Permit (159) CITY OF TIGARD ELECTRICAL PERMIT
Ili ' ` COMMUNITY DEVELOPMENT Permit#: ELC2019-00220
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/04/2019
I
Parcel: 2S102DB01900
Jurisdiction: Tigard
Site address: 13245 SW BURNHAM CT
Project: LEWIS Subdivision: BURNHAM PARK Lot: 13, PT 8
Project Description: (10)branch circuits for kitchen, bathroom, and family room remodel.
Contractor: CORPORATE FINANCIAL SOLUTIONS LLC Owner: LEWIS, EVAN W& KAREN E
25027 SE HWY 224 13245 SW BURNHAM CT
BORING, OR 97009 TIGARD, OR 97223
PHONE: 503-320-2703 PHONE:
FAX:
FEES
Quantity Description Date Amount
10 crt Branch Circuits wo/Purchase 04/04/2019 $122.96
Specifics: Service or Feeder
1 ea 12%State Surcharge- 04/04/2019 $14.76
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $137.72
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 th 180
days. ATTENTION: Oregon law requires you to follow the rules ad•. -. ..by_Jhe Oregon Utility Notification Center �/..e rules are set forth in AR
952-001-0010 through OAR 952-001-0090. You ma •• -'. . •. of t'-rules or direct questi•'s to OUNC by calling 503. c2.19: 0,. 6'.3 /. 44.
Issued By: -` — Permittee ign. . -. rdi`///
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 s Fo iz 01 1 1 C 11 i.S I. ON I.v
City of Tigard REE ED Received permit#: G'
eeuu.... Date/BY: 4 f i`� '- ifa.21 1>' (.6A1,
III13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
96
Phone: 503.718.2439 PR 4 2019 Date/By: Related Permit#:/157;420/C�-_ �,
Email: TigardBuildingPermits@Tigard-or. o' �Cd Ready Date/By: Juris: ® See Page 2 for
1 I G A K D Inspection Line: 503.639.4175 Int I I '_a1r�� Notified/Method: Supplemental Information
TYPE OF '®tNG�`V� ,® PLAN REVIEW
❑New construction ,EI"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.
❑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 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use agricultural
amps for all other installations.
0 Multi-family ❑Master builder 0 Other: Elum Fire buildings.
Installation p. 0 Installation of 150 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived
�f ` ❑Addition of new motor load of system.
Job#: Job site address:
31 v L! 3 rbuyt Yx Y\r..„ 6. 100HP or more. ❑«A» «E» «1_z» "l-3„
City/State/ZIP: �-- t-' ❑Six or more residential units. occupancy.
Lcy-Lvte.0 C-FAI -Ce 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt.#: Project name: 0 Hazardous locations. 0 Supply voltage for more than
❑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
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
Y---A r (with above sq.ft.) 75.00 2
+� �
" + i � `t0 7- 4c -C-.---1,..".- 4.,\...y - 7Q'`-'-. Limited energy,multi-family
?,� VZ
residential(with above sq.ft.) 75.00 2
i"` sir e k' I VZ-e 4- a Renewable Energy 0 See Page 2
0 PROPERTY OWNER 0 TENANT, Services or feeders installation,alteration,and/or relocation
Name: 200 amps or less 100.70 2
Address: 201 amps to 400 amps 133.56 2
401 amps to 600 amps 200.34 2
City/State/ZIP: 601 amps to 1,000 amps 301.04 2
Phone:( ) 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 1
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2
Owner signature: Date: 401 amps to 599 amps 168.54 2
0
APPLICANT ❑'CONTACT PERSON Branch circuits-new,alteration,or extension,per panel
A.Fee for branch circuits with
Business name: above service or feeder fee,
each branch circuit 7'42 2
Contact name: B.Fee for branch circuits without
Address: service or feeder fee,first q
branch circuit 56.18 ye,„t? 2
City/State/ZIP: Each add'l branch circuit 1 7.42 .64._"7' 2
Miscellaneous(service or feeder not included)
Phone:( ) Each manufactured or modular
dwelling,service and/or feeder 67.84 2
Email: Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name: C, t-LASign or outline lighting 67.84 2
Signal circuit(s)or limited-energy
Address: . 5-C),921 SE 1-t Loy '14 panel,alteration,or extension. 0 See Paget 2
City/State/ZIP: /r Each additional inspection over allowable in any of the above
i+�Lam•U`C� l l ! 7C^C f. Additional inspection(1 hr min) 66.25/hr
Phone:(5-63) 4,-)qo --Clo (2 Investigation(1 hr min) 90.00/hr
Industrial plant(1 hr min) 78.18/hr
Email:r C hcc c,l a'c�1/44- C. 410 41 it yv%-L..kA ,C0....._.... Inspections for which no fee is
CCB Lic.:' Electrical Lie.: C ` Suprv.Lie.: specifically listed('h hr min) 90.00/hr
�a11(� 4 t i )3t1 p � f`1�S
�//,,{{ ,� J ELECTRICAL PERMIT FEES
Suprv.Electrician signat/ ,`r `ulred: 1-. 1,/""t efjt//1 Subtotal: ) 2 ,e1<''
Print name: /- II,S 1 L C j t„ Dateeti Ay a, \q 0 Plan Review Required(25%of permit fee):
VVI State surcharge(12%of permit fee): I i(. 242
TOTAL PERMIT FEE: 7
Authorized signature: 7
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_PermitApp_ELR_ERE.doc Rev 10/26/2017 440-4615T(11/05/COM/WEB
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL`WORK ONLY: FiE . ULE
Description Qty. Each I Total
Fee for all residential systems combined: $75.00 Renewable electrical energy systems:
2
Check Type of Work Involved: 5 kva or less 133.
5.01 to 15 kva 133.5656 2 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
50.01 to 100 kva 552.26 2
❑ Garage Door Opener*
>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(1/2 hr min
CO ` WORK ONLY* E ERMrr FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1):
(SEE OAR 918-309-0000) * Number of inspections allowed per permit.
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ 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:\Building\Permits\ELC_PermitApp_ELR_ERE.doc Rev 10/26/2017
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13245 SW BURNHAM CT, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2019-00220
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor