Permit (53) \\(\s-c4-0c6.' vc� 13\
CITY OF TIGARD ELECTRICAL PERMIT
' 11.. COMMUNITY DEVELOPMENT Permit#: ELC2018 00373
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/06/2018
T f "�R`O g Parcel: 2S103AD00507
Jurisdiction: Tigard
Site address: 11180 SW ERROL ST
Project: MEEKER Subdivision: ECHO HEIGHTS Lot: 10
Project Description: (1)100 amp service and(16)branch circuits for ADU.
Contractor: GARNER ELECTRIC Owner: MEEKER,ANDREW R&KATHLEEN A
2920 SE BROOKWOOD AVE A 345 W 145TH ST#8C3
HILLSBORO, OR 97123 NEW YORK, NY 10031
PHONE: 503-648-4552 PHONE:
FAX: 503-642-7925
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 06/06/2018 $100.70
Specifics: amps or less
16 crt Branch Circuits w/Purchase 06/06/2018 $118.72
Type of Use: SF Service or Feeder
Class of Work: ADU 1 ea 12%State Surcharge- 06/06/2018 $26.33
Electrical
Type of Const:
Occupancy Grp:
Total $245.75
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 may obtai -copy o = ules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: _. Permittee Signature: ��ic- `/( lie-_.
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.
TO/y
��,� Electrical Permit Application Project#
�" .••r, Washington County,155 N.1a AV,Suite 350,MS 12,Hillsboro,OR 97124, _
oEEGON Phone:503-846-3470,Fax:503-846-3993/lutbldg@co.washington.or.us Permit# at-C. AO I w373
Inspection Requests: 503-846-3699/www.co.washington.or.us/piro insT g 0J y rua't
TYPE OF WORK PLAN REVIEW
0 New construction gl Addition/alteration/replacement 0 Other: Please check all that apply:
0 Service or feeder 400 amps 0 Hazardous locations
or more where the available 0 Service or feeder 600 amps or more
CATEGORY OF CONSTRUCTION fault current exceeds 0 Building over three stories
44.1-and 2-family dwelling 0 Commercial/industrial 0 Accessorybuilding10,000 amps at 150 volts or
❑ Marinas and boatyards
less to ground,or exceeds
❑Multi-family 0 Master builder 0 Other: 14,000 amps for all other ❑ Floating buildings
JOB SITE INFORMATION AND LOCATION installations. ❑ Commercial-use agricultural
buildings
Job no.: Job address: 11180 SW ERROL ST. ❑ Fire pump 0 Installation of 150 KVA or larger
❑ Emergency system separately derived sysicm
City/State/ZIP:TIGARD, OR Addition of new motor
ad of 100HP or more ❑ "A""E,""I-2,""I-3" ccatpaticy
a more HP or ml ❑ Recreational vehicle parks
Suite/bldg.lapt.no.: Project name: IRLECEIY0 Supply voltage for more than
❑ Health-care facilities 600 volts nominal
Cross street/directions to job site:
JUN 6 2C 18 FEE SCHEDULE
•I ription Qty. Fee Total *
Subdivision: Lot no.: CITY Of TIC C A. - dential single-or multi-fancily dwelling unit.
es attached garage.
Tax map/parcel no.: BUILDING I�IVIS1 61q,ft.or less (s/`"-- 00 4
DESCRIPTION OF WORK Ea.add'I 500 sq.ft.or portion 47.00
Limited energy,residential
795 SQ.FT ADU (with above sq.ft.) 107.00 2
Limited energy,multi-family 107.00 2
residential(with above sq.ft.)
❑ PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less -/C,,A. / /d_7t; 2
201 amps to 400 amps 161.00 2
Address: 401 amps to 600 amps 214.00 2
City/State/ZIP: 601 amps to 1,000 amps 321.00 2
Over 1,000 amps or volts 642.00 2
Phone:( ) Fax:( ) Temporary services or feeders installation,alteration,and/or
relocation
Owner installation:This installation is being made on residential or farm property owned by me or a member of 200 amps or less 107.00 2
my immediate family. This property is not intended for sale,exchange or rent.(ORS 479.540(1)and 479.560(1). 201 amps to 400 amps 161.00 2
Owner signature: Date: 401 amps to 599 amps 214.00 2
0 APPLICANT 0 CONTACT PERSON Branch circuits—new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name:Garner Electric above service or feeder fee, /4 //r 7
each branch circuit 2
Contact name:Melissa Stock B.Fee for branch circuits
Address: 2920 SE BI OOkWOOd Ave. Ste. A without service or feeder 107.00
fee,first branch circuit 2
City/State/ZIP: Hillsboro, OR 97123 Each add'1 branch circuit 9.50
Miscellaneous(service or feeder not included)
Phone:(503)648-4552 Fax:(503)642-7925 Each manufactured or modular
dwelling,service,and/or feeder 113.50 2
E-mail:melgarner@garnerelectric.com Reconnect only 107.00 1
CONTRACTOR Pump or irrigation circle 107.00 2
Business name:Garner Electric Sign or outline lighting 10200 2
Signal circuit(s)or limited-
Address:2920 SE Brookwood Ave. Ste. A energy panel,alteration,or
extension.Describe: 107.00
City/State/ZIP:Hillsboro, OR 97123 2
Phone:(503)648-4552 Fax:(503)642-7925 Each additional inspection over allowable in any of the above
Per inspection 107.00
E-mail:melgamer@garnerelectric...CCB lic.no.: 121159 Investigation fee(sm compliance) _
Electrical lie.no.:34-30 ?7 0-7S Other:
Supervising electrician ELECTRICAL PERMIT FEES
signature,required: Subtotal 00 ZJ 9.H�
Print name: 6/5/18 Plan review(25%of permit fee)
Charles Gamer— Date: State surcharge(12%of permit fee) .04 i.3)
Authorized 11''
signature: '' 'Q' TOTAL PERMIT FEE 7'04 75-
This permit application expires if a permit is not obtained
6/5/18
Print name: Melissa Stock Date: within 180 days after it has been accepted as complete
*Number of inspections allowed per permit. Revision 6/13