Permit (73) RECEIVED
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City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
. .
Request for Permit Action
CITY OF
MAR 5 2018
4L:F.-'t. GA
TIGARD 13125 SW Hall Blvd. •Tigard, Oregon 97223 • 503-718-2439 • .- IIIVISRIODN
TO: CITY OF TIGARD
Building Division V 0 1 0
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503-718-2439 Fax: 503-598-1960 TigardBuildingPermits@tigard-or.govAAfAgir
FROM: )tr Owner n Applicant 0 Contractor Ell City Staff
Check(/)one
REFUND OR Name:
I
INVOICE TO: (Business or Irulivida* 4-104- ex viin
1)1.....4.--)
Mailing Address: 136 0 c.SC.-J I 1 I-30e
City/State/Zip: ---5.7Ard)r, Oa- 5?"-Z Z 3
Phone No.: L57)-5) :11 3 --(f-Ce 2- 4-
PLFASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
0.. CANCEL/VOID PERMIT APPLICATION.
,Fft REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
D INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
E REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit#: 4 C i e-ya -a -
Site Address or Parcel #: j, ,.=
Project Name: 1134ige.)(A)
Subdivision Name: Lot#:
EXPLANATION: , _ .0, •__ , .,- , 4, .
7-e- &-"-- 1,1i /Oa- TO iLi e-Xie-- e€7/4-7,z-cr-CA 4(.7(1.6.6-4._ EZ c2 /f— '0
Signature:
/ 4 , Date: *-7/- e---
Print Name: Ffrzkr
itetl2wEs214,c,
1. The city's Community Development Director,Building Official or City Engineer may authorize the refund of:
• Any fee which was crnmeously paid or collected.
• Not more than SO"/u of the application or plan review fee when an application is withdrawn or canceled before review effort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,
FOR OFFICE USE ONLY
Route to Sys Admin: Date B' Route to Records: Date , c?-2 /C. 13 =Sr
Refund Processed: Date 'AgZrAgllIlrz':'' Invoice Processed: Date By
Permit Canceled: Date jer, By ..f.*.' Parcel Taz Added: Date 13'
i:\Buiiding\Forms\ReciPemmArnon J )2.5 4 dor
II
i q
TIGARD
City of Tigard
April 18, 2018
Harlan Borow
13030 SW 115th Ave.
Tigard, OR 97223
Re: Permit No. ELC2018-00026
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 13030 SW 115`h Ave.
Project Name: Borow
Job No.: N/A
Refund Method: ® Check#228168 in the amount of$62.92.
0 Credit card "return"receipt in the amount of$ .
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$ .
Comment(s): Permit created in error;work required licensed contractor under separate
permit ELC2018-00055. Refund 100% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
,,e :1"
r
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
Dianna Howse
From: Dianna Howse
Sent: Wednesday, February 28, 2018 12:13 PM
To: 'hsborow@gmail.com'
Cc: #Building Permit Technicians
Subject: ELC2018-00026 - 13030 SW 115th
Attachments: Req PermitAction_092314.pdf
Importance: High
Hello Harlan,
Evidently your contractor sent you in to obtain an electrical permit for(1) branch circuit for a trench that you dug for the
electrical conduit to be run for the solar system being installed by Tesla (SolarCity). Our inspector,Jeff Grove, explained
that this was just trench work and that no electrical work was performed by you,therefore a permit is not required for
just digging a trench. The electrical work will actually be inspected under the permit that Tesla obtained.
Please complete the attached request for action and email it back to me for to request a full refund of all permit fees
paid for this electrical work. At that time we will also void this permit as all electrical work is being performed by
Tesla. Please allow 3-4 weeks for the refund check to be mailed.
Please note that our electrical inspector will also be having a conversation with Tesla to ask them not to send customers
in for a "trench" permit.
Thank you and our apologies for any inconvenience.
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
DISCLAIMER: E-mails sent or received by City of Tigard employees are subject to public record laws. If requested, e-mail
may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E-mails are retained
by the City of Tigard in compliance with the Oregon Administrative Rules"City General Records Retention Schedule.'
1
Inspection Detail Portlet: Edit Mode Page 1 of 1
ELC2018-00026-BOROW
Menu Update Reset Cancel View Log Reports Help
Case# Inspection Type * Address
ELC2018-00026 105 Underground/slab cover 13030 SW 115TH AVE,TIGARD,OR 97223
Request Date Request Time Requestor's Phone Requestor
02/26/2018 '7 2 s," : 42 v l PM V 5037138627 Selectron Selectron
Request Comment
50371386271hsborow@gmail.comllnspect trench and bedding backfill for installation of electrical conduit associated with Solar Panel
install
Scheduled Date * Scheduled Time
02/28/2018 t2i 112_ V : 00 v AM v
Inspection Date Status * Department *Current Department Inspector *Currei
02/28/2018 I PASS V I Building LJeffGrove
Result Comment ft Standard Comments _._.__.._^^....
Date:2/28/2018
Trench only by homeowner ok
check spelling
CAP Type * Internal use only * Inspection Time
Building/Res/Electrical/NA 18RES-00000-00081 11 V : 05 V IAM V
Submit Date Submit Time
102/28/2018 11 v : 05 V AM V
https://ay.accela.com/portlets/inspection/inspectionDetailCapSpecific.do?mode=view&from... 4/6/2018
CITY OF TIGARD ELECTRICAL PERMIT
'11 3' COMMUNITY DEVELOPMENT Permit#: ELC2018-00026
and OR 97223 503.718.2439
13125 SW Hat Blvd.,Ti Date Issued: 01/16/2018
T f to t1 ft.i� 9
Parcel: 2S103D1300100
Jurisdiction: Tigard
Site address: 13030 SW 115TH AVE
Project: BOROW Subdivision: None Lot: None
Project Description: (1)branch circuit for conduit from house to detached garage for solar photovoltaic system.
Contractor: OWNER Owner: BOROW, HARLAN S
HARLAN BOROW 13030 SW 115TH AVE
13030 SW 115TH AVE TIGARD, OR 97223
TIGARD, OR 97223
PHONE: 503-713-8627 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 01/16/2018 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 01/16/2018 $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 th les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 952-001-0090. You ma obtain copy of the rules or direct questions to OUNC by calling 503.23 .1 87 or 1;800.332. 44.
Issued By: 'i► _ -, _ _ ti Permittee Signature: /f4,7,
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 OFFICE USE ONLY
City of Tigard "� .��.. Received
°," Date/B : ! I' 1 fill X� ► �,�
* 13125 SW Hall Blvd.,Tigard,OR 972 Plan Review
t C Phone: 503.718.2439 Date/B : Related Permit#:
Email: TigardBuildingPermits@Tigard or.gov,NNN 1 v L Ready Date/By: Mall la See Page 2 for
T I G A R D Inspection Line: 503.639.4175 Internet: ION rti gard-or.Bv. f ;Notified/Method: Supplemental Information
�.
TYPE.rOF WO V t X44 �+. PLAN REVIEW
❑New construction Q Addition/alteratiRoaffe ti ,i- 7 ? Please check all that apply(submit 2 sets of plans w/items checked):
i .L1:110- 0 Service or feeder 400 amps or more ❑Building over three stories.
❑Demolition ❑Other: � N where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION'; exceeds 10,000 amps at 150 volts or 0 Floating buildings.
dwelling El 1:1r1-and 2-family ❑Accessory building less to ground,or exceeds 14,000 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump. ❑Installation of 150 KVA or
•
JOB SAND
$TE INFORMATION LOCATION ❑Emergency system. larger separately derived
30 ❑Addition of new motor load of system.
Job#: Job site address: `
30 Sc.c l\ST ._ 100HP or more. ❑"A","E","1-2","1-3",
Six or more residential units. occupancy.
City/State/ZIP: \� r! DO -CZZ 0 Health-care facilities. 0Recreational
l vehicle parks.
Suite/bldg./apt.#: Project name: /.it')r 0 Hazardous locations. 0 Supply voltage for more than
T-� 0 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: 1 1 51-- j- I—U vi.kr-- FEES EDULE
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'l 500 sq.ft.or portion 33.92 1
DESCRII (')N OF WORK'4` Limited energy,residential 75.00 2
���--- _, (with above sq.ft.)
�\XNA F�1 k.z?r 4-./•(..._ C"Otti6IA(AA;- ,�- CR) 0, iIV eitt..' t Limited ener
gy,multi-family 75.00 2
�� - ( � } Lresidential(with above sq.ft.)
Renewable Energy 0 See Page 2
( RORERTY OWNER -- '"'''",,,Z;. i `TENANT Services or feeders installation,alteration,and/or relocation
Name: 1--\\--Ki`a_ Gr (--)Lc) 200 amps or less 100.70 2
Address: 1 3C), 0 s tAJ `(c ^A v e 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: .1-- (.11,1/41-CAI. 0(1` 9-z.-2.---5 601 amps to 1,000 amps 301.04 2
Phone:(_5-62,) 71 t -- O t., Over 1,000 amps or volts 552.26 2
rTemporary services or feeders installation,alteration,and/or
Email: 0?-0.-3 1�--
44 1 L C vW
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,lea ent,o},excha ge ccording to ORS 447,449,670,and 701.�/ 201 amps to 400 amps 125.08 2
Owner signature: "vZG2 t,L` ) Date: 1(10 1[�J 401 amps to 599 amps 168.54 2
A.
fir- PLICANT ,-u BranchFeefor circuitsbranch-ccircunew,its alteration,with or extension,per panel
J ? ,,, t'"6 CONTACT PERSON:' _',
Business name: above service or feeder fee,
each branch circuit 7.42 2
Contact name: 56v4L- c? Lr e- B.Fee for branch circuits without
Address: service or feeder fee,first 56.18 �7 </ 2
branch circuit J
City/State/ZIP: Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:( ) 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: 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:( ) 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(%hr min)
ELECTRICAL.' ERMIT FEES
Suprv.Electrician signature,required: Subtotal: 570,14
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 4, N
TOTAL PERMIT FEE: ` G 1
Authorized sigp ure: � . ��
46,,,L6A
� / This permit application expires if a permit is not obtained within 180
Print name: �J1,/ Date: f//b J/� days after it has been accepted as complete.
/ ( * Number of inspections allowed per permit.
1:\Building\Permits\ELCPermitApp_ELR ERE.doc Rev 10/26/2017 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 'ORIS ONIN: FEE SCHEDULE
Description I 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
Fl 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
n Garage Door Opener* >100 kva(fee in accordance
with OAR 918-309-0040) 552.26 2
H Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva:
System* Each additional kva over 25 7.42 3
Fl Vacuum Systems* >100 kva—no additional charge 0.0 3
Each additional inspection over allowable in any of the above:
n 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('/hr min)
fi
EES
COMMERRCIAL,WORI ONLY• ELECTRICAL.,Pnteron "Page
Fee for each commercial system: $75.00 Subtotalp per permit. 1):
y * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
n Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
n Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
n Protective Signaling
n 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 10/26/2017