Permit Support Document CITY OF TIGARD ELECTRICAL PERMIT
Per
III '� , mit#: ELC2019-00422
� COMMUNITY DEVELOPMENT �
. � Date Issued: 06/23/2019
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T l C;;E It f} 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 . iril
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Parcel: 2S104DC04600
Jurisdiction: Tigard
Site address: 13529 SW CLEARVIEW PL
Project: Method Subdivision: BENCHVIEW ESTATES Lot: 46
Project Description: Kitchen plugs and lighting. 7/3/19:REPRINT to add(2)branch circuits.
Contractor: LEONARD ELECTRIC INC Owner: NAAS, JAMELAH A
PO BOX 411 13529 SW CLEARVIEW PL
HUBBARD, OR 97032 TIGARD, OR 97223
PHONE: 971-570-8103 PHONE:
FAX:
FEES
Quantity Description Date Amount
4 crt Branch Circuits wo/Purchase 06/23/2019 $78.44
Specifics: Service or Feeder
1 ea 12%State Surcharge- 06/23/2019 $9.41
Type of Use: SF Electrical
Class of Work: ALT 2 crt Branch Circuits w/Purchase 07/04/2019 $14.84
Service or Feeder
Type of Const: 0 ea 12%State Surcharge- 07/04/2019 $1.78
Occupancy Grp: Electrical
Total $104.47
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OA' ••2-001-00•'. You j-y obtain a co• • le r les or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: /� /4 . Permittee Signature: �/� Gt
/ OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Electrical Permit Apvlica 10 ' "', " ' ,i ' ' �i "" '
ipilCity ojTigara r AT/��0 _. . :
■ 13125 SW Hall Blvd.,Tigard,OR 97223 U ?s 019 Man Review It>'+ated Permit :
a ' Phone: 503.7182439 Fax: 503.598.1960 Datels
- inspection Line: 503.639.4175
`s:
1rt.;�;.fl CIPI OI " `D NtfeMBd: liiIM
Internet: www.tlgBld-Or.$OY
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• PLAN REVIEW
D Ncw construction ®Addition/alteration/replacement Plane clleck ail that apply(submits sets of plans writers checked):
0 Service or feeder 400 amps or mote CI Dividing 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 ❑Floating buildings.
01-and 2-family dwelling 0 Commercial/industrial p Accessory building less to or exceeds 14,000 ❑Commercial-use agricultural
amps for all other installations, bwIdiugs.
0 Multi-family Il Master builder 0 Other: (]Fire pump. ❑Installation of 150 K VA or
JOB SITE INFORMATION ANI) LOCATION ❑EIBY systrlm. larger separately derived
0 Addition of new motor load of system.
Job#: I Job site address:13529 SW Clearview P1 100HP or more. ❑"Ad,"1?",-1-2",..1.3"
CI Sia or more acoccupancy
residential utile" QQC
City/State/ZIP: Tigard OR f
[a Flealtb•care facilities- Cl Recreational vehicle partes.
Suite/bldg./apt.4: I Project name: t1 Hazardous locations, 0 Supply voltage for more than
CI Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: FEE SCIREDL1I0E.
rsc iatiss. I Qts. I Each f Total i"
New residential single-or multi-family dwelling unit.
Subdivision:Benchview estates I Lot#:46 includes attached arage. -
1,000 sq.ft.or less 168.54 4
Tax map/parcel#t:2510411004600Ea.edd'I 300 sq.R.or potion 3392 t
DESCRIPTION OF WORK • Limited energy,residential 75-00 2
Need 2 circuits added to existing permit for funace in attic and AJC (with about mi.ft.)
Limited energy.multi-family 75.00 2
Existing Permit number ELC2019-00422 residential(with above sq.ft.)
Renewable Energy CI See page 2
PROPERTY OWNER i CI 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 aaltre 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 lnstallatton,alteration,and/or
Email. rel0eation
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 447,449,670,and 701. 201 amps to 400 amps _ 125.08 2
Owner signature: Date:------75.----APPLICANT
- -- 401 amps to 599 amps 168,54 T 2
— BBranchBranch circuits—stew,alteraton,or extension, r panel
[a ,aRp1+1 ICAp I--- ❑ CONTACT PERSON •T A.Fee for branch circuits with
Business name: above service or*Feder fee, 7,42 2
each branch circuit
Contact name: D.Fee for branch circuits wlrhout
service or feeder fee,fust 56.1 s 2
Address: branch circuit
City/State/ZIP: Each add'I branch circuit 2 7.42 14.82 2
Miscellaneous(service or feeder not included) ,
Phone:( ) Fax::( ) Each manufactured or modular 67.84 2
dwelling,service and/or feeder
Email: . _ Reconnect only 67.84 2
CONTRACTOR Pump or irrigation circle 67.84 2
Business name:Leonard Electric Inc. Sign or outline lighting67.84 2
ti-See Page 2 —2
Address:PO Box 411 panel,alteration,or extension.
"" - — Each additional inspection over allowable in any of the above
City/Statt/ZIP:Hubbard OR,97032 _ Additional inspection(1 hr-min) 66.25/hr. .
Phone:(971)570-8103 Fax:(5-3)981-2343 Investigation(I lir nein) 90.00/hr
Email:leonardelectricinc®gmail.com Industrial plant(1 hr min) 78.18/hr
inspections for which no fee is 90,00/tlr
CCB Lie.: 218984 Electrical Lic.: C1348 Supry 'c.: 52058 _specifically listed(i,hr min)
- .. ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required: ' Subtotal:
Print name: Keith Leonard Date: 7/1 19 - CI Plan Review Required(25%of permit fee):
Stare surcharge(12%ofpermit fee):
Authorized signature: TOTAL PERMIT FEE:
'Phis permit app$ndon',pins If a permit Is not obtained within 180
Print name: Date: days after it baa been accepted as complete.
• Number of inspections allowed per permit.
I:Spui14'ne\PermitstEtc Penei(App,ELtt, ,RE.doe RevOe/17/t01$ 440.4611Y(It/O5#COh
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
13529 SW CLEARVIEW PL, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Electrical ELC2019-00422
Inspection Type: Inspector:
199 Electrical final David Young
Result:
PASS - NoCofO
Comments:
Violation Summary:
Inspector Contractor