Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2016-00717
T[GAR r) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/21/2016
Parcel: 1S133CD14200
Jurisdiction: Tigard
Site address: 11949 SW TALLWOOD DR
Project: Strakes Subdivision: PEBBLECREEK NO.2 Lot: 33
Project Description: Reconnect only.
Contractor: OWNER Owner: FARB, FRIEDA&
STRAKES, LESLIE
11949 SW TALLWOOD DR
TIGARD, OR 97223
PHONE: PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 1 ea Reconnect Only 09/21/2016 $67.84
1 ea 12%State Surcharge- 09/21/2016 $8.14
Type of Use: SF Electrical
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 Notification Center. Tho-= rules are s=t forth in OAR
952-001-0010 through OAR 952-0 90. You may obtain a copy of the rules or direct questions to OUNC by calling 50 232.1 7 r 1.80.33,.2344.
Issued By: Permittee Signature: •,=.
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 ApplicationRECEIVED FOR OFF1cF t sr Oyl.l
City of Tigard Received o2/ 4, <A1/ mem# �" / 0 -OO 7/
13125 SW Hall Blvd.,Tigard,OR 97223 1 :
Phone: 503.718.2439 Fax: 503.598.1960 22016 Plan Review
SEP
Inspection Line: 503.639.4175 Jt Date/B : Related Permit#:
Internet: Line:www.tigard-or.gov
gov CITY OF TI�r-� D RAY D��Y J1115 See Page 2 for
QUILDlNI? ��VISlQN Notified/Method: Supplemental Information
Type of Work Print name: L
0 New construction 0 Addition/alteration/replacement
0 Demolition ®Other: Reconnect electrical service Plan Review
Category of Construction Please check all that apply(submit 2 sets of plans w/items checked):
El Service
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building or more or feeder 400 0 Building
amps 0 Multi-family 0 Master builderwhere the available fault current over three stories.
0 Other: Marinas
JOB SITE INFORMATION AND LOCATION exceeds 10,000 amps at 150 volts or and boatyards.
lJob#: J Job site address: 11949 SW Tallwood Dr. amps to ground,
all otthe�mst�ilati�
0 Floating
City/State/ZIP:Tigard, OR 97223 0 Fire buildings.
Pump. ❑
Suite/bldg./apt.#: I Project name: 0 Emergenty system. Commercial-use
0 Addition of new motor agricultural
Cross street/directions to job site: load of buildings.
100HP or more. ❑
ElSix or more residential Installation of 150
Subdivision: units. KVA or
I Lot#:
0
larger separately derived
Tax map/parcel#: Health-care facilities. system.
0 Hazardous locations. ❑ "A
Description of work 0 "E""1-2","1-3
Service or feeder 600 0occupancy.
Y
Inspection of property to reconnect electrical service amps or more.
Recreational vehicle
parks.
Property owner
rl ❑ Supply
1 0 TENANT voltage for more than
Name: Leslie Strakes 600 volts nominal.
Fee Schedule
Address: 7055 SW 103rd Ave. Description I Qty I Each I Total
City/State/ZIP: Beaverton,OR 97008 New residential single-or multi-family
dwelling unit.
Phone:( 503 ) 643-2146 I Fax:( ) Includes attached garage.
Email: 1,000 sq.ft.or less 168.54 4
Owner installation:This installation is beingmade onpropertyEa.add'l 500 sq.ft.or portion 33.92 1
intended for sale,lease,rent,or exchange acording to OR47,449,670,and 701.not Limited(wanergy,residential.f.)
(with above sq.ft.) 75.00 2
Owner sig e: ‘LA,A,t„ C\ / Date: ft/1-1 i Lt Limited energy,multi-family
0
Applicant I Contact residential(with above sq.ft.) 75.00 2
person
0 See
Business name: Renewable Energy
Page 2
Contact name: Mike Hamburger Services or feeders installation,alteration,and/or
Address: relocation
200 amps or less 100.70 2
City/State/ZIP:Tigard, OR 97223 201 amps to 400 amps 133.56 2
Phone:(503)704-2088) I Fax: :( ) 401 amps to 600 amps 200.34 2
601 amps to 1,000 amps 301.04 2
Email:mike@mjhamburger.com
Over 1,000 amps or volts 552.26 2
Contractor Temporary services or feeders installation,
Business name: alteration,and/or relocation
Address: 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
City/State/ZIP: 401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,
Phone:( ) I Fax:( )
per panel
Email: A.Fee for branch circuits with
above service or feeder fee,
CCB Lic.: I Electrical Lie.: I Suprv.Lie.: each branch circuit 7.42 2
Suprv.Electrician signature,required: B.Fee for branch circuits without
service or feeder fee,first
branch circuit 56,18 2
Print name: I Date:
Each add'i branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Authorized signature: Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Reconnect only I 67.84 8.14 2
Pump or irrigation circle 67.84 2
Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See
panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any
of the above
Additional inspection(1 hr min) 66.25/hr
Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
specifically listed('/2 hr min) 90.00/hr
Electrical permit fees
Subtotal: 7,,
❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): f, /y
TOTAL PERMIT FEE: 75; d
This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.
* Number of inspections allowed per permit.
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
11949 SW TALLWOOD DR, TIGARD, OR, 97223
Residential - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00717
Jeff Grove
Violation Summary:
Inspector Contractor