Permit (35) CITY OF TIGARD ELECTRICAL PERMIT
°I . COMMUNITY DEVELOPMENT Permit#: ELC2018-00378
I '" "11 ? r''; Date Issued: 06/08/2018
I f c3 D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
WAVIER Parcel: A06500
Jurisdiction: Tigard
Site address: 13322 SW HILLSHIRE DR
Project: Perreira Subdivision: HILLSHIRE Lot: 65
Project Description: (3)branch circuits for basement bathroom. 9/27/18:REPRINTED permit to include(2)branch circuits.
Contractor: OWNER Owner: KOGA,WENDY M
WILLIAM PERREIRA PERREIRA,WILLIAM K
13322 SW HILLSHIRE DR 13322 SW HILLSHIRE DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 808-389-2728 PHONE:
FAX:
FEES
Quantity Description Date Amount
5 crt Branch Circuits wo/Purchase 09/27/2018 $85.86
Specifics: Service or Feeder
1 ea 12%State Surcharge- 09/27/2018 $10.30
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $96.16
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 OAR 952-001-0090. You y obtain a coCt the rule or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: �e! �'� c. �e Permittee 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.
• WY "
RECEIVED
Electrical Permit Application rOR OFI ICI' USE ONI_1.
JUN b 2018 /�
City of Tigard natdB`- ��1 • iEZ C.20/if-ars'76
0 13125 SW Hall Blvd.,Tigard,OR 97 -R/ TI GA ) plan Revier
Phone: 503.718.2439 Fax: 503.5 Rdaled Permit i{:
Inspection Line: 503.639.4175 13 DING DIVISION add.: . :y:, �,(1 .Rats: B See Pa 2 for
1 1".'s n.1 Internet: www.tigard-or.gov Notified/Metho4' f/FAlYPV
Srppbmantal Information
TYPE OF WORK /
❑New construction ®Addition/alteration/replacement Authorized signature:
❑Demolition 0 Other: Print name: I
'< CATEGORY OF;CONSTRU ot-. t
® 1-and 2-family dwelling 0 Commercial/industrial 0 Ac• , :. , PLAN R1WU%V
❑Multi-fatnily ❑Master builder 0 Oth, Please check all that apply(submit j�sets of plans Whams checked):
0 Service or feeder 400 amps or more 0 Building over three stories.
.,, . ;: ,JOB'3JTE INFORMATION.AND:CatT p where the available fault current 0 Marinas and boatyards.
Job#: Job site address:13322 SW Hlllshire Dr exceeds 10,000 amps at 150 volts or ❑Floating buildings.
less to ground,or exceeds 14,000 0 Commercial-use agricultural
City/State/ZIP:Tigard,OR 97223 amps for all other installations. buildings.
❑Fire pump. ❑Installation of 150 KVA or
Suite/bldg./apt#: Project name:bassement bathroom inst ['Emergency system. larger separately derived
Cross street/directions to job site:
0 Addition of new motor load of system.
loom.or more. 0"A","E","1-2","1-3",
❑Six or more residential units. occuPaceY•
❑Health-care facilities. ElRecreational vehicle parks.
Subdivision:Hillahire Lot#:65 ❑Hazardous locations. ❑Supply voltage for more than
❑Service or feeder 600 amps Of more. 600 volts nominal.
Tax map/parcel# 2S104CA06500 ; , ..�. , SCW D ,4 , .;. ,
:, �:; z. Descriprba Qty I dwelling
) Total [•;. '.
- DESCRI ti15*E*Wi'" , ,iia
` New residential single-or multi-family dwelling unit.
electrical Jf1or base ent bathroom installation Includes
[/� /� //�_ ]�' Includes attached garage.
',.,.,'-';'11,'„':::,:.'.:: PIt�I"a;I Y .! // ! l i fyL•!/✓L✓'�1 Cr r re-., i ) , SCSI or portion ' t3g'92 ! i
4 1 1000 SQ. t
Ea add'1
OWNSR r. :;....❑'TENt�IT' . Limited energy,residential
75.00 2
Name:William Perreira (with above sq.ft.) _
Limited energy,multi-family 75.00 2
Address:13322 SW Wilshire Dr residential(with above sq.R)
City/State/ZIP:Tigard,OR 97223 Renewable Energy ❑ See Page 2
Services or feeders Installatlontalteration,and/or relocation
Phone:(808)389-2728 I Fax:( ) 200 amps or less 100.70 2
201 amps to 400 amps 133.56 2
Email: t j it t Z any s p-yYe 1 r CO lthi research v Corn 401 amps to 600 amps 200.34 2
Owner installation:This installation is being made on property that I own which is not 601 amps to 1,000 amps 301.04 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. Over 1,000 amps or volts . 55226 2
Owner signature: (44.4....^--:--- `,_ : Date: C'I y I l1 Temporary services or feeders installation,alteration,and/or
: _.. . ._® APPJ,TGKf . r^ .. f w -tggCpNTiC3PQN.. r relocation
Business name:
' 200 amps or less 59.36 1
201 amps to 400 amps 125.08 1 2
Contact name:William Perreira 401 amps to 599 amps 168.54 2
Address:13322 SW Hillshire Dr /E/?, 6.—fritvi_ Branch circuits—new,alteration,or extension.Qer panel _
A.Fee for branch circuits with
City/State/ZIP:Tigard,OR 97223 , O/7 -- : yr serviceciltecierke' -_ 7.42 2
Phone:(808)389-2728 I Fax::( ) 4/4/.4B.Fee service bbr fncherrcu,circuits without(
i 1$ 56.18 2
Email:william.perreira@lamreseareh.com branch circuit
``.... :'',::.::,:::,:=,..- ..eti CTO _..` .r. ., t ,`. ._ ,:::,-;1,-;,.....:, s. Each add'I branch circuit 7.42 .L*r/2
Miscellaneous(service or feeder no Included)
Business name: Each manufactured or modular '
Address: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
City/State/ZIP: Pump or irrigation circle 67.84 2
Phone:( ) I Fax:( ) Sign or outline lighting 67.84 2
Signal circuits)or limited-energy ❑ See Page 2 2
Email: panel,alteration,or extension. .
Each additional inspection over allowable in any of the above
CCB Lic.: Electrical Lic.: Suprv.Lic.: Additional inspection(1 hr min) 66.25/hr
Suprv.Electrician signature,required: Investigation(1 hr min) 90.00/hr -
Industrial plant(1 hr min) 78.18/hr
Print name: Date: Inspections for which no!be is _ 90.0o!hr
specifically listed(16 hr min) d
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CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2018-00378
T I A F D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/08/2018
Parcel: 2S104CA06500
Jurisdiction: Tigard
Site address: 13322 SW HILLSHIRE DR
Project: Perreira Subdivision: HILLSHIRE Lot: 65
Project Description: (3)branch circuits for basement bathroom.
Contractor: OWNER Owner: KOGA,WENDY M
WILLIAM PERREIRA PERREIRA,WILLIAM K
13322 SW HILLSHIRE DR 13322 SW HILLSHIRE DR
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 808-389-2728 PHONE:
FAX:
FEES
Quantity Description Date Amount
Specifics: 3 crl Branch Circuits wo/Purchase 06/08/2018 $71.02
Service or Feeder
1 ea 12%State Surcharge- 06/08/2018 $8.52
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $79.54
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 copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ! — Permittee Signature: + A7 " 17"1/71-/e7-7C),"/
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.
-
/y :
R D
Electrical Permit Application JUN
FOR OFFICE USE ONLY
City of Tigard JUN b 2018 Received r",",
n DateB : 0 p <9:.-. PermitEZ c 0if-oaf,'7,
13125 SW Hall Blvd.,Tigard,OR 97 T/ OF i_1 CnAR Plan Bevies
' - 2 Phone: 503.718.2439 Fax: 503.5 rt r Related Permit#:
Inspection Line: 503.639.4175 1-1/;`41-7 -�l� l`° l y Read y VI See Page 2 for
TIGARDyDate/B :/' �^ loris:
, Internet: www.tigard-or.gov Notified/Metho4 I i 4iN Supplemental Information
TYPE OF WORI{ ;el/41C- 41/14:-//
❑New construction ®Addition/alteration/replacement Authorized signator ;
❑Demolition 0 Other: Print name:
CATEGORY OF CONSTRUCTION
® 1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building PLAN REVIEW
Please check all that apply(submit 2 sets of plans w/items checked):
❑Multi-family 0 Master builder
0 Other:
0 Service or feeder 400 amps or more 0 Building over three stories.
JOB SITE INFORMATION AND LOCATION where the available fault current ❑Marinas and boatyards.
exceeds 10,000 amps at 150 volts or 0 Floating buildings.
Job#: Job site address: 13322 SW Hillshire Dr
less to ground,or exceeds 14,000
0 Commercial-use agricultural
City/State/ZIP;Tigard,OR 97223 amps for all other installations, buildings.
❑Fire pump. 0 Installation of 150 KVA or
Suite/bldg./apt.#: Project name:bassement bathroom inst 0 Emergency system. larger separately derived
Cross street/directions to job site: ❑Addition of new motor load of system.
100HP or more. ❑"A","E","1-2","1-3",
❑Six or more residential units. occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
Subdivision:Hillshire Lot#:65 ❑Hazardous locations. 0 Supply voltage for more than
❑Service or feeder 600 amps or more. 600 volts nominal.
Tax map/parcel#:2S104CA06500 FEE SCHEDULE
DESCRIPTION OF WORK nescriptlon I Qty. I Each I Total 1
New residential single-or multi-family dwelling unit.
electrical for basement bathroom installation
Includes attached garage.
1,000 sq.ft.or less 168.54 4
h,„ PROPERTY OWNER El TENANT Ea.add'I 500 sq,ft.or portion 33.92 1
Limited energy,residential
Name:William Perreira (with above sq.ft.) 75.00 2
Address: 13322 SW Hillshire Dr Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
City/State/ZIP:Tigard,OR 97223 Renewable Energy 0 See Page 2
Services or feeders installation,alteration,and/or relocation
Phone:(808)389-2728 Fax:( ) 200 amps or less 100.70 2
Email: Witt 1 am e p„k,rre t& @i Ian')resew -c 401 amps to 00 0. corn 401 amps to 400 amps 203.34 2
Owner installation:This installation is being made on property that I own which is not 1amps 301.04 2
601 amps to 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. ,000 301.04 2
w��_ N Over 1,000 amps or volts 552.26 2
Owner signature: /, ' - Date: Co I y I I 16 Temporary services or feeders installation,alteration,and/or
C4 APPLICANT 123 CONTACT PERSON relocation
Business name: 200 amps or less 59.36 1
201 amps to 400 amps 125.08 2
Contact name:William Perreira 401 amps to 599 amps 168.54 2
Address:13322 SW Hillshire Dr fo—iza,.... Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
City/State/ZIP:Tigard,OR 97223 t /2,0/..-; above service or feeder fee,
each branch circuit 7.42 2
Phone:(808)389-2728 Fax::( ) k//4/I/Jit-) — B.Fee for branch circuits without
Email:william.perreira«lamresearch.com service or feeder fee,first 1 56.18
branch circuit 56.18 2
CONTRACTOR Each add'I branch circuit 7,42 2
Business name: Miscellaneous(service or feeder not included)
Each manufactured or modular
Address: dwelling,service and/or feeder 67.84 2
Reconnect only 67.84 2
City/State/ZIP: Pump or irrigation circle 67.84
2
Phone:( ) Fax:( ) Sign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Email: panel,alteration,or extension. ❑ See Page 2 2
CCB Lic.: Electrical Lic.: Each additional inspection over allowable in any of the above
Suprv.Lic.: Additional inspection(1 hr min) 66.25/hr
Suprv.Electrician signature,required: Investigation(I hr min) 90.00/hr
Print name: Industrial plant(1 hr min)) 78.18/hr
Date: Inspections for which no fee is
specifically listed(V2 hr min) X90.00/hr
1:\Building\Permits\ELC PennitApp_ELR ERE.doe Rev 06/17/2015 440-4615T(11/05/COM/WEB S Ct7 e 7-7 7/,of
Tz27?9z 79,57
•
ELECTRICAL PERMIT FEES
Subtotal: 56.18
❑Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): 6.74
TOTAL PERMIT FEE: 62.92
This permit application expires if a permit is not obtained within 180 days after it has been accepted as
complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC_PermitApp ELR_ERE.doe Rev 06/17/2015
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
13322 SW HILLSHIRE DR, TIGARD, OR, 97223 January 14, 2019 at
10:04:09 AM
Record Type: Record ID:
Residential - Electrical ELC2018-00378
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor