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Permit CITY OF TIGARD ELECTRICAL PERMIT rP COMMUNITY DEVELOPMENT PERMIT #: ELC2008-00120 ° DATE ISSUED: 3/3/2008 T1GAKD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DD-11300 SITE ADDRESS: 11879 SW 125TH CT ZONING: R -4.5 SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT : 150 JURISDICTION: TIG PROJECT: MERCER Project Description: Installing (4) branch circuits for kitchen. 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: 3 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: ERIC & JANINE MERCER L D ELECTRIC LLC 11879 SW 125TH CT PO BOX 642 TIGARD, OR 97223 CLACKAMAS, OR 97015 Phone: 503 - 265 -6555 Contact #: PRI 503 - 260 -6555 FAX 503 - 658 -1681 FEES Description Date Amount Reg #: ELL' 26 -1078C IELPRMT] ELC Permit 3/3/2008 $66.80 LIC 165117 [TAXI 12% State Surchar 3/3/2008 $8.02 SUP 4644S Total $74.82 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: r/ 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'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. e rrY.. oc 2 t. c_ -:)c)1 ar.) • "•�• Electrical Permit A lication '' i reau of Development Services o 1900 SW 4th Avenue, Portland, Oregon 97201 • 503-823-7363 • FAX 503 -823 -3018 • TTY 503 -823 -6868 • www.portlandonline.com /bds ;Type of work ; +Plan Review ❑ New construction ■ Addition /alteration /replacement Please check all that apply ❑ Fire pump ❑ Building over three stories ❑ Demolition ❑ Other: #Cate o of construction ❑ Emergency system 1:1 Service or feeder 600 amps 9 rY ' ❑ Addition of new motor load of or over l' 1 & 2 family dwelling ❑ Commercial /industrial ❑ Accessory building 100 HP or more ❑ Commercial use agricultural ❑ Multifamily Li Master builder ❑ Other: • Li Patient area health care facility buildings ❑ Installation of 150 INA or larger ...lob site information and location • ❑ Hazardous locations separately derived system Job no.: Job address: : 7' S, ', ( /, /,,5 ZJt (_,•, . ❑ Recreational vehicle parks ❑ 'A', 'E', '1 -2, '1 -3' occupancies City /State /ZIP: p ! ( ❑ Marinas and boatyards ❑ Service or feeder 400 amps ANi ✓ / t • ' - 22- D Floating buildings or more where the available fault current exceeds 10,000 ❑ Suite/bldg./apt. no.: Project name: r ,[ Six or more residential units amps at 150 volts or less Cross street/directions to job site: S-c'tf(�GUS / -- / , za- ❑ Supply over 600 volts nominal to ground, or exceeds 14,000 amps for all other Subdivision: Lot no. Tax map /parcel no. ❑ Voluntary plan review installations , Submit 2 sets of plans with any of the above. ;Description of work : ; The above are not applicable to temporary construction service. ,40 C I i / r s — 049A) e..)6 IFee* Schedule Description Qty. Total lil i2- L V� S Residential single or multifamily dwelling unit. Combination Permit no. Includes attached garage. Li Reference RS / Combin 1,000 sq. ft. or less - $195 — ■ Property owner • Tenant - • 1 Each added 500 sq. ft. or portion MIME Ell Name: / c ✓ /7; ate I It a • Limited energy, residential -O —© • Limited energy, multi - family -M —© G Address: 7/ 8 7 ( S 1 O5 T/1 C T_ }Services or feeders installation, alteration, and /or relocation City /State /ZIP: / A) , .22 2-3 200 amps \5 kva or less - $100 — 201 to 400 amps \5.01 to 15 kva -m — Phone: 5 - 6 52-4/064 FAX: 401 to 600 ampst15.01 to 25 kva - $187 —© Owner installation: This installation is being made on property that I own, which is not intended for sale, lease, rent, 601 amps to 1,000 amps -M — or exchange. Over 1,000 amps or volts _p — Owner si. nature: Date: 'Temporary services or, feeders installation, alteration,, and /or ' i irelocation EM Contractor !Subcontractor ∎ 200 amps or less IIIII $ 89 — Business name: L b E ('f- ' 201 amps to 400 amps Ell $136 El 401 amps to 600 amps Address: "P 10X7 644 Z 1 Branch circuits - new, alteration, or extension, per`pane!3 City /State /ZIP: C(.4 A .Fee for branch circuits w ith �� ': C(A raf}_ t`2 . ' 7 0 1 � ,,;,?i b ra n ch i t feeder fee, each I d Phone: 543 265 65,15 ., FAX: branch circuit r , B. for branch circuits without Y b ES h service or feeder fee, first 7 • Elec. lic. no. L 6 ( Q ] r�C -7/ CCB lic. no. (p j / f ( G( branch circuit Metro or City lic no. Date: Each additional branch circuit ; E vr3��■ Supervising electrician / Miscellaneous (service, or feeder not included) u Signature, required:, .d , Each manufactured or modular ■�© nn , /� L, dwellin• service and /or feeder 1� _ tEW A Print name: - ' License no. ' - 7 Reconnect only - $ 91 — Pump or irrigation circle -M —© Authorized signature: Sign or outline lighting -EER — Print name: Date: Signal circuit(s) or limited- energy ■EI II ! . - - } panel, alteration, or extension. ■ Applicant • • Contact,Person Describe: `J V�T) a� additional inspection over;allowab allowable in any of the above ' Business name: • LLC Hourly —IM ,Each add Contact name: (CrlTA IZI) S4 Per inspection -ECM —. Address: 3 Z©Q S W 6U ) c 1 - Investigation fee -_ —IMI Other -_ —■ • �Q 1 i !� !Electrical _ permit fees* � Phone: 50 5 ) -(qq ( FAX: Subtotal ir, , . 70 E-mail: Plan review (25% of permit fee) -r:9 State surcharge (12% of permit fee) 7,02- Credit Card ❑ Trust ❑ RS Permit/No Fees Due ❑ TOTAL PERMIT FEE $ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete ' Fee methodology set by Tri -County Building Industry Service Board p p •' Number of inspections allowed per permit. permitapp_electrical 12/18107 CITY OF TIGARD 1l BUILDING DIVISION PERMIT #: ELC200B -00120 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/3!20138 Phone: (503) 639 -4171 fin ., %h i l e� Inspection Requests (24 Hrs.): (503) 639 -4175 �'� INSPECTION WORKSHEET FOR DATE: 3/4/2008 TIME: 7:00AM PAGE: 28 SITE ADDRESS: 111079 SW 125T1H1 CT CLASS OF WORK: SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 150 TYPE OF USE: PROJECT NAME: MERCER DESCRIPTION: Installing (4) branch circuit; for kitchen. OWNER: MERCER, ERIC & JANINE. PHONE #: 503-285-6555 CONTRACTOR: 1. D ELECTRIC LLC k\A -' PHONE #: 5n260-65% Inspection Request Scheduled For: Date: 3/4/20013 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 086049-01 503.5049917 '• Y Corrections /Comments /Instructions: CAI I / IT- 0 M -- T WE 1.3x OW roc` 'nit 1(11'6.1 .l 64E15 15 +S -i V iN 1 4 __..„------______________ ..----7 (;i6 ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: v + N 68 C Date: OF (A Phone #: (503) 718- Digt w J - ‘� iii—z-,--,cz,- �" V — I i SW ANT�� . V \ / J A r — — 1 1 � � ! E -----, Arl - ( _ 1- \ i T ie _-__ \ / G 0 / \ . 4 ,1%,, ...,-. _1 1 N c+, . ,,-.1 DAKOTA 2\S 84 L)-. _. 'Mr 4 1 —____.,--, qv [ \ CT EDGE AT R w11Cn7 _ _ / CT I \- \T I \l C V �� ,�\ �� _ SUMMER ST I _____L 4 � , .- y LAKE ✓ t v � • �I \� \ ''-1----C6 �� — Q 6 VILLAGE_PARK_ N \ A_ \ s ( jgZ O - WI T ME ESTONECT i t �' s N E LAKEAR� \ ,,,t, ..,,,,ip ■� _ 7\ 1L �I f L Lp _ _I AJ .-- F \ in ALCON -RISE DR U _ ■ M017 �\ \ I 1 a. ¶TRISE R N , f _LE rn �1 N E7TH R - ----- I - l 1 1 CV 1 9 _,, __ „L___, l \ -ST IHERINE T „,;\ T\ ' . C __ INEY RIDGE ST Q \\ \ J I I I a � _J '� V PL \I illa,,.1 y ij r n,, _ 1 i / 2 4 j \ \ ZANN - CT \ ,' � Y \\ \ o � KA a Tiir ' y. 3 \ EJ `�� ✓ A E --- m o o \� \ g---- ' ►s o BROOK�C H_s1 \_ ✓ �i' z! ] ° °0o Q a0000 �_.1 1 1 \ �— or /-- -1 - a - 11 \ l \ ?UNEFF ST ‘1.\ \ \ \ Af mi SW ��1 ::-. ■ Q\ y , y \ \ --_____-,-, = 4/ \ \ \ __ j �� L : ;v IIII ��, \ !EC T ,.� Ivy v 1 � �P I r I � L ti� - I - -,A TIPPITT PV'n