Permit 1111 adz
CITY OF TIGARD ELECTRICAL PERMIT
1. ' COMMUNITY DEVELOPMENT Permit#: ELC2018 00095
and OR 97223 503.718.2439
13125 SW Hall Blvd.,Ti Date Issued: 02/12/2018
T[CjaL3 9
Parcel: 2S114AB04500
Jurisdiction: Tigard
Site address: 9330 SW MILLEN DR
Project: FRESON Subdivision: KNEELAND ESTATES Lot: 32
Project Description: (1)200 amp panel and(8)branch circuits for ADU addition.
Contractor: CONDUIT ELECTRIC Owner: FRESON FAMILY JOINT TRUST
19461 SW 89TH AVE BY FRANK G/MAXINE E FRESON TRS
TUALATIN, OR 97062 289 PENTER LN
NEWPORT, OR 97365
PHONE: 503-692-1428 PHONE:
FAX: 503-692-3652
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 02/12/2018 $100.70
Specifics: amps or less
8 crt Branch Circuits w/Purchase 02/12/2018 $59.36
Type of Use: SF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 02/12/2018 $19.21
Electrical
Type of Const:
Occupancy Grp:
Total $179.27
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 • to foil•, : _ - .'opted by the Oregon Utility Notification Center.- Tho a rules set forth in OAR
952-001-0010 through• 952-001-0090. You may ob opy of the rules or irect questions to OUNC by calling 503.232.198 r 1. 0 .332.23
Issued By: -
er 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 Application Folz 011.1( 1r I st ()NEI.
City of Tigard GENE . , _ T. ir.
13125 SW Hall Blvd.,Tigard,OR 97223 A ,I, 4 �T ��s1J� Permit 4:
X 'Ian Review .�---��
Phone: 503.718.2439 Fax: 503.598.1960 I)atelB Related Permit#: /t2 ( 7 1 1 r/
Inspection Line: 503.639.4175 Ready Date/By: H See Page 2 for
Internet: www.tigard-or.gov 1-E E3 1 2 2018
gg�• Notified/Method: IML Supplemental Information
TYPE OF WORK [� TIGARD PLAN REVIEW
0 New construction Addition/alteratio 1 ems!ent T g/ Please check all that apply(submit 2 sets of plans w/items checked):
❑Demolition 0 Other: V l DING DIVISION 0 Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑Floating buildings.
Q 1-and 2-family dwelling 0 Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations. buildings.
❑Multi-family 0 Master builder 0 Other: 0 Fire pump 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: �/ `
0 Addition of new motor load of system.
L 33 ) /t t„..., r7h()l L'„, D i/` 100HP or more. ❑«A «E„«1 2„ «1 3
City/State/ZIP: / �✓) /' ❑Six or more residential units. occupancy.
I ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: ❑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.
Tax map/parcel#: 1,000 sq.ft.or less 168.54 4
DESCRIPTION OF WORK Ea.add'1500 sq.ft.or portion 33.92 1
Limited energy,residential
} 1 (with above sq.ft.) 75.00 2
A�`v`' 11 ( ' ' N Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
0
PROPERTY OWNER 0 TENANT Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less J 100.70 j .7 2
Address: 201 amps to 400 amps 133.56 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
Email: 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
0 APPLICANT '4 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,each
branch circuit 7.42 '134, 2
Contact name: 44-r , J eit/.5 t'/✓ B.Fee for branch circuits without
Address: service or feeder fee,first branch
circuit 56.18 2
City/State/ZIP: Each add'l branch circuit 7.42 2
Phone (�z'j ) i17 '3 (/ Fax: ( ) Miscellaneous(service or feeder not included)
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: „ ' /fir✓��/C, ry�
�4W�w�r) r( '✓lC �'/ ,��✓�� 7-45U� Sign or outline lighting 67.84 2
Address: f�y r7 J/ Signal circuit(s)or limited-energy
( ` i 6 1 ,e` N� 4 i ( 4 t/ panel,alteration,or extension. 0 See Page 2 2
City/State/ZIP: / K r1 -�, `,�s ��7 0 6 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.:/0,9'6'el Electrical Lic.: 4 ..*5G Suprv.Lic.:11.5-0/S specifically listed(%z hr min) 90.00/hr
. ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:
Subtotal: 1 ,0, ,
Print name:
G4/4il le)
/1 Date: �I/,) // ❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): /4 •X
Authorized signature: TOTAL PERMIT FEE: /f 7 q .)..7
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:\BuildingWermits\ELC_PermitApp_ELR ERE.d°c 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:
9330 SW MILLEN DR, TIGARD, OR, 97224 August 22, 2018 at
11 :12:02 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00095
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
No panel change done on this permit, not needed per contractor.
Violation Summary:
Inspector Contractor