:\Building\Permits\ELC_PerniitApp_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 11631 SW 114TH PL, TIGARD, OR, 97223 Residential - Electrical 199 Electrical final FAIL ELC2016-00521 Herb Stabenow Postponed customer will recall for Tuesd to be done by Jeff Violation Summary: Inspector Contractor