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Permit (161) CITY OF TIGARD ELECTRICAL PERMIT s COMMUNITY DEVELOPMENT4 Permit#: ELC2019 00198 TfaAD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/08/2019 Parcel: 2S103DA04701 Jurisdiction: Tigard Site address: 10474 SW PARK ST Project: AL-SHAMARI Subdivision: None Lot: None Project Description: Installing(1)temporary electrical meter/post. Contractor: OWNER Owner: ALSHAMARI,AHMAD AHMAD AL-SHAMARI 1593 ROBERT DR 1593 ROBERTA DR SAN MATEO, CA 94403 SAN MATEO, CA 94403 PHONE: 650-430-2410 PHONE: 650-430-2410 FAX: FEES Quantity Description Date Amount Specifics: 1 ea Temp Services or Feeders- 04/04/2019 $59.36 200 amps or less 1 ea 12%State Surcharge- 04/04/2019 $7.12 Type of Use: SF Electrical Class of Work: ALT Type of Const: Occupancy Grp: Total $66.48 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 52-001-0090. 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: J � Permittee Signature: fC` \ACe11(§: 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. Electrira1 Permit Application - -. 1 Oiz O11 i( I I ,,I ()NI l City of Tigard MAR 2 5 2019 Received I t i Ci S_ Permit#:�,.LC.;)tG-<`;Ci CC ;� 13125 SW Hall Blvd,Tigard,OR 97223 Phone: 503.718.2439 Fax: 503.598.1960 c.. ,.:,1 14111111111 Related Permit#: i-1G\t:D Inspection Line: 503.639.4175 i' 5 t -; 5 , ReadyDate/By: /1111111 Si See Page 2 for Internet: www.tigard-or.gov NotiSed/Me hod: Supplemental Information TYPE OF WORK " , . !- PLAN REVIEW r ❑New construction 0 Addition/ teration/replacement Please check all that apply(submit a sets of plans w/items cheated): A� / �� /� 0 Service or feeder 400 amps or more 0 Building over three stories. ❑Demolition Other:leiii y i-neer TC''/ where the available fault current 0 Marinas and boatyards. ' CATEGORY;OF CONSTRUCTI'ION.... i`• ,i.,''1 exceeds 10,000 amps at 150 volts or ❑Floating buildings. igri_and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to ground,or exceeds 14,000 0 Commercial-use ag icuitmal amps for ❑Multi-family 0 Master builder 0 Other: Elir otter installations. buildings. lo pump. 0 Installation of 150 KVA or ,''''',,,:1:-2,'',R'JOB SITE INFORMA'T'IONAND O,,.kTION', .,,, , , ❑Emaseaay system larder separately derived Job#: I Job site address: wt./7g �n e Q1. ❑ ofaew motor load of system. �I "� �T►� 100HP or more. ❑"A^,'E","1-2'°,"1-3^, City/State/: d �j?Z2 3 ❑Sot or more residential units. eY. ( / 7 ❑lIealth�aro facilities. ❑Recreational vehxk parrs. Suite/bldg,./apt#: I Project name: ❑Hazardous locations. ❑Supply voltage for more than 0 Service or feeder 600 amps or more. 600 volts nommal. Cross street/directions to job site: w• W �d4'klui� r'i Je ..:;` . FEESC1�DUi.F" .. " .. . ,, neserioae■ I Qtr. I )Furl, I: � . .Toed *- New residential single-or nimbi-family dweMng unit Subdivision: I Lot#: Includes attached garage. 1,000 sq.ft or less 16834 4 Tax map/parcel#: Ea add'l 500 sq.ft or portion 33.92 1 „DlESCRIP7ION;OF WOEN.2;,_ *s>¢, 1,1� /����[_,. ted energy,residential pt. t,iteef'fM ibr eke-kir—a/ L (with above sq.ft.) 75.00 2 Y Limited anergy,multi-family 75.00 2 residential(with above sq.ft.) _ Renewable Energy 0 See Page 2 P PROPERTY OWNER I', r Qz'I'BNAl1NT - Services or feeders installafbn,alteration,and/or relocation Name: Ahs Al-SI cu 200 amps or less 100.70 2 Address: (593+ �R� �r 201 amps to 400 amps 133.56 2 City/State/ZIP: � M�t / Cal 401 amps to 600 amps 200.34 2 Safi �fX/ ���03 601 amps to 1,000 amps 301-04 2 Phone:( ) 1430— 264I d Fax:( ) Over 1,000 amps or volts 552.26 2 �y ���� a Valid/. Temporary services or feeders installation,alteration,and/or Email' Aff 41Th t/t'1C'liri Op A0.001 relocation Owner installation:This installation is being made on property that I own which is not 200 amps or less 1., 59.36 /1 1 intended for sale,lease,ren or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 125.08 2 Owner signature: Date:3-2 6—ZOI p 401 amps to 599 amps 16834 2 Branch circuits-new,alteration,or extension, r panel PLICAN Y' 'COl4TACT PER50I;r A.Fee for branch circuits with Business name: above serviceor feeder fee, 7.42 2 Contact name: A hwtad 4 I-SitalMtie1 B.Fee for Feet r an circbrbranch circuits uity without f593 service Cfeedertee,first Address: Robet.46 >� branch circuit 56.18 2 City/State/ZIP: �I McAfee 6.411�'a/ 9411403 Each add'1 branch circuit 7.42 2 I /// Miscellaneous(service or feeder not included) Phone:( ) q 30-2K 10 Fax::( ) Each manufactured or modular 67.84 2 -_-- dwelling,service and/or feeder Email: Al� _I�1 h ©6 YaheCIACCV41 Reconnect only 67.84 2 CONTRACTOR`•, ;xr Pump or irrigation circle 67.84 2 Business name: Ou)+/t' • Sign or outline lighting 67.84 2 Signal circuit(s)or limited-energy Address: panel,alteration,or extension. ❑ Ser Page 2 2 Each additional inspection over allowable in any of the above City/State/'ZIP: Additional inspection(1 hr min) 6625/hr Phone:( ) Fax:( ) Investigation(1 hr min) 90.0W hr Email Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 9000/hr CCB Lic.: Electrical Lic.: Suprv.Lic.: specifically listed(%brmin) "' ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: Subtotal: Print name: I Date: ❑Plan Review Required(25%of permit fee): State surcharge(12%ofpetmit fee): Authorized signature: TOTAL PERMIT FEE: �1 p / This permit application expires if a permit is not obtained within 180 Print name: 14 It /J I',`Iran„,! Date: 3/26/ c,/4:7 days alter it has been accepted as complete. iSnulld�Wam�ls.0 PermhApp II,g EREdoe Rev 06/17/2015 4411.461 7 s IT of inspeMioms allowed per permit 51'(I1lOS/COM/wFB r Electrical Permit Application—City of Tigard Page 2—Supplemental Information Limited Energy Permit Fees: Renewable Energy Permit Fees: '„...:-M1.0!,%' 1 i < 8,wit :47,1 Description 1 lKr. 1 Each I Meat 1 .< Fee for all residential systems combined: $75.00 Renewable electrical energy systems: Check Type of Work Involved: s kva or less 100.70 2 5.01 to 15 kva 133.56 2 O Audio and Stereo Systems* 15.01 to 25 kva 200.34 2 Wind generation systems in excess of 25 kva: p 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 with OAR 918-309-0040) 552.26 2 ❑ Heating,Ventilation and Air Conditioning Solar generation systems in excess of 25 kva: System* Each additional kva over 25 7.42 3 O Vacuum Systems* >100 kva-no additional charge 0.0 3 Each additional inspection over allowable in an of the above: D 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 lei .. . ,� s (55 mm) Subtotal(Enter on Page 1): Fee for each commercial system: $75.00 • Number of inspections allowed (permit (SEE OAR 918-309-0000) 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* O Protective Signaling ❑ Other: Total number of commercial systems: _ *No licenses are required. Licenses are required for all other installations L•1BmldiaglP nnta .0 PamitApp ELR_EREdoc Rev 06/17/2015 City of Tigard 13125 SW Hall Blvd. Tigard, OR 97223 Tel: 503.718.2439 Location: Inspection Date: 10474 SW PARK ST, TIGARD, OR, 97223 Record Type: Record ID: Residential - Electrical ELC2019-00198 Inspection Type: Inspector: 199 Electrical final Jeff Grove Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor