Permit CITY OF TIGARD ELECTRICAL PERMIT
�� _ COMMUNITY DEVELOPMENT Permit#: ELC2016-00859
Date Issued: 11/07/2016
T j G1 P D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S 111 BA05800
ie; ". l Jurisdiction: Tigard
Site address: 14145 SW 97TH PL
Project: PETERSON Subdivision: SOLARCREST Lot: 10
Project Description: (8)branch circuits for kitchen remodel. 11/8/2016:REPRINTED permit to show change of contractor from owner to
Frahler Electric.
Contractor: FRAHLER ELECTRIC COMPANY Owner: PETERSON, MICHEL E&LINDSAY A
11860 SW GREENBURG RD 14145 SW 97TH PL
TIGARD, OR 97223 PORTLAND, OR 97224
PHONE: 503-639-4627 PHONE: 503-441-2119
FAX: 503-639-4673
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo/Purchase 11/07/2016 $108.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/07/2016 $12.97
Type of Use: Electrical
Class of Work: 45 Misc Administration Fee 11/08/2016 $45.00
Type of Const:
Occupancy Grp:
Total $166.09
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 rul s are set forth in OAR
952-001-0010 through OAR 952-001-0090. You •• -copy of the ru,s or direct questions to OUNC by calling 503.232.1987 or 1.800. 2.2 4.
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 ApplicationFOR OFFICE USE ONLY
t
City Of Tigard RE!iew'
permit No.: c4 • Dco1 "(.Cd'J��131SWHalllvd,Tigard,OR 97 ,
Phone: 503.718.2439 Fax: 503.598. 1 Date/By: Other Permit:
TI GARD Inspection Line: 503.639.4175 ryt". Date Ready/By: kids: H See Page 2 for
Internet www.tigard-or.gov 15 1. Notified/Method Supplemental Information
TYPE OF WORK v t� � PLAN REVIEW a
0 New construction .®Addition/alterati0laceT1-1 t g ISU Please check all that apply(submit 2 sets of plans w/items checked below):
�s,C l * 0 Service or feeder 400 amps or more 0 Building over three stories.
El Demolition ❑Other: 1`t ,
w]ere the available fault current ❑Mannas and boatyards.
CATEGORY OF COVSt�JCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
,. .. ' _ . ,a t- _ less to ound,or exceeds 14,000
P.' gr ❑Commercial-use agricultural
�-and 2-family dwelling 0 Commercial/industrial ❑Accessory building amps for all other installations. buildings.
❑Multi family 0 Master builder ❑Other: 0 Fire pump. 0 Installation of 75 KVA or
JO$ SI Z E INE ORI ... -.. NAND 1i OGi1TION ❑Emergency system. larger separately derived system.
., . .. ❑Addition of new motor load of 0"A","E","1-2","1-3",
�7 Job site address: /) 100HP or more. occupancy.
Job no.: g
(�/ Y. �� 7 �(Grz,
0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP:'77 "`^ Qk 972- 2 q ❑Health-care facilities ❑Supply voltage for more than
/ � ❑Hazardous locations 600 volts nominal
Suite/bldg./apt.no.: Project name: I.3 kr_ser nye. ❑Service or feeder 600 amps or more.
nowmalCross street/directions to job site: ,FEE SCHEDULE;
Description I Qty. I Fee. I Total
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq.R.or less 168.54 4
Ea.add'l 500 sq.ft.or portion 33.92 1
Tax map/parcel no.: Limited energy,residential 75.00 2
DESCRIPTION O`H'WO { (with above sq.ft.)
' Limited energy,multi-family 75.00 2
Rnu± /�2 rin t ''LC o j , -OQg.s 9j • residential(with above sq.ft.)
r r1_ �� /"`^ / Services or feeders installation,alteration,and/or relocation
(.rt r (..' E4,C75^'G 200 amps or less 100.70 2
❑ PROP.ER'I'Y OWNER q/ ❑,TENANT 201 amps to 400 amps 133.56 2 i
401 amps to 600 amps 200.34 2
Name:
601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
City/State/ZIP:
relocation •
Phone:( ) Fax:( ) 200 amps or less 59.36 1
Owner installation:This installation is being made on property that I own which is not 201 amps to 400 amps 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 168.54 2
Branch circuits—new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
.APPLICAN.I above service or feeder fee,
❑ GONT',G Z PERSON 7.42 2
. ., .. _. . ._ each branch circuit
Business name: B.Fee for branch circuits without
service or feeder fee,first
Contact name: • branch circuit 56.18 2
Each add'l branch circuit 7.42 2
Address: Miscellaneous(service or feeder not included)
Each manufactured or modular
City/State/ZIP: dwelling,service and/or feeder 67.84 2
Phone:( ) Fax: :( ) Reconnect only 67.84 2
' Pump or irrigation circle 67.84 2
E-mail:
• Sign or outline lighting 67.84 2
CONTRACTOR Signal circuit(s)or limited-energy
Business name:J,2,/4 Tr/C.0 eiLa Fit-abler E0Cfr.ic. panel,alteration,or extension. Page 2 2
Each additional inspection over allowable in any of the above
Address: j�S D ,St G/, bAdditional inspection(1 hr min) 66.25/hr
City/State/ZIP:7,d 04. 9i 7� Investigation(1 hr min) 66.25/hr
Industrial plant(1 hr min) 78.18/hr
Phone:(5!0)639_4(6.27 Fax:(.3) 43 5-41-4,73 • Insttections for which no fee is
specifically listed(%z hr min) 90.00/hr
CCB Lic.: i"7/ 7.2. Electrical Lic.: C$6/ Suprv.Lic.:5no 5l y ` ,EZ,EGTI7ICAL $1VIIT,FEES,_ .,;
Suprv.Electrician signature,required: Subtotal:
Adam( • �/� i Plan review(25%of permit fee):
Print name: am 67111zd, ,1 Date: %ldg//6 State surcharge(12%of permit fee):
TOTAL PERMIT FEE:
Authorized signature: 'This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: * Number of inspections allowed per permit.
I:\Building\Permits\ELC-PermitApp.doc 07/01/10 440-4615T(11/05/COM/WEB
CITY OF TIGARD ELECTRICAL PERMIT
U • COMMUNITY DEVELOPMENT Permit#: ELC2016-00859
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/07/2016
T t c;r4 1?Dg Parcel: 2S111BA05800
Jurisdiction: Tigard
Site address: 14145 SW 97TH PL
Project: PETERSON Subdivision: SOLARCREST Lot: 10
Project Description: (8)branch circuits for kitchen remodel.
Contractor: OWNER Owner: PETERSON, MICHEL E&LINDSAY A
MICHEL PETERSON 14145 SW 97TH PL
14145 SW 97TH PL PORTLAND, OR 97224
TIGARD, OR 97224
PHONE: 503-598-6661 PHONE: 503-441-2119
FAX:
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo/Purchase 11/07/2016 $108.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 11/07/2016 $12.97
Type of Use: Electrical
Class of Work:
Type of Const:
Occupancy Grp:
Total $121.09
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 may obtain.copy of th- les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.23 .
Issued By: •=rmittee Signature: �
v
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 pU � Received FOR OFFICE Lsr:ONLY
City of Tigard
11
Date IB . (y CEINWEINEVII
13125 SW Hall Blvd.,Tigard,OR titt:°''
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960ill
j 1 zo Date. : Related Permit#:M�, , ( ,. Oa&c
Inspection Line: 503.639.4175 NONI Ready Date/By: El See Page 2 for
1 I"A RI) Internet: www.ti and-or. ov Notified/Method:
g gOf R. � Supplemental Information
TYPE OF Wt � _ � 11",c>ts. PLAN REVIEW
0 New construction Addition/alterat i} 'T17e Please check all that apply(submit 2 sets of plans w/items checked):
P y
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating)21_1-and 2-familydwellingCommercial/industrialless to ground,or exceeds 14,000 0 Commercial-use agricultural
0 0Accessory building amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: ❑Fireum .
p p 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
�_ a 0 Addition of new motor load of system.
Job#: Job site address: / 11i 'tom / --) /l�?G.t 100HP or more. ❑"A","E",°°l-2",°°1-3",
City/State/ZIP: I% ' �- � / `'?'''L-2--//
.2,pl ❑Six or more residential units. occupancy.
"� sL R. ❑Health-care facilities. ❑Recreational vehicle parks.
Suite/bldg./apt.#: Project name:
//7-�i�� 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.ftor portion 33.92 1
DESCRIPTION OF WORK
4,11/g- / j�,�` � y- Limited energy,residential
/2• 01/ Z //i/V4Ci 1 !( C r ✓() �itini-4- (with above sq. lti 75.00 2
ern �' t�'� Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
)d J 7 tri I O 41-I� 11 4-111-116; 6.,1cg( i4i iRt Renewable Energy ❑ See Page 2
fa PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: ---0//a./7::'?„, /4e- &,.a 200 amps or less 100.70 2
�f,6/_ 201 amps to 400 amps 133.56 2
Address: /( 7r` �`f+ �/
` / 401 amps to 600 amps 200.34 2
City/State/ZIP: ((71 / 601 amps to 1,000 amps 301.04 2
Phone:( :0'')/-;:11,( (/ / Fax: ( ) Over 1,000 amps or volts 552.26 2
j Temporary services or feeders installation,alteration,and/or
Email: 1�j- 4„1 p � ®a”/ - relocation
Owner installation:Thi installs' n i }!•e g made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,rent r eye c rding to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: ,/� '1-� Date: �� �� 401 amps to 599 amps 168.54 2
0
APPLICANT 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
7.42 2
each branch circuit
Contact name: B.Fee for branch circuits without
service or feeder fee,first
Address: branch circuit j 56.18 .0 ,,s, 2
City/State/ZIP: Each add'l branch circuit 7 7.42 5 f 2`l 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: Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:( ) Fax:( ) Investigation(1 hr min) 90.00/hr
Email:
Industrial plant(I hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%=hr min)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal: d -)
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): i j_,(7
Authorized signature: TOTAL PERMIT FEE:4/ I. e
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit. lVI
WO'
l:\Building\Permits\ELC_PermitApp_ELRERE.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:
0414 7. iu a �nmL ',
f1 '"= '` ' Description Qty. I 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
El 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
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
El Vacuum Systems* >100 kva-no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
El 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(/
hr
, L - ALRMT
r COMMERCIAWO .. ! tSubtotal(Enter on Page 1):
$75.00 Number of inspections allowed per permit.
Fee for each commercial system:
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ 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:ABuilding\Permits\ELC_PermitApp_ELRERE.doc Rev 06/17/2015
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
M EIV $AAAIAAA
Request for Permit Action
TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503-718-2439 • www.tigard-or\if& 8 2016
CITY OF TIGARD
TO: CITY OF TIGARD BUILDING DIVISION
Building Division
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.gov
FROM: ,Kj Owner ❑ Applicant ❑ Contractor ❑ City Staff
Check(✓)one
REFUND OR Name:
INVOICE TO: (Business or Individual) v^ ¢�')�1 C—T-�l 7A)
Mailing Address: 1 `(1 t/ Q4I 1P4 Pt
City/State/Zip: -I (U;'A-K Pi Ut 7i,f
Phone No.: co - -- 62(e% /
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
❑ CANCEL/VOID PERMIT APPLICATION.
❑ REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
L2 REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: -L-6 ZG) i ( OCRs1
i
Site Address or Parcel#: 5,01-14A a A-3 -, --) ' t,
Project Name: - G sj po
Subdivision Name: Lot#:
EXPLANATION: A/20 l Pj 6 (A4- i,�y'Z
Signature: -�1 Date: L! /r� /G 6
Print Name: 4€/C;(tr
Refund Policy
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was erroneously paid or collected.
• Not more than 80%of the application or plan review fee when an application is withdrawn or canceled before review effort
has been expended.
• Not more than 80%of the application or permit fee for issued permits prior to any inspection requests.
2. All refunds will be returned to the original payer in the form of a check via US postal service.
3. Please allow 3-4 weeks for processing refund requests.
f-RefRoute to Sys Admin: Date 7/ 1 4l. By j_ Route to Records: Date/4,2/,.2/40, By/ '715/-
Refund
und Processed: Date By Invoice Processed: Date By
Permit Canceled: Date By Parcel Tag Added: Date By
I:\Building\Forms\RegPermitAction_092314.doc
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
14145 SW 97TH PL, TIGARD, OR, 97224
Record Type:
Residential - Electrical
Inspection Type:
199 Electrical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
December 29, 2016 at 2:20:23
PM
Record ID:
ELC2016-00859
Inspector:
David Young
Contractor