Permit INCITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: ELC2019 00456
Date Issued: 07/17/2019
T 6 AR L 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109BA04700
Jurisdiction: Tigard
Site address: 14103 SW WAGONER PL
Project: RUTHERFORD Subdivision: HILLSHIRE SUMMIT NO.2 Lot: 29
Project Description: (1)branch circuit for hot tub.
Contractor: NW ELECTRICAL SOLUTIONS Owner: RUTHERFORD,ABDUL&TENETIA
PO BOX 805 14103 SW WAGONER PL
MOLALLA, OR 97038 TIGARD, OR 97224
PHONE: 503-759-3952 PHONE:
FAX:
FEES
Quantity Description Date Amount
1 crt Branch Circuits wo/Purchase 07/17/2019 $56.18
Specifics: Service or Feeder
1 ea 12%State Surcharge- 07/17/2019 $6.74
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $62.92
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty odes 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 ssu.nce, or if work is suspende• • more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notific tion enter. Those rules - •-t forth in OAR
952-001-0010 through OAR 9 2-001-0090. You may•- - _ es o •' - • estions to OUNC by calling 5 3.232 1987 or 1.800. = .234,
Issued By: - Permittee Signature:
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 Applica fiTt,kalO . r1< I l ,l.(1\l ti
City of Tigard Received
'a 13125 SW Hall Blvd.,Tigard,OR 972 I Z 019 Date t • 7 / i1,� ` - r
■ Plan Review
Phone: 503.718.2439 Fax: 503.598. Related Permit 4:
DateB
Inspection Line: 503.639.4175 w i. r+,
t�1 H.[) �` �-' ���ys��i � Ready DateBy: �. H See Page 2 for
Internet www.tigard-or.gov j + r iai► ,' ,, Noufied/Method ntal Information
In Suppheme
❑New construction Addition/alteration/replaoement Please check au that apply(submit z sets of l ns ...... �
phms ai:g over three stones.
where the available fault current ❑Marinas and boatyards.
�y CATEG ; OP`CONSTRUCTION ., exceeds 10,000 amps at 150 volts or ❑Floating buildings.
! 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building less to smrnd or exceeds 14,000 0 commercial-use agricultural
❑Multi-family 0 Master builder 0 Other: amps
for all other installations. buildings.
❑Fire pump. 0 Installation of 150 KVA or
JOB SIE INFORMATION AND;L4 ATIO a y, - ❑Emergency system. larger separately derived
Job#: 1 Job site address: (4 f d 3 Sin/ 'Jr//�R ❑Addition of new motor load of system
R. 100HP or more. ❑"A","E","l-2","1-3",
City/State/ZIP: ��4 t /�P i 7224,
Z Z/1 ❑Six or more residential units. meoPancY.
V f, 4, '/ (� 0 Health-care facilities. 0 Recreational vehicle parks.
Suite/bldg./apt#: I Project name:/ J ' (/__j�( ❑Hazardous locations. 0 Supply voltage for more than
T use,��_www I ❑Service or feeder 6)0 a>ups or more. 600 volts nominal.
Cross street/directions to job site: Sw /14;:d./,_: o . D r HEDUL, a
Descriptioa .I Qty. I Each I Total I *
New residential single-or multi-family dwelling unit
Subdivision: I Lot 4: Includes attached garage.
Tax map/pazcel#: 1,000 sq.ft.or less 168.54 4
Ea add'l 500 sq.ft.or portion 33.92 1
'' ,' ' `� N Of WORK . , Limitedenergy,residential
d �; with above ft 75.00 2
U) byj t;1v2�i r ' '" b. Limited energy,multi-family
b`�7c�.rr, �/y l 02-.77
residential(with above sq.ft.) 75'()0 2
lit C 7 Renewable Energy ❑ See Page 2
'Ii O'G EIt. I' 0`' EN'A 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:( ) I Fax:( ) Over 1,000 amps or volts 552.26 2
Email: Temporary services or feeders installation,alteration,and/or
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,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
° � Branch circuits-new,alteration,or extension,per panel
l' �I` 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 ' 56.18 To,I, 2
branch circuit
City/State/ZIP: Each add'1 branch circuit 7.42 2
Phone:( ) Fes. . Miscellaneous(service or feeder not included) vr
:( ) Each manufactured or modular
Email' dwelling,service and/or feeder 67.84 2
( e j t 6,0W ,.t ca. Reconnect only
c��N� wv '. 67.84 2
A� CTOR Pump or irrigation circle 67.84 2
Business name: /e4 r iLD4— 6- _S 1 4�4� _ !Sign or outline lighting _6 — 2 -
Address: + ' Let 1�1.T 'Iig� (s)or limited-energy
51' IN i//O./Yfiy AVZ panel,alteration,or extension. 0 P e 2 2
City/State/ZIP: / � Each additional inspection over allowable in any of the above
Ft)le S F v,f s ti 1 o " 7116 t j Additional inspection(I hr min) 66.25/hr
Phone:(503)S 4 2 5 G/ Fax:( ) Investigation(1 hr min) 90.00/ht'
Email:as b� T 3 ® L7 M /r 1 Industrial plant(1 hr min) 78.18/hr
Inspections for which no fee is
CCB Lic.: C+ Electrical Lie.:(_.144-51/ Sppry j k6,:si'f 1 C specifically listed(Vi hr min) �/lir
- 7 JELECTRICAL;P E '
Suprv.Electrician signature,required: - !'-
/ � / ;t ,r '.._ Subtotal: ,/�
L
Print flame: a,,,.,111-)“.1 G` s.fM St ,-Date:(sz 7 `l Q ❑Plan Review Required(25%of permit fee):
l� �1 (. "'''''‘L.
� � l ( State surcharge(12%of permit fee): (0. 7
Authorized signature: TOTAL PERMIT FEE: .•1,
"3— S J e 7 This permit application expires if as rp s t�tained within 180
Print name::3-JI97—. J�_[/ Date: / /�9 after it has d pc complete.
e..a_v., ,r rt !
* Number of inspections allowed per permit.
1:M:holding\PeratitAELC P _ _ERE.d°c Rev 06117/2015 490-46151(11/05/COM/wEB
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
14103 SW WAGONER PL, TIGARD, OR, 97224 July 22, 2019 at 10:42:18 AM
Record Type: Record ID:
Residential - Electrical ELC2019-00456
Inspection Type: Inspector:
199 Electrical final Jeremy Burrows
Result:
PASS - NoCofO
Comments:
Minor label #ELS 641040
Violation Summary:
Inspector Contractor