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Permit Support Document (41) • CITY OF TIGARD f 3 i, ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2018-00548 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/15/2018 TIGARD 9 Parcel: 2S114BA10700 Jurisdiction: Tigard Site address: 16430 SW MEADOWOOD WAY Project: O'Gorman Subdivision: COPPER CREEK STAGE 2 Lot: 60 Project Description: Kitchen Remodel. 8/23/2018: REPRINT to add(1)200 amp service. Contractor: YOUNG ELECTRIC LLC Owner: BAKER, MARISA PO BOX 91364 O'GORMAN, IAN PORTLAND, OR 97291 16430 SW MEADOWOOD WAY TIGARD, OR 97224 PHONE: 503-706-9867 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 08/23/2018 $100.70 Specifics: amps or less 5 crt Branch Circuits w/Purchase 08/15/2018 $37.10 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea 12%State Surcharge- 08/23/2018 $16.54 Electrical Type of Const: Occupancy Grp: Total $154.34 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 throug R 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: L _ Permittee Signature: ©A/ /W6.7-- OWNER i'✓C�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 , . ..„_ _ , ...., I(IR()IA fel:usu.().\1.1 City of Tigard Application , FI ill ' . . 3 _.,_:.,_ V 7et ,23 'd -- _112 ap. Lts--2,4,20/, -t, se/, , .. 13125 SW Hall Blvd.,Tigard.OR 97223 Plan Review Phone: 503.718.2439 Fax: 503.598,1960 ., . Date,f0 Related Permit i; ; _ inspection Line: 503,639.4175 A I 1[1 2 0 't 0 1 8 Ready nuttily: AIM: El See Page 2 for Internet: www.tigard-or.gov Notitietifhlerhoth Soot:demential Information TYPE OF WilDEN Of li GAR") PLOT REVIEW 0 New construction 4ddition/altittiblittAMellIVISIoN Please check all that apply(submit Isms of plans*them&checked): 0 Service or feeder 400 amps or more 0 Rending over three stories, ID Demolition 0 Other: where the available fimit current 0 Marinas and boatyards. CATEGORY oy cciNgmcctiote *tweeds 10,000 amps as 150 volts or 0 Floating buildings. :.„g4-and 2-family dwelling 0 Comniercialiindustrial 0 Accessory building teas to ground,or exceeds 14,000 0 Conunercialmse agricultural amps for all other inations. buildings. 0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 lustallation of 150 KVA or JOB SITE INFORMATION AND LOCATION 2Eg cY_ larger separately derived U Additit:of sr:110:'motor load of system. Job#: Job site address: i VII 3 c. s-- ,^ tsoz„. ,..,i ( 100HP or more. 1. 0 Six or more residential units, mcuPancY• City/State/ZIP; T ,s 0 Healtti.care facilities. OReereational vehicle parks. Suite/bldg./apt.#: I Project name: 0 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 SCHER= ' Destription 1 Qty. 1 Lath 1 Total 1 * New residential single-or multi-family dwelling unit. Subdivision: Lot#: Includes attached garage. ' 1,000 sq.ft.or less 168,54 4 Tax map/parcel#: Ea.awl 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 --r-c.., * (with above so,ft.) Limited energy.multi-family 75.00 2 - residential(nith above sq.Il.) Renewaiti ' 1 0 See Page 2 0 PROPERTY OWNER 0 1-ElsrAn -..,.'lervices or feeders East adult.alteration,and/or relocation Name: (......2200113 amps or less / 100.70 2 -arrplir 400 amps 133.56 2 Address: 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 Temporary services or feeders installation,alteration,and/or Email: relocation Owner Installation:This installation is being made on property that I own which is not 200 amps or less 59.36 I intended for sale,lease,rent,or exchange,according to ORS 447,449.679,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date: 401 amps to 599 amps 168.54 2 Brabetcircuitnew,. alteration,or extension,pr panel OA A PPLICANT _ 0 CONTACT PERSON A,Fee for branch circuits with Business namm .Nf ,,,,•tal e„,...A.--64%ç,,, above sernce or feeder fee, 7.42 2 each branch circuit 4-) Contact name: B,Fee for branch circuits without service or feeder fee,first Address. C.,c-A. 5\.,-, 1,-....-i. \& V,,,,--Sixi, 0 a.,4- k branch circuit 56.18 2 r- City/State/ZIP: PO?t, 0\f..- - Each add')branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:f-'1 1 I - ' ‘-‘17 - ...-7yi I Fax::( ) Each manufactured or modular 67.84 2 . dwelling,service andIor feeder Email' 1-\-It. r,:-I, i'... \-1 0.-4't ct(I,?f, 1 e-tokY1/4*(- (--°1'I' Recormeet only 67.84 2 _ -- - CONTRACTOR Pump or irrigation circle 67.84 2 Business name: 'IlL .‘, .„ 1 .6„.....,i(-v:e_ (,.L L..... Sign or outline lighting 67,84 2 Signal elm-inns)or limited-energy 0 See Page 2 2 Address: I'Ilketelet s,,, L....„, S1,-- 5 1 . ''',..)._)-- k panel,alteration,or extension. Each additional Inspection over allowable in any of'the above City/State/ZTP: 7\) 0 ?,... e:l--7 7 2 c-- Additional inspection(I hr min) 66.25/hr Phone:(cl71) 9 iq c'1)-i,' I Fax:( ) Investigation(1 lir min) 90.00/hr Industrial plant(1 hr min) 78.18/hr Email: ii.1...4: kk. c, tzi 'LI„...i. ,i..- 4,k,(.....,:*r,,. L ,, t. 17v-- , ' S Inspections for which no fce is 90,00/hr CCB Lie,: .9-1 17 i t Electrical Lie.: C .-- 's.--1.3, Suprv.Lic,: 31 ($ S- sPecineallY listed(v2 hr min) / ELECTRICAL PERMIT FEES Suprv.Electrician signature.required:_,, ".2?-- _._;,,,,::__ Subtotal: Print name: ..,,r Date: ogi:..:A0 Plan Review Required(25%of permit fee): ..1, 4 „ ' t ' /eI -I-- State surcharge(12%of permit fee): iI 7,,,,..1/ —e.„.„, i TOTAL PERMIT FEE: Authorized siprire: . This permit application expires If a permit is not obtained within 180 Print name: :,,--,? ,..„ , ..„.„,_ 1L,----\ Date: l'.:71,.„,./2,...0.,i i days after it has been accepted as complete. Number of inspections allowed per permit. I:BalldnigWannirr EI.C_YermuApp kIK_ERE.dor gar 061 l7,2014 440-4415T511,05COM,Whti City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 16430 SW MEADOWOOD WAY, TIGARD, September 20, 2018 at OR, 97224 9:07:54 AM Record Type: Record ID: Residential - Electrical ELC2018-00548 Inspection Type: Inspector: 199 Electrical final Chip Barnett Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor