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Permit (159) CITY OF TIGARD ELECTRICAL PERMIT ' COMMUNITY DEVELOPMENT Permit#: ELC2019-00228 Date Issued: 04/08/2019 TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S102CCO2600 Jurisdiction: Tigard Site address: 13885 SW 102ND AVE Project: ORTIZ Subdivision: FRELEON HEIGHTS NO.2 Lot: 12 Project Description: (1)200 amp service with(29)circuits for basement remodel. Contractor: BLUE LINE ELECTRIC LLC Owner: ORTIZ, DANIEL J& KAREN A PO BOX 741 13885 SW 102ND AVE YAMH ILL, OR 97148 TIGARD, OR 97223 PHONE: 971-287-8873 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 04/08/2019 $100.70 Specifics: amps or less 29 crt Branch Circuits w/Purchase 04/08/2019 $215.18 Type of Use: SF Service or Feeder Class of Work: ALT 1 ea Investigation Fee 04/08/2019 $90.00 Type of Const: 1 ea Investigation 12%State 04/08/2019 $10.80 Surcharge Occupancy Grp: 1 ea 12%State Surcharge- 04/08/2019 $37.91 Electrical Total $454.59 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 issuan - if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notificati•- Center. Those rules are set forth in OAR 952-001-0010 through OA 952-001-0090. You may obtain a cop e rules or direct questions to OUNC by calling 5^ .232.1987 or 1 800.3324. irAie Issued By: ` Permittee Signature: iiutid 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 Applicationr�� FOR OI FI F. I SE OyI,1 City of Tigard Cj Received /, DateB : `-1 :- - W� �S w 13125 SW Hall Blvd.,Tigard, 23 % `1Q19 Plan Review 1 9 Phone: 503.718.2439 Fax: 503.598 Date/B : Related Permit#: T 1 l A K D Inspection Line: 503.639.4175 GPRD,` Ready Date/By: EMI IN See Page 2 for Internet: www.tigard-or.gov , Ofi 1\,'"\`o,v Notified/Method: Supplemental Information TYPE OF l t ' ;,ANGii PLAN REVIEW ❑New construction 0 Addition/alteration/replacement Please check all that apply(submit 2 sets of plans w/items checked): Demolition 0 Service or feeder 400 amps or more ❑Building over three stories. ❑ ®Other:Basement Remode 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 Fre for all other installations. buildings. ❑Multi-family 0 Master builder 0 Other: ❑Fire pump. 0 Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived AddJob#: Job site address:13885 SW 102"d Ave. ❑100HPior mor ee o of omotor load of system. . ❑"A","E","1-2","1-3", City/State/ZIP:Tigard OR,97223 ❑Six or more residential units. occupancy. ❑Health-care facilities. 0 Recreational vehicle parks. Suite/bldg./apt.#: Project name:Basement Remodel 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:SW McDonald Street FEE SCHEDULE Description I Qty. I Each I Total 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.add'I 500 sq.ft.or portion 33.92 1 DESCRIPTION OF WORK Limited energy,residential 75.00 2 Basement Renovation (with above sq.ft.) Limited energy,multi-family 75.00 2 residential(with above sq.ft.) Renewable Energy 0 See Page 2 0 PROPERTY OWNER 0 TENANT Services or feeders installation,alteration,and/or relocation Name:Dan Ortiz 200 amps or less 1 100.70 100.70 2 Address:13885 SW 102"d Ave. 201 amps to 400 amps 133.56 2 401 amps to 600 amps 200.34 2 City/State/ZIP:Tigard OR,97223 601 amps to 1,000 amps 301.04 2 Phone:(614)374-6157 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 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 215.18 Business name:Blue Line Electric LLC above service or feeder fee, 29 7.42 2 each branch circuit Contact name:John Gregor B.Fee for branch circuits without Address:PO Box 741 service or feeder fee,first 56.18 2 branch circuit City/State/ZIP:Yamhill OR,97148 Each add'l branch circuit 7.42 2 Miscellaneous(service or feeder not included) Phone:(971)287-8873 Fax: :( ) Each manufactured or modular 67.84 2 dwelling,service and/or feeder Email:john@bluelnelectric.com Reconnect only 67.84 2 CONTRACTOR Pump or irrigation circle 67.84 2 Business name:Blue Line Electric Sign or outline lighting 67,84 2 Signal circuit(s)or limited-energy Address:PO Box 741 panel,alteration,or extension. ❑ See Page 2 2 City/State/ZIP:Yamhill OR 97148 Each additional inspection over allowable in any of the above Additional inspection(1 hr min) 66.25/hr Phone:(971)287-8873 Fax:( ) Investigation(1 hr min) ( 90.00/hr /a.�'� Email:john@bluelnelectric.com Industrial plant(1 hr min) 78.18/hr INT Inspections for which no fee is CCB Lie.: 218741 /pie Electrical Lic.: C1344 ( Suprv,Lie.: 5582S )i,it,� specifically listed('Vs hr min) 90.00/hr �A� A ELECTRICAL PERMIT FEES Suprv.Electrician signature,required: (� /, Q. 2. l. Subtotal: tomfir - Print name: John M Gregor te: 4/6 f'Y 0 Plan Review Required(25%of permit fee): State surcharge(12%of permit fee): , hr. .71 Authorized signature: TOTAL PERMIT FEE: 5`q,5-7 This permit application expires if a permit is not o tained within 180 Print name: John Gregor Date: 4/6/19 days after it has been accepted as complete. * Number of inspections allowed per permit. I:1Buitding\Permits\ELC_PermitApp_ELR ERE.doc Rev 06/17/2015 440-4615T(r t/o5/COM/WEB City of Tigard Tel: 503.718.2439 Location: Inspection Date: 13885 SW 102ND AVE, TIGARD, OR, 97223 June 24, 2019 at 12:41 :34 PM Record Type: Record ID: Residential - Electrical ELC2019-00228 Inspection Type: Inspector: 199 Electrical final Aaron Cillo-Gobel Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor