Permit (7) CITY OF TIGARD ELECTRICAL PERMIT
111
I' - COMMUNITY DEVELOPMENT Permit#: ELC2016 00547
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/07/2016
Parcel: 2S110BB02800
Jurisdiction: Tigard
Site address: 12334 SW CHANDLER DR
Project: Fridlyand Subdivision: ARLINGTON RIDGE Lot: 5
Project Description: (4)branch circuits for NC and furnace.
Contractor: ELECTRIC EXPERTS LLC Owner: FRIDLYAND,ALEKSANDR&MARINA
1502 SW 25TH AVE 12334 SW CHANDLER DR
BATTLE GROUND,WA 98604 TIGARD, OR 97223
PHONE: 360-624-1340 PHONE:
FAX:
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 07/07/2016 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/07/2016 $9.41
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $87.85
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done-i actor ne we ipproved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
daATTENTION: Orego law equ es you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
95�001-0010 thrpugh OAR 952- 1�. y4�may obtain a copy of the rules or direct questions to OUNC by calling503.2�1987G,�$bU.332.2344.
Sseued By: \ "� i �, / Permittee Signature: wl �t( �1
....
�_ 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 INS/ LLATION ONLY
SIGNATURE OF SUPR.ELEC' r 4-(L 1 1 Date:
LICENSE NO. 5rfa-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 Application' s !'t FOR OFFICE IL Si: ()NI.)
„� �J��
City g e 1'ir' h Received
Permit#: �(y/(e OO 51/7
ofTigard 7 Date/B : ��
13125 SW Hall Blvd.,Tigard,OR 97223`�1-/� Plan Review
Phone: 503.718.2439 Fax: 503.5 ` ` Za161111
Date/B : Related Permit#:
Inspection Line: 503.639.4175 r° P ( h Ready Date/By: kris: la See Page 2 for
TIGARU '. ' +
Internet: www.tigard-or.gov a"1 s1 $ t !. Notified Method: Supplemental Information
TYPE OF WORK r 44 j81Q PLAN REVIEW
0 New construction r.l Addition/alteration/replacement
. Please check all that apply(submit 2 sets of plans w/items checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
O 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-and 2-family dwelling ❑Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATIONAND LOCATION 0 Emergency system. larger separately derived
J0 Addition of new motor load of system.
Job#: Job site address: i 2, -&--s L( s%-a a Q M 01 i Qe._ 100HP or more. ❑"A","E">"1 2","I-3",
Ci /State/ZIP: (Z 0 t 61 1 2_2-4 0 Six or more residential units.
❑Health-care facilities. occupancy.
y
Recreational
l vehicle parks.
1. ❑Hazardous locations. ❑Supply voltage for more than
Suite/bldg./apt.#: Project name: 600 volts nominal.
❑Service or feeder 600 amps or more.
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'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
C /� (with above sq.ft.) 75.00 2
1 t `C jYv - ^t �1�° °( ��Q c-.0Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
0 PROPERTY OWNER ❑ TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
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
APPLICANT El CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
Ag
A.Fee for branch circuits with
Business name: ` 1 (Z� C 1' .Q— ..-' 5 L L C above service or feeder fee,
7.42 2
_ each branch circuit
Contact name: ->c„.11...6.-- �/1`� fR_c `1c:� V B.Fee for branch circuits without
serAddress: 0 .'t.�9s/"r% A 1 ' branchce or feeder fee,first 1 56.18 S�, Q 2
Z 2 5 /V branch circuit
City/State/ZIP-j c,'-4 1 . (.--2� L4 iV el LOA 1 a6,0,-, Each add'l branch circuit 3 7.42 ).9,,,2 4, 2
/ 2 1 1 Miscellaneous(service or feeder not included)
Phone:(3(e)6O 2.. l{ '- I ,� L10 Fax: :( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email:e._/�C x �/"� p t i , G lit-A- Reconnect only 67.84 2
CON1ACTOR Pump or irrigation circle 67.84 2
Business name: l`1 ac:r p i'L X [J p42N j L Sign or outline lighting 67.84 2
A VA Signal circuit(s)or limited-energy
S <_ �
Address: 1 G panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: '}"�j i .e G-(j..'D t„{0.. /' `T �yo(�. Each additional inspection over allowable in any of the above
t t `` I 1 '`- '� Additional inspection(1 hr min) 66.25/hr
Phone:( 6 24 - 1'3 k4 o Fax:( ) Investigation(1 hr min) 90.00/hr
Email: '2t C.G. (24cp Ciil�Vv.G 1 , c�,,r.., Industrial plant(1 hr min) 78.18/hr
_ Inspections for which no fee is 90.00/hr
CCB Lic.: I �j�139 Electrical Lic.:( 49!\ �Suprv.Lic.: S 4 2 specifically listed('/z hr min)
j �� ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ? t •��-� �� ���� Subtotal: 73,44
Print name: Qc..-424-/ \-0, .Q r\� `
t7 Date: 1 -'7 o (,69---z 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 9'1,5
Authorized signature: TOTAL PERMIT FEE: ' 'f t-
This permit application expires if a permit is not obtained within 180
Print name: Z(?r c% 14_,-, EE., ` ` J Date: —7 - '7 ' (fp days after it has been accepted as complete.
* Number of inspections allowed per permit.
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Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: FEE SCHEDULE
Fee for all residential systems combined: $75.00 DesRenewan Qty' Eeen T°tai `
Renewable electrical energy systems:
Check Type of Work Involved: 5 kva or less 100.70 2
5.01 to 15 kva 133.56 2
❑ Audio and Stereo Systems* 15.01 to 25 kva 200.34 2
Wind generation systems in excess of 25 kva:
❑ Burglar Alarm 25.01 to 50 kva 301.04 2
50.01 to 100 kva 552.26 2
n Garage Door Opener*
>100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System*
Each additional kva over 25 7.42 3
❑ Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
❑ Other: Each additional inspection is 66.25/hr
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed('/z hr min)
COMMERCIAL WORK ONLY:
ELECTRICAL PERMIT F'EE$„
$75.00 Subtotal(Enter on Page 1):
Fee for each commercial system: * 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
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
n 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015