Permit CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: ELC2008
DATE ISSUED: 11/7/2008
TtcA►�, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 104AA -05 700
SITE ADDRESS: 12740 SW WILLS PL ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 2 LOT : 078 JURISDICTION: TIG
PROJECT: STEDMAN
• Project Description: Installing (3) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUTLINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVCI FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS • ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 . PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CATIE STEDMAN BEAR ELECTRIC
12740 SW WILLS PL P.O. BOX 389 •
TIGARD, OR 97223 DONALD, OR 97020
Phone: 503 - 590 -5952 Contact #: PRI 503 - 678 -1355
FAX 503 - 678 -1108
• FEES
Description Date Amount Reg #: ELE 24 - 107C
[ELPRMT] ELC Permit 11/7/2008 $60.15 LIC 20919
[TAX] 12% State Surchar 11/7/2008 $7.22 SUP 4881S
Total $67.37 REQUIRED ITEMS AND REPORTS
•
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
/ n /
Issued By: � i� � � Permittee Signature: ��P iCGP��GY✓
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'N: DATE:
LICENSE NO: •
Call 503.639.4175 by 7 :00 a.m. for an inspection that business day.
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.
INSPECTOR'S SIGNATURES ARE NOT -
Inspections Required for: --c,OWS REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By . I ✓ Code Inspection Description I PASS Date I By .
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 12 0 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in -
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
•
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection _ 599 Final inspection
I: \ Building \Forms \InspCard- AOP- Blank.doc 02/02/07
III ate, CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00628
° COMMUNITY DEVELOPMENT DATE ISSUED: 11/7/2008
11646'; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104AA -05700
SITE ADDRESS: 12740 SW WILLS PL ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 2 LOT : 078 JURISDICTION: TIG
PROJECT: STEDMAN
Project Description: Installing (3) branch circuits.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRRIGATION:
EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG:
LIMITED ENERGY: 401 - 600 amp: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CATIE STEDMAN BEAR ELECTRIC
12740 SW WILLS PL P.O. BOX 389
TIGARD, OR 97223 DONALD, OR 97020
Phone: 503- 590 -5952 Contact #: PRI 503 - 678 - 1355
FAX 503 - 678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
[ELPRMT] ELC Permit 11/7/2008 $60.15 LIC 20919
[TAX] 12% State Surchar 11/7/2008 $7.22 SUP 4881S
Total $67.37 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / j j ` ` i� � , Permittee Signature: S �e C' / C
i/
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'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
-11/07/2008 FRI 8:19 FAX 5036781108 Bear Electric, Inc. Z001/002
...
H C. 900 g- 66 5V
. . .
Electrical Permit Application . FOR OFFICE USE ONLY •
City of Tigard .-•-•: • ..,: •..,-. ,
Received
ffi Penni! No.: /' ......; eAj
13125 SW Hall Blvd., Tigard, OR ,.., i r•. t c
Ph Date/13 :
k i': 2110.0 Review
Phone: 503.639.4171 Fax: 503.598.196A x i h pj 20 8 - .0a1c/BY: Other Permit: p 7
'TIGARD Inspection Line: 503.639.4175 Nu v v I Date Ready;By: lois: fil See Page 2 for
Internet: www.tigard-or.gov NotifiedMethod: ' Supplemental Information
0 New construction N Addition/gob 11.1 : - - nt Please check all that apply (submit l scts of plans wfitems checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
. f'4,14 oyiftittiff ,,': exceeds 10.000 amps at 150 volts or 0 Floating buildings.
' • '''' .:' '''':'''"' ''..-'" "''''''''''''
-..; '''-''''''-''' "-"';''''''''''''' ''''""'''''' '''''''" less to ground. or exceeds 54.000 0 Commercial-use agricultural
al_ and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
( iik'itiiiiqi-owitgaiwiw-Y.tekx,f6514: -:?•-•,, . . . -.,,,:•:.., o Eme system. larger separately derived system.
Job no.: ' 1
Job site address: \ 2 ....., \k, I ,, p\
,, s,..„ 100HP or more.
* 0 Six or more residential units. 0 occupancy.
Recreational vehicle parks.
City/State/ZIP: 7 .‘ n o - 'yl 1 (:)Q A e n 723 0 Health facilities
0 Hazardous locations. 0 Supply voltage for more than
600 volts nominal.
Suite/bldg./apt. no.: Project name: 0 Service or feeder 600 amps or more.
raV
Cross street/directions to job site: Description 1 Qty. Fee. 1 Total 1 •
New residential single-or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. addi 500 sq. ft. or portion 33.40 I
Tax map/parcel no.: Limited energy, residential
IT.',V1:**14SagailfWV44460,1* (withalwle sq. ft-) 75.00 2
Limited energy, multi-family
)C) --- 57)0i 0e,_A Ve'S P \ CP .001re I residential (with above sq. ft.) 75.00 2
-• Services or feeders installation and/or relocation
ce c..,e W ,, 200 amps or less 80.30 2
: . 0 PR Os ' • . : ..' '-....'" ..;•:- 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
_ relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being 201 amps to 400 amps , 100.30 2
made on property that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
m,z;ioarie above service or feeder fec,
6.65 7.
each branch circuit ,
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: circuit 1 46.85 q( 2
first branch
Address: Each add'I branch circuit -2. _ 6.65 13,3 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 2
clig, service and/or feeder
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E Pump or irrigation circle 53.40 2
0***4.03P0k10.cf: . ;-'....:::.",: ..i.' . .;:a Sign or outline lighting 5340 2
Signal circuit(s) or limited-
Business name: . Q. , RC ....,... vE- \-- _e . C ... cjC_ , s4c .......L________
energy panel, alteration, or
Address: c.) c B 3%c ‘ extension. Describe: Page 2 2
City/State/ZIP: 116 % . a 0 t , ,.., Each additional inspection over allowable in anv of the above
- - Per inspection 62.50
Phonc: (5.3)1,021:13i4 Fax: (50 ) r1 ,- 1 . b ., Investigation per hour (1 hr mitt) 62.50
. -
CCB Lic.: -2, iq Electrical Lic.: 71.4 -1014 Suprv. Lic.: 1-17.) Industrial plant per hour 73.75
-- - tiletiztic4. , ititgiVetts . .
. . . _ . ....... , . . . ...., ...,..
Suprv. Electrician signature, required: Subtotal: Up0. 1 5
........_
.
Print name: y r_
• • .. p_ . c , Date: i k---'( )_ Plan review (25% of pennit fee):
State surcharge (12% of pennit fee): * ? _
%
Authorized signature: ,
_ TOTAL PERMIT FEE: (ci 7:7 7
. ... I.:. •
1 TIliA permit application expires if a permit is not obtained v‘it in 180
Prim naine: Date: days after it has been accepted as complete.
-- - • Number of inspections allowed per permit
I. t3»id l',Initl EI.C•I'crnitApp.15, 00 2 00 440.4015Ti I I 00 CO M WEB
• •
•