Permit (125) CITY OF TIGARD ELECTRICAL PERMIT
III 11 COMMUNITY DEVELOPMENT Permit#: ELC2017-00913
Date Issued: 12/11/2017
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S111CC13800
Jurisdiction: Tigard
Site address: 10235 SW HIGHLAND DR
Project: McKee Subdivision: SUMMERFIELD NO.4 Lot: 189
Project Description: Relocate light switches and outlets for kitchen remodel.
Contractor: ONE WEST ELECTRIC LLC Owner: MCKEE, CAROL T
575 BROWN CT 10235 SW HIGHLAND DR
WOODBURN, or 97071 TIGARD, OR 97224
PHONE: 503-807-8188 PHONE:
FAX:
FEES
Quantity Description Date Amount
7 crt Branch Circuits wo/Purchase 12/11/2017 $100.70
Specifics: Service or Feeder
1 ea 12%State Surcharge- 12/11/2017 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
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 •'R• -ill-90'+. 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: ,, Permittee Signature: 9/1
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 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 / Folz 0EFICL 1 SE ON 1,1
RFEIV
Received E
City of Tigard Date/B ' /7 /7 4:9'ia 'ennit 4: --Z-C- /7-75e9/,..3
III V 13125 SW Hall Blvd.,Tigard,OR 97223y Plan Review
a Phone: 503.718.2439 Fax: 503.598.1960 LJ F C 1 1 2017 Date/13 : Related Permit#:
/
T 1 G A R D, Inspection Line: 503.639.4175 Ready Date/By: ET See Page 2 for
Internet: www.tigard-or.gov . 4 . ,, �, Notified/Metho ,//' 7EMI Supplemental Information
,; -3,
, `'' <:`P1�;O1M 'Q��a t. ® i< < � ,,� .. ",';PL04*tYE`Pv' . ,, , '
0 New construction ®Addition/alte 1; r ll-f• . • • ! 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.
0 Demolition 0 Other:
where the available fault current 0 Marinas and boatyards.
C4TEQO Y OF k1CIKiltt) ','- 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 ❑Other: 0 Fire pump. 0 Installation of 150 KVA or
JOB$1T1 11 oR AT1oI4 tocA,"I'1f3Pt 0 Emergency system. larger separately derived
Job#: I Job site address: 10235 SW Hi bland DR ❑Addition of new motor load of system.
g 100HP or more. 0"A","E", 1-2", '1-3",
City/State/ZIP:Tigard OR 97224 ❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I Project name:Mckee 0 Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 'IM" SCH DULE `
DescriptionI Qty. I Each ITotal
New residential single-or multi-family dwelling unit.
Subdivision: I 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
B� IP1ION OP'WORK-# Limited energy,residential
relocate light switches and outlets (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy 0 See Page 2
of'iltOPERTY e @ SikrServices or feeders installation,alteration,and/or relocation
Carol 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Address: 10235 SW Highland DR
401 amps to 600 amps 200.34 2
Tigard OR 97224 601 amps to 1,000 amps 301.04 2
1 I '' Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or
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
keit* Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:TL Remodel&Construction above service or feeder fee,
7.42 2
each branch circuit
Contact name:Chris Kyle B.Fee for branch circuits without
service or feeder fee,first 56.18 2
Address:PO Box 1996 branch circuit
City/State/ZIP:lake oswego OR 97035 Each add'l branch circuit (rj 7.42 2
Miscellaneous(service or feeder not included)
Phone:(503)7057611 I Fax::( ) Each manufactured or modular 67.84 2
Email:Chrisk@tlremodel.com dwelling,service and/or feeder
Reconnect only 67.84 2
Pump or irrigation circle 67.84 2
Business name:One West Electric LLC Sign or outline lighting 67.84 2
Address:575 Brown Ct Signal circuit(s)or limited-energy 0 See Page 2 2
panel,alteration,or extension.
City/State/ZIP:Woodburn OR 97071 Each additional inspection over allowable in any of the above
Additional inspection(1 hr min) 66.25/hr
Phone:(203)8078188 I Fax:( ) Investigation(1 hr min) 90.00/hr
Email:Alex@onewestelectric.com
Industrial plant(1 hr min) 78.18/hr
Vj/- Inspections for which no fee is 90.00/hr
- CCB Lic.: 210997 I Electrical Lic 1208 j Suprv.Lic.: 6j/r7zQs specifically listed(Y�hr min)
ELECTRICAL PE
Suprv.Electrician signature,required: -_, v i '- led/ Subtotal: /0 p ,'20
Print name: Ar, f x_.), ,�j� ' Date: 6 /Z ,, 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 7,/,
Authorized signature: TOTAL PERMIT FEE: //a,
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.
I:\Building\Penults\FLC PermitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
10235 SW HIGHLAND DR, TIGARD, OR, 97224 January 26, 2018 at
10:48:08 AM
Record Type: Record ID:
Residential - Electrical ELC2017-00913
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Install outlet cover removed for painting.
Violation Summary:
Inspector Contractor