Permit (129) . ........ . . RECEIVED
. . .... ...
',.. .-..., ......,:„: City of Tigard 0 COM M U:\VI''‘ DEVELk)1,".M.E::',:T DEPART\n-.,\T
ReqPermit for Action MAR 8 2018
. „
..,... „
i'i',1177.1:4.3.-'•A'iii,t):-.• i.1 25 5Th 1 I ail Blvd, . I Idgai.d, () p op 97223 . 5073;718-243') • b:b-bs-dtg.1 PslsodsdLiCITY OF 1"KiARD
•
TO: CITY OF'FIGARD
Building Division V (.1 I fl,...,„,.,'
13125 SV311 all Blvd.,'I'igard,OR 972'23
Phone: 503-718-2439 Fax: 303-598-1960 1FigitrdBuildingPerrnitsigitigard-ongov
FROM: On r Owner El Applicant El Contractor El City Staff
Ru..:N
REFUND OR Narne: . 7 /
INVOICE To: ticiii,ii Of Inds,,i,m1; ,2112)11,7A1-/-77-- 4 7 /1 2/C,.//
ii ,,,?s---d—
N tail i rig i\ddress: ", '—' 7f e-tibli i ii
Let -4e tai X.1
rit,r,,,,,z,,,,,c/Zip: /1,./& 7 -, ii:
., .. ..._
mam: N .: 0
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CA REEL/VOID PERMIT:\PPIJCTION..
RI',FL NI) PERI\Ulf HIES (attach (dim' of Uri ictal receipi,',did provide eiiptimation below)...
IN VOlRIIII. 1/10 IIIIII,S 1)C1II (attach. can fee schedule and provide explanation below).
RI li\ /III. RitP1 On II I CONTRAC FOR ON Pi IRINI IT (do not cat cd permit).
Permit#:
Site Address or Pared #: .....-
/ 7, 3 . . ... ggi/h 56 _ _........„_
proi,,ct "Mao
Subdivision IN idde: I„dr 11:
.i. „
EXPLANATION:
a:"I / / #4, 1 1
'
tZ2, 114* ,Wei 'nit r. 376-E---
. ,
1 et te —,petz7 4,9, . . .
Sigi tat ure: / I ' ° 6(---(f.4' l'if -- - Datc-:.
Print Name: V.01C4 ill
,,,t-uoy.),
1. .ilw ci,,,, ..,„,,,inuni, D.,,,c4rro.or 1)icccrBr,,Building(',Ifici il or("'w, I,'Ilgin,',..1-in,ty,ittrhori/c III 01 19 of.
• \wc liw which wr,,,.kiflitilit'OUSIA p,od or w 62f.,litij,
O NI nil fL'11 L111 SCP:i 4 1 hc apriic:liwn,,r 1q21.1 foic, lo.'-,,,,ihAi..,.n trptic.31 in k'‘,..rckicm 1 ,:',r r;:w1cdc'd lit fi,rc lc Ii a en",wr
11.1
III 'I'cNp,B111,d
.s \il,.mon,:di III 9),i.,.t ihr srpirdniii.,,.01 la,ite Id:ti}t iiiiiiiiiiii3 piiiin uts p6,,r to AEly inTceijoil,,,,,,iut,-0,..
2. ',It rcfulwi,'.wii]bc rcrunicd w thg,qi...,-Jcc,.1 pArcr W rhc 'iii ,•,f illcck viri I'S po.,.ui 'C IC
I Phi,c all,w.-3 4)11110 for 9r1 ccr.411,,,rt'.wid 1
Litoutc ro St.w. 341frun: i I/ to 119 I,J-19:w.9i 1114 '; 19'419,22 07-2-Ap : 4t
1 114.;fund Po/-t99cd: SIC YA0 /F-- 15: ,_. 1 Invoice Proce4sc,11: .4-1-,41e 1 18-
— „
13.:rmit C111c44494: 1 119.142. 'y 6 A f- 11\ -,7- ,.. 11.34944 1oO0de6: 1.)a e i ,114-
4'.141i41,41j41,94,404,-.44.11 i \43H44342.31. ,4,,
Dianna Howse
From: Gary Nelson <garysannelson@comcast.net>
Sent: Thursday, March 8, 2018 11:46 AM
To: Dianna Howse
Cc: #Building Permit Technicians
Subject: RE: ELC2017-00583 - 15195 SW 98th Ave. - Nelson
Attachments: CCF03082018_00001 jpg
Hello Dianna
Thanks for taking the time to talk to us recently to advise us as to how to proceed with electrical work at our residential
remodel. Attached you will find the completed form that you sent. It is a Request for Permit Action. We are canceling
the permit ELC2017-00583.
Bear Electric will be taking out a permit soon for all of the electrical work at the home, which in addition to the panel,
will include electrical work throughout the home.
Thanks
Sandra Nelson
From: Dianna Howse [mailto:Dianna@tigard-or.gov]
Sent: Wednesday, February 28, 2018 7:47 AM
To: 'garysannelson@comcast.net
Cc: #Building Permit Technicians
Subject: ELC2017-00583 - 15195 SW 98th Ave. - Nelson
Good morning Sandra,
The building official and electrical inspector agree that the licensed electrician must take out a new permit to complete
the work for this project. Please be sure that the new permit includes the service panel that was not installed under the
current permit.
I have attached a request for permit action form to refund the service panel fees and close the original permit. Please
complete this form and return by email to me. Once the new permit has been taken out, we will close the original
permit with notes to see the new permit for the completion of the work. Please allow 3-4 weeks to process refund
requests.
Thank you and please let me know if you have any questions.
Dianna L. Howse
Building Division Services Supervisor
City of Tigard I Community Development
13125 SW Hall Blvd I Tigard, OR 97223
503-718-2430 Direct 1503-718-2439 Permits
1
1111111
TIGARD
City of Tigard
6/1/2018
Kevin Nelson
15671 SW Summerfield Dr.
Tigard, OR 97224
Re: Permit No. ELC2017-00583
Dear Applicant:
The City of Tigard has processed a refund for fees on the above referenced permit(s) as
follows:
Site Address: 15195 SW 98th Ave.
Project Name: Nelson
Job No.: N/A
Refund: ® Check#228661 in the amount of$58.17.
0 Credit card "return"receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit"receipt in the amount of$ .
Comments: Per applicant's request as a licensed electrician to perform the work under
ELC2018-00278. Refund 100% of the difference for the electrical panel work.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
t. CITY OF TIGARD ELECTRICAL PERMIT
•
€ COMMUNITY DEVELOPMENT t 1 Permit#: ELC2017-00583
T f GAReD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Jfgall
Date Issued: 08/03/2017
Parcel: 2S 111 CA00400
Jurisdiction: Tigard
Site address: 15195 SW 98TH AVE
Project: Nelson Subdivision: ALDERBROOK FARM Lot: 10
Project Description: (2)branch circuits for second story bathroom.8/817, REPRINTED to add(1)service panel.
Contractor: OWNER Owner: NELSON, GARY&SANDRA
KEVIN, GARY&SANDRA NELSON NELSON, KEVIN ERIC
15195 SW 98TH ST 15671 SW SUMMERFIELD LN
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503-639-9539 PHONE: 503-639 9539
FAX:
FEES
Quantity Description Date Amount
Specifics: 1 ea Services or Feeders-200 08/08/2017 $100.70
amps or less
2 crt Branch Circuits w/Purchase 08/03/2017
Type of Use: SF Service or Feeder $14.84
Class of Work: ALT 1 ea 12%State Surcharge- 08/08/2017 $13.86
Type of Const: Electrical
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. ATTE N: Ore..• la requires you to follow the rules adopted by the Oregon Utility Notificatio Center. Those rules are set forth in OAR
952-001-0 0 through OAR 9, -001-0.•a. You may obtain a copy of the rules or direct questions to OUNC by callin 3 23 .1987 or 1.800.332.2344.
Issue By: 0 �P 1
Permittee Signa ure: /,-, _,�
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 OFFIcI: Isl: Oy1.1
"L p Eew
$ permit#:T(t . 13125 SW Hall Blvd.,Tigard,OR 97
C Phone: 503.718.2439 Fax: 503.598.1960 Date/B : Related Permit#:
Inspection Line: 503.639.4175 AUG 8 2017 Ready Date/By: auris: H See Page 2 for
1 I(,A 11) Internet: www.tigard-or.gov f� Notified/Method: Supplemental Information
TYPE OF t,l, Y'(U'F raGARuR PLAN REVIEW
0 0 1'flour,
i lQ N Please check all that apply(submit 2 sets of plans w/items checked):
New constructionAddition/altera 10 1
0 Service or feeder 400 amps or more 0 Building over three stories.
O Demolition 0 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 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family ❑Master builder ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
❑Addition of new motor load of system.
Job#: Job site address: /5115 5 lA "Yells, A.., 100HP or more. ❑"A","E","1-2","l-3",
❑Six or more residential units. occupancy.
City/State/ZIP: --r t j�r.d / 6). £S 71.Z.� ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 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.ft.or portion 33.92 1
DESCRIPTION OF WORK Limited energy,residential
` �+ (with above sq.ft.) 75.00 2
Y 17� PC)- _.,/__ �� C t•��� - 60 5k 3 Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 5....ir„: A.k is cr, 200 amps or less / 100.70 / ..7l) 2
Address: 201 amps to 400 amps 133.56 6 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 ' ❑ CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
0A.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 56.18 2
Address: branch circuit
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) Fax: :( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: O w Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy ❑ See Page 2 2
Address: panel,alteration,or extension.
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(1 hr min) 78.18/hr
Inspections for which no fee is 90.00/hr
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed('/2 hr mm)
ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: Subtotal:
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 4
TOTAL PERMIT FEE: 17
Authorized signature: �•/
This permit application expires if a permit is not obtained within 180
Print name l Date: g/g/i 7 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\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:
RESIDENTIAL W i ® L C; n ° ! DUE ;
Description Qty. I Each I 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
❑ 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
❑ 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
charged at an hourly(1 hr min) 66.25/hr 1
Inspections for which no fee is 90.00/hr
specifically listed('A hr min)
waiTi
C L WORK ONLY: + &., E t PEtant . _ x§
� ` „ ' t �� Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(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:\Building\Permits\ELC_PermitAppELR_ERE.doc Rev 06/17/2015
CITY OF TIGARD ELECTRICAL PERMIT
111 22: Permit#: ELC2017 00583
COMMUNITY DEVELOPMENT Date Issued: 08/03/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S111 CA00400
Jurisdiction: Tigard
Site address: 15195 SW 98TH AVE
Project: Nelson Subdivision: ALDERBROOK FARM Lot: 10
Project Description: (2)branch circuits for second story bathroom.
Contractor: OWNER Owner: NELSON, GARY&SANDRA
KEVIN, GARY&SANDRA NELSON NELSON, KEVIN ERIC
15195 SW 98TH ST 15671 SW SUMMERFIELD LN
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503-639-9539 PHONE: 503-639-9539
FAX:
FEES
Quantity Description Date Amount
2 crt Branch Circuits wo/Purchase 08/03/2017 $63.60
Specifics: Service or Feeder
1 ea 12%State Surcharge- 08/03/2017 $7.63
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $71.23
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 0 952-001-0090. You may obtain a co• • e rules•r direct questions to OUNC by calling 503. 2.1987 or 1.800.332.2344.
Y
Permittee Signature: L ZC�'C. -41
Issued By:
4,
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 OH 1( 11 t Sl. Oyl.l
City of Tigard , Received
11,1 . 41 13125 SW Hall Blvd.,Tigard,OR 97223 I Date/B ` -a- z _
ill AVIA
Phone: 503.718.2439 Fax: 503.59978212
98 1 . Plan Review
Date/g Related Permit#: -.
Inspection Line: 503.639.4175 , � ' 2._
T I i,A R f7 Ready Date/By: H See 'age 2 for
Internet: www.tigard-or.gov r_ s ���j Notified/Method: � Supplemental Information
TYPE OF WORK NU l) I PLAN REVIEW
❑New construction ❑Addition/alteration/replac l%(s i n Please check all that apply(submit 2 sets of plans w/items checked):
$q
0 Service or feeder 400 amps or more 0 Building over three stories.
❑Demolition 0 Other:
lSi where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONS{7� exceeds 10,000 amps at 150 volts or
❑ 1-and 2-familydwellingk ❑Floating buildings.
❑Commercial/Indo a ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
0 Multi-family amps for all other installations. buildings.
Y 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION0 Emergency system. larger separately derived
Job#: Job site address: j / f".--t ❑Addition of new motor load of system.
` ci 7�7 ,.5 __Q:61w f 7#� 100HP or more.
City/State/ZIP: 77, r CL x?. �-7�a( l' ❑Six or more residential units. occupancy.
(j/� 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ,DO/1)1 tr.=/2 0 Hazardous locations. 0 Supply voltage for more than
Cross street/directions to job site: 6,/-2__ ❑Service or feeder 600 amps or more.
600 volts nominal.
FEE SCHEDULE
Description I Qty. I Each I Total
New residential single-or multi-family dwelling unit.
Subdivision: Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add'l 500 sq.ft.or portion 33.92 1
O Limited energy,residential
_0J.QC ./Lc-r e" -1----t! a � G{_p� aill (with above sq.ft.)
r.
75.00 2
/J c�f Limited energy,multi-family
7z�t,-69-6 1-Y1 Z,�yL,. 2' i---1.0 )L (1� fC residential(with above sq.ft.) 75.00 2
1_1PROPERTY OWNER ❑,TENANT Renewable Energy ❑ See Page 2
, Services or feeders installation,alteration,and/or relocation
Name: /1-�1/4w / m (-6--,,,,,z „ etet.44_���/ e,11\ 200 amps or less 100.70 2
Address: /4� ,R �) 1 �� t f? L J 201 amps to 400 amps 133.56 2
City/State/ZIP: cJ Gt. 401 amps to 600 amps 200.34 2
�i 6''' '`" 6/:-..__ Pi _" k-/ 601 amps to 1,000 amps 301.04 2
Phone:(5z 5) 3% _ - -_ q Fax:( ) Over 1,000 amps or volts 552.26 2
Email: C 1/� / Temporary services or feeders installation,alteration,and/or
0 ,, —` `"' , relocation
Owner inst ation. s installation is being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lea ent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature:� -�%''1-LA- v(,e_i4Zryt-- Date: S::-- j —r`7 401 amps to 599 amps 168.54 2
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,
Contact name:
each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first
branch circuit ( 56.18 G7 �., 2
City/State/ZIP: Each add'l branch circuit / 7.42 --"? iv_ 2
Phone: Miscellaneous(service or feeder not included)
( ) Fax: :( ) Each manufactured or modular
Email: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy
panel,alteration,or extension. ❑ 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(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(V2 hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal: 6 <4 L'I
Print name: Date: ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): "7 S.3
Authorized signature: TOTAL PERMIT FEE: 71,23
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. . eiEs 7(ejt1,
I:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB 't - -I'
j Id
EPagelectrical2 Permit ApplicationInformation–o City of Tigard
–Supplemental
Limited Energy Permit Fees: Renewable Energy Permit Fees:
�y ', Description
1#ESIDE .t ,''-,s x I Qt3'• I Each I Total I
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved: 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:
n 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 552.26 2
with OAR 918-309-0040)
❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
>100 kva—no additional charge 0.0 3
❑ Vacuum Systems*
Each additional inspection over allowable in any of the above:
❑
Other: Each additional inspection is 66.25/hr 1
charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(1/2 hr min)
� mom
A�
CO1 ,. . . ;:.. l°E Tl Su
tal(Enter on Page�
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ C• lock Systems
n D• ata Telecommunication Installation
n Fire Alarm Installation
❑ HVAC
In 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 06/17/2015