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Permit (280) ,, CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2016-00964 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/23/2016 Parcel: 2S 109D 608600 Jurisdiction: Tigard Site address: 13087 SW BLACK WALNUT ST Project: Summit Ridge No.5,Lot 154 Subdivision: SUMMIT RIDGE NO.5 Lot: 154 Project Description: (1)branch circuit for A/C Contractor: SUNLIGHT ELECTRIC INC Owner: DR HORTON INC 2800 NE 65TH AVE SUITE B 4380 SW MACADAM AVE VANCOUVER,WA 98661 PORTLAND, OR 97239 PHONE: 360-772-3877 PHONE: FAX: 360-694-9728 FEES Quantity Description Date Amount 1 crt Branch Circuits wo/Purchase 12/23/2016 $56.18 Specifics: Service or Feeder 1 ea 12%State Surcharge- 12/23/2016 $6.74 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $62.92 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•-2-00000 -'090: You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: � �-� / ,e> ' Permittee Signature: el�1/ 1 /e. 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. EIectrical Permit ApplicatioI I , (),z 0,., i c I_ l 1:r>\i., City of TigardDEC 2 2 016 Received4 Permit No.: n 13125 SW Hall Blvd.,Tigard,OR 97223 D'C t, Date/By: .44/01?// 4't4ta'-• �`L,<�2a� ©D n y i pPlan Review Phone: 503.718.2439 Fax: 503.59811/ OF F''(. AR D may. Other Petmit/Vg�• 7/6.-pO f.56 i'1,, ,R n Inspection Line: 503.639.4175 B u i Lod`N G u l`f i s i ry :Date ReadyBy: 1uris: H See Page 2 for Internet: www.tigard-or.gov W �A Notified/Method: , Supplemental Information TYPE OF WORK. - • PLAN- ;' <: • Please check all that apply(submit I sets of plans w/items checked below): ®New construction 0 Addition/alteration/replacement ❑Demolition Service or feeder 400 amps or more 0 Building over three stories. ❑Other: where the available fault current 0 Marinas and boatyards. CATEGORY OF CONSTR`VCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings. ❑1-and 2-famil dwellin less to ground,or exceeds 14,000- ❑Coritmercial-use agricultural y g ❑Commercial/industrial- ❑Accessory building amps for all other installations. buildings. 0 Multi-family 0 Master builder ` 0 Other: ❑Fire pump• 0 Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately derived system. 0 Addition of new motor load of 0"A","E","1-2","1-3", Job no.: Job site address: 13087 SW Black Walnut Street toolrn or more. occupancy. ❑Six or more residential units. 0 Recreational vehicle parks. City/State/ZIP: ❑Health-care facilities. 0 Supply voltage for more than ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt.no.: Project name: Summit Ridge 0 Service or feeder 600 amps or more. Cross street/directions to job site: FEE SCHEDULE Description I pry. I Fm I Total I • • New residential single-or multi-family dwelling unit. Includes attached garage. Subdivision: Lot no.: 154 1,000 sq.ft.or less 168.54 4 Tax map/parcel no.: Ea.add'l 500 sq.ft.or portion 33.92 1 Limited energy,residential 75.00 2 DESCRIPTION OF WORK.. ... . • (with above sq.ft) Limited energy,multi-family Electrical App for adding AC residential(with above sq.ft.) 75.00 2 Services or feeders installation,alteration,and/or relocation 200 amps or less 100.70 2 0 PROPERTY OWNER [] TENANT 201 amps to 400 amps 133,56 2 Name: 401 amps to 600 amps 200.34 2 ' 601 amps to 1,000 amps 301.04 2 Address: Over 1,000 amps or volts 552.26 2 City/State/ZIP: Temporary services or feeders installation,alteration,and/or 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 v ❑ APPLICANT f 0 CONTACT PERSON above service or feeder fee, 7.42 2 each branch circuit Business name: DR Horton Inc • B.Fee for branch circuits without Emerald Weeks service r feeder fee,first / 56.18 2 bra Contact name: branch circuit Address: 4380 SW macadam Ave Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) City/State/ZIP: Portland OR 97239 g Each manufactured or modular 67.84 2 dwelling,service and/or feeder Phone:( 503) 222-4151 Fax::( ) a Reconnect only 67.84 2 E-mail: "` Pump or irrigation circle 67.84 2 CONTRACTOR Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Business name: (4 tia.�� g 4 6.14-7,,.;c. ..7.7...1.. panel,alteration,or extension. Page 2 11, t/ Each additional inspection over allowable in any of the above Address: (go Li/ /j_ )/ 2 /j/�' o��`� .,� t Additional inspection(1 hr min) 66.25/hr City/State/ZIP: 1 a . v� /j/�' p p� / { Investigation(1 hr min) 66.25/hr VVV V J Q (7 ( Industrial plant(1 hr min) 78.18/hr Phone:(36^a 5/f.- ,-,5-,..9 Fax:Ogsn 32c- 9660 Inspections for which no fee is CCB Lic.:/12,6- ,9 Electrical Lic.:-C-230 Suprv.Lic.: / specifically listed{Z hr Tin) 90A0/hr T 9.� $ ELECTRICAL FERMI' FEES Suprv.Electrician signature,required- d:ti2 , b_...fr____41Subtotal: Print name:Ch 6-sib,--4. Plan review(25%of permit fee): ( ��J,,� ,2 -f,� - Date: State surcharge(12%of permit fee): _ Authorized signature: ���G�%L� �" _ TOTAL PERMIT FEE: This permit application expires if a permit is not obtained within 180 Print name: Date: days after it bas been accepted as complete. * Number of inspections allowed per permit. I:1BuildingtPermits\ELGPermitApp 440a615Tp I/05/COM/WEB