Permit (48) CITY OF TIGARD ELECTRICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: ELC2018-00292
IGARTD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/08/2018
Parcel: 2S 1036 D03700
Jurisdiction: Tigard
Site address: 11905 SW FONNER ST
Project: Huber Subdivision: None Lot: None
Project Description: (7)branch circuits for additional lighting in workshop.
Contractor: OWNER Owner: HUBER FAMILY TRUST
DONALD HUBER 11905 SW FONNER ST
HUBER FAMILY TRUST TIGARD, OR 97219
11905 SW FONNER ST
TIGARD, OR 97223
PHONE: 503-969-1231 PHONE:
FAX:
FEES
Quantity Description Date Amount
8 crt Branch Circuits wo/Purchase 05/08/2018 $108.12
Specifics: Service or Feeder
1 ea 12%State Surcharge- 05/08/2018 $12.97
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $121.09
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 appli•=ble 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 sus,•-nded for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility N-"-- '-• e = Those r are set forth in OAR
952-001-0010 through• '52-001-0090. You may obtain a•••y of the r -s or direct questions to OUNC by calling •, 1.800.3
Issued By• `__ 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
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 RECEIVE I holt Orrice isi:OM.)
City of Tigard Received
Date/B : '' Permit#:
II 13125 SW Hall Blvd.,Tigard,OR 97223 MAY 8 2018 Plan Review111 I �" I 'w� 1`�
Phone: 503.718.2439 Fax: 503.598.1960 Related Permit#:
Date/B ,-1 _-
1 I G A R D '� SuInspection Line: 503.639.4175
CITY IT �^�R 9Ready Date/By: H Seepplemental InPage 2 forformation
Internet: www.tigard-or.gov �� h k,tified/Method:
TYPEOFWORK)ILDIN(D1V1SIe
PLAN REVIEW
❑New construction ❑Addition/alteration/replacement 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.
I=1 Demolition ❑Other:
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION 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 ❑Master builder ❑Other: ❑Fireum
P P• 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
Job#: Job site address: ,`e� ❑Addition of new motor load of system.
0. LL 'c'� `ay‘ift 4 100HP or more. ❑"A","E","1-2","1-3",
City/State/ZIP: � " � �� ❑Six or more residential units. occupancy.
it.-70,,,,4 9 1.12_7---, ❑Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: I' Project name: ..c), i ❑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
Ea.add'l 500 sq.ft.or portion 33.92 1
DESCRIPTION OF WORK
Limited energy,residential
1 I .-11,\S r- , -----1/4,...a v (with above sq.ft.) 75.00 2
Limited energy,multi-family
residential(with above sq.ft.) 75.00 2
Renewable Energy ❑ See Page 2
0 PROPERTY OWNER 0 TENANT
rte_ Services or feeders installation,alteration,and/or relocation
NameariT
ti‘..)‘01..,,i ‘,‘1 Jj'k 200 amps or less 100.70 2
Address: liCj , , C - 201 amps to 400 amps 133.56 2
( -T�� 401 amps to 600 amps 200.34 2
City/State/ZIP: L 601 amps to 1,000 amps 301.04 2
Phone:(! `y c10.c1 ,—L7.3 i Fax:( ,) Over 1,000 amps or volts 552.26 2
Email: tJ�CJ1/l �l�o('`a l I.a,
Temporary services or feeders installation,alteration,and/or
v.i , L'Yyt relocation
Owner install. •t n:This installatio I being made on property that I own which is not 200 amps or less 59.36 1
intended for sale,lease,r-n : ex according to ORS 447,449,670, d 7 lc. 201 amps to 400 amps 125.08 2
Owner signatu t : j� .--- Date: f� ampsamps- i et 401 to 599
l tP 168.54 2
nimarr
0 ' ' ' r '1' 0 CONTACT PE SO Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
Contact name:
each branch circuit 7.42 2
B.Fee for branch circuits without
Address: service or feeder fee,first 1
y 56.18 1 2
branch circuit 1 ,.
City/State/ZIP: Each add'I branch circuit 7 7.42 5i,Idi 2
Phone: Miscellaneous(service or feeder not included)
( ) Fax: :( ) Each manufactured or modular
dwelling, 67.84 2
Email: service and/or feeder
Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: Sign or outline lighting 67.84 2
Address: Signal circuit(s)or limited-energy
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:( ) 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.: Electrical Lic.: Suprv.Lic.: specifically listed(V hr min) 90.00/hr
Suprv.Electrician signature,required: ELECTRICAL PERMIT FEES
Subtotal: i d g,i 2
Print name: Date: 0 Plan Review Required(25%of permit fee):
State surcharge(12%of permit fee): O q`°7
Authorized signature: TOTAL PERMIT FEE: 94.CJ j
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\Permits\ELC_PertnitApp_ELR_ERE.doc Rev 06/17/2015 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RE EN, IAL WORKONLY: ..� .�_ -: •r: . FEE SCHEDtLE
Description
I Qb'• I Each I Total I *
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
5 kva or less 100.70 2
Check Type of Work Involved: 133.56 2
5.01 to 15 kva
❑ 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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener* >100 kva(fee in accordance 552.26 2
with OAR 918-309-0040)
LI 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:
Each additional inspection is 66.25/hr 1
• Other: charged at an hourly(1 hr min)
Inspections for which no fee is 90.00/hr
specifically listed(%hr min)
O OnY; ELECTRICAL PERMIT£'FEES
CO IMERCIAL `' ,k Subtotal(Enter on Page 1):
Fee for each commercial system: $75.00 * Number of inspections allowed per permit.
(SEE OAR 918-309-0000)
Check Type of Work Involved:
LI Audio and Stereo Systems
n Boiler Controls
LI Clock Systems
LI Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
LI Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
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:
11905 SW FONNER ST, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2018-00292
Inspection Type: Inspector:
199 Electrical final Jeff Grove
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor