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Permit (188) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2018-00180 Date Issued: 03/15/2018 T-[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S110DD90361 Jurisdiction: Tigard Site address: 10885 SW MEADOWBROOK DR 36 Project: TOKUDA Subdivision:SUMMERFIELD BROOKSIDE CONDO Lot: 36 Project Description: Replacing(1)200 amp service panel. Contractor: ELECTRIC INC Owner: TOKUDA, KAZUHIDE PO BOX 820386 10885 SW MEADOWBROOK DR#36 VANCOUVER,WA 98682 TIGARD, OR 97224 PHONE: 360-903-5691 PHONE: 503-449-6815 FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 03/15/2018 $100.70 Specifics: amps or less 1 ea 12%State Surcharge- 03/15/2018 $12.08 Type of Use: MF 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._wies adopted by the Oregon Utility Notification Center. Those rule , - set forth in OAR 952-001-0010 through!_R 952-001-0090. You may obtain- copy of the rules. •irect questions to OUNC by callirfg 503.232.1987 or 1.800.332.22334' Issued By: mac.. - •nature: � f 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. UFcE !" FOR OFF=ICE ISE O\L1 Fleet Permit Application Received _,fj ,lj City of Tigard plan Review Related Permit#: + 13125 SW -1.';1118B. 1141319 all Blvd.,Tigard,°01.599782.46-1‘.1 R 97223 ® See Page 2 for II a Phone: 5Line:.5 39 Fax: 503.598. 9 0 ` ;1 ( t+'s'" �.F Ready Date/By: MEM Supplemental Information InspectionLine: 503.6 r.gov I L 7, 1- )I+1 1 a Notified/Method TIGARDLAI' . 4 '.. Internet: www.tigard-or.gov Please check all that apply(submit a sets of plans w/items checked): Building over three stories. ®Addition/alteration/replacement 0 Service or feeder a amps or more 0Marinas and checked):❑New construction where the available fault current ❑Marinas and boaty. 0 Other exceeds 10,000 amps at 150 volts or ❑ ❑Demolition or exceeds 14,000 0 Commercial-use agricultural IRI less to ground buildings. - 0 Commercial/industrial 0 Accessory building amps for all other installations. ❑buildings.n of 150 KVA or ❑ 1-and 2-faintly dwelling0 Other: ❑Fire Pump larger neon of 15derived 0 Master builder ❑Emergency system. system. ®MUltt faintly t „:"; ❑Addition of new motor load of "1-2",derive wimp or more. 0"A","E",E 7ob#: Job site address:10885 SW MEADOWBROOK DR ❑Six or more residential units. Recreational❑ vehicle parks. ❑Health_care facilities. 0 ecply voltage forc more than City/State/ZIP:TIGARD,OR 97224 0 Hazardous locations. 600 volts nominal ❑Service or feeder 600 amps or more. Suite/bldg./apt.#:36 Project name: L'a•�o �E �� ,� °� AND SUMMER- , Ease Total Cross street/directions to job site:NORTH FROM SW DURHAM » TURN RIGHT ON MEADOWBROOK DR New residential single-or multi-family dwelling unit. FIELD DR, Includes attached garage. 168.54 _� Lot#: 1,000 sq.ft.or less Nil 0 Subdivision: ft.orportion 33.92 _© Ea-add'1500 sq. ■ Tax map/parcel#: Limited energy,residential 75.00 nom with above r.multi-family ■ Limited energy, th above 7500 REMOVE OLD PANEL AND REPLACE WITH NEW residential with above r.ft. Renewable Ene A 0 See Pa_e 2 —NE T j Services or feeders installation alteration, a d/or relo00 cation; ry 200 amps or less in 1111 133.56 _© Name:KAZUHIDE TOKUDA 201 amps to 400 amps 200.34 r �� St 401 amps to 600 amps 11111� 301.04 �© Address: Qg 70 S� ; 601 amps to 1,000 amps A 9722 55226 _ City/State/ZIP: a r� V Over 1,000 amps or volts ( )449-6815 113 Temporary services or feeders installation,alteration,and/or Phone: 503 relocation 59.36 _© 200 amps or less IN made on pfoperty that I own which is not 159.36 _© 201 amps to 400 amps - pwnde for sale,lease,This installation is being,acording to ORS 447,449,670,and 701. 168.54 _ 401 amps to 599 amps intended for sale, rent,or exchange, Date: gi Branch circuits—new alteration,or extension, Owner Signature � �� *�l�l A.Fee for branch circuits whit �■© Ty service or feeder fee, . t a � each branch circuit 1111 Business name:ELECTRIC INC above B.Fee for branch circuits without 11service or feeder fee,first 56.18 Contact name:NATHAN WINSTON branch circuit _�_© Address:PO BOX 820386 Each add'1 branch circuit WA 98682 Miscellaneous service or feeder not cluded City/State/ZIP:VANCOUVER, Each manufactured or modulaz III 67.84 1111111 dwellin c,service and/or feeder me Phone:(360)798-7372 67.84 _© Reconnect only 67.84 Email:NWINSTON e�?ELECTRICOS IT COM pump Or irrigation circle IIII �� 1� a Business name:ELECTRIC INC Sign or outline lighting 111167.84 Signal circuit(s)or limited-energy Address: ❑See Page 2 ,. el,alteration or extension. PO BOX 820386 Each additional ins i ction over allowable in an of the above (1 hr min) 6625/hr _ WA 98682 Additional inspection9000/hr _■ City/State/ZIP:VANCOUVER grMMIIIIIIIIIIIIIIIIIII investigation(1 hr min) ■ Phone:(360)798-7372 Industrial plant(1 hr min) _ Inspections for which no fee is ■ 90.00/hr -. Email:NW NSTON@ELECTRIC-INC.COM C s, tficalt listed '/2 hr min 0 l b L prv.Lic.: Q(tY l ,, ;n�' �, CCB Lic.: 156850 Electrical Lic.:37 /1� Subtotal: ,•--- 017/ --- permit fee): Suprv.Electrician si attire,required: v� 0 Plait Review Required(25%of MUM /�r S�"H Date: "'j /S^'le aMIIIIIIII State surcharge(12%of permit fee): Print name:: ✓13 TOTAL PERMIT FEE: MIMI expires if a permit is not obtained within 180 This permit applicatroe j/ days atter it has been accepted as complete Authorized signature: drift Date: 3 ri r a Number of inspectionsfallowed per permit. Print name: v ✓! atRI — 440 46t5T(11/05/C0M/Wm IBg„ildineermitslELC PermitAppELRERE.doc Rev 06/17/2015 � r Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: Fee for all residential systems combined: $75.00 Description ( Qty' gaeh [ Total I 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 ❑ Garage Door Opener* 50.01 to 100 kva 552.26 2 >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 ❑ 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 66.25/hr 1 charged at an hourly(1 hr min) Inspections for which no fee is 90.00/hr specifically listed('/z hr min) ! 0 014 ' e` ° _ .. J Fee for each commercial system: $75.00 Subtotal(Enter on Page 1): * 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 n 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:SBuilding\Pennits\ELC PennitApp_ELR_ERE.doc Rev 06/17/2015