The URL can be used to link to this page

Permit (86) CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT Permit#: ELC2019-00457 T iR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/16/2019 Parcel: 2S111 CA04300 Jurisdiction: Tigard Site address: 9720 SW LAKESIDE DR Project: Funicello Subdivision: SUMMERFIELD NO.12 Lot: 663 Project Description: (1)service and(10)branch circuits for remodel. Contractor: LIGHTING ELECTRIC LLC Owner: FUNICELLO, KATHLEEN MARY PO BOX 890 9720 SW LAKESIDE DR WOODBURN, OR 97071 TIGARD, OR 97224 PHONE: 971-338-8989 PHONE: FAX: FEES Quantity Description Date Amount 1 ea Services or Feeders-200 07/15/2019 $100.70 Specifics: amps or less 1 ea Investigation Fee 07/15/2019 $90.00 Type of Use: SF 1 ea Investigation 12%State 07/15/2019 $10.80 Class of Work: ALT Surcharge Type of Const: 10 crt Branch Circuits w/Purchase 07/15/2019 $74.20 Service or Feeder Occupancy Grp: 1 ea 12%State Surcharge- 07/15/2019 $20.99 Electrical Total $296.69 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 -001-0090. You of the rule • direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ��_ - mittee Signature: �-�.P ' 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 1 o►z ori wt.i I i oy►.l CityIN ofTigard $° eceived J / d_ g '' , li 1::: �t @ F ' Date/By: 7 g/t i j Permit#: i j/ -_r t`1`cOI - 13125 S50 Hall Blvd.,Tigard,OR 97223 Plan Review =t _ Phone: 503.718.2439 Qty Date/By: Related Permit#: Email: TigardBuildingPertnits@Tigard-or.gov 1'�.J 1_ i �. Ready Date/By: Juris' H See Page 2 for T I G A R D Inspection Line: 503.639.4175 Internet: www.tigard-or.gov,- n -Notified/Method: /. Supplemental Information TYPE OF WORK,r,, V` 1 i, i l t-A ,4 rosioN PLAN REVIEW 0 New construction 0 Addition/alteratioi ent �U'`'/ Please check all that apply(submit 2 sets of plans w/items checked): iVe0�/ wiw t 0 Service or feeder 400 amps or more 0 Building over three stories. 111 Demolition ❑Other: *Or' �� rr �/A.f where the available fault current 0 Marinas and boatyards. 7 CATEGORY OF CONSTRUCTION ---1-11 /L9 c , j,y.IU- exceeds 10,000 amps at 150 volts or 0 Floating buildings. 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory buildi Multi-family ❑Master builder ❑Other: less to ground,or exceeds 14,000 Commercial-use agricultural l ;,v amps for all other installations. buildings. Fire pump. ❑Installation of 150 KVA or JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived Job#: I Job site address: q 7Z0 S ie ` r ❑Addition of new motor load of system. (/ � / � f�� 100HP or more. ❑«A„ «E» «l_2„ «l_3„ City/State/ZIP: / �'`i l ❑Six or more residential units. occupancy. T/d 4 i"C.A g 7 Z 2 0 Health-care facilities. ❑Recreational vehicle parks. Suite/bldg./apt.#: / Project name: /`=/',l 0 Hazardous locations. 0 Supply voltage for more than "f/"'1 ❑Service or feeder 600 amps or more. 600 volts nominal. Cross street/directions to job site: FEE SCHEDULE Description 1 Qty. 1 Each I Total I * New residential single-or multi-family dwelling unit. Subdivision: I 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 (with above sq.ft.) 75.00 2 l /ii5-C.1"24c� /-,111--/-,111-- � --aY L-/1-}-� lR:// CA 4i41--.t 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: // AI, r ,., 200 amps or less i 100.70 /a).-Joh 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 I 0 CONTACT PERSON Branch circuits-new,alteration,or extension,per panel A.Fee for branch circuits with Business name: above service or feeder fee, ��,,� c. 7�/ 7.42 07.1; 2 yv r`� S �'J each branch circuit ��1 Contact name: B.Fee for branch circuits without Address: service or feeder fee,first 56.18 2 branch circuit City/State/ZIP: Each add'I branch circuit 7.42 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 - z$usiness name: Am or outline lI iTir 67.84 -- 2 fi Address: ) B®X "J© Signalnel, len orextension. limited-energy 0 See Page 2 2 �, panel,alteration,or ,� .../r- / Each additional inspection over allowable in any of the above City/State/ZIP: ✓- ©f� 61707 k Additional inspection(1 hr min) 66.25/hr Phone:(11( ) 3 'Q $city(4 Investigation(1 hr min) 90.00/hr Email: j V Industrial plant(1 hr min) 78.18/hr Inspections for which no fee is 90.00/hr CCB Lic.: /gg 692, I Electrical Lic.: Cop I Suprv.Lic.: 6 b`-1(�S, specifically listed(Vs hr min) �I f ELECTRICAL PERMIT FEES Suprv.Electrician signature,required:, 4„e 4 ke Se ! /-, Subtotal: /,t%, 7/L Print name: t>c!C Zi. tr- ,.�f-Date: it 0 Plan Review Required(25%of permit fee): �� 7 State surcharge(12%of permit fee): � 11 TOTAL PERMIT FEE: L qS Authorized signature: Fil 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\ELCPermitApp_ELR_ERE.doc Rev 10/26/2017 440-46151(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: FEE SCHEDULE Total I Qty. I Each I T Fee for all residential systems combined: $75.00 Description 3' Renewable electrical energy systems: Check Type of Work Involved: 5 kva or less 100.70 2 5.01 to 15 kva 133.56 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 n 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('h hr min) COMMERCIAL tK ONLY: * i ELECTRICAL'FEIRMI'r FEES= Fee for each commercial system: $75.00Subtotal(Enter on Page 1): * Number of inspections allowed per permit. (SEE OAR 918-309-0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems n 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\ELCPermitApp_ELR_ERE.doc Rev 10/26/2017 City of Tigard Tel: 503.718.2439 Location: Inspection Date: 9720 SW LAKESIDE DR, TIGARD, OR, 97224 September 6, 2019 at 9:08:18 AM Record Type: Record ID: Residential - Electrical ELC2019-00457 Inspection Type: Inspector: 199 Electrical final Jeremy Burrows Result: PASS - NoCofO Comments: Violation Summary: Inspector Contractor