Permit CITY OF TIGARD ELECTRICAL PERMIT
4
PERMIT #: ELC2008 -00355
° ,. COMMUNITY DEVELOPMENT DATE ISSUED: 6/20/2008
:T i c ARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DD-10300
SITE ADDRESS: 11830 SW 125TH CT ZONING: R - 4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT : 140 JURISDICTION: TIG
PROJECT: BROWN
Project Description: Installing (1) branch circuit for new outside light.
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: SIGNAUPANEL:
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: 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:
MARY BROWN CHANCO INC
11830 SW 125TH CT 3521 SW CARSON
TIGARD, OR 97223 PORTLAND, OR 97219
Phone: Contact #: PRI 503- 245 -7774
FAX 503 - 244 -4804
FEES
Description Date Amount Reg #: ELE C209
[ELPRMT] ELC Permit 6/20/2008 $46.85 LIC 171892
[TAX] 12% State Surchar 6/20/2008 $5.62 SUP 688S
Total $52.47 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: — Permittee Signature: Si: ,/� 7�4-/
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.
' MIKE OR DAVE CHANDLER
t 503.244.4804 p. 2
PP . t " A A A[. L' i4`h" , O l t * In �, a 4t 5 a z - -, ♦ ill
Electrical Permit A lication s }'�r':
1 {. �, City of Tigard ( rl �4y ��,� j" Pe l r,e.. - •
11 111C ''' • 13125 SW Hall Blvd., Tig.1 (' L.=- flan Review
. a Phone: 503.639.4171 Fax: 503.598.1960 Date,B •: Other Pemrit: Z1 .. • , a
, 'i. Ins 39.4175 Line: 503.639.4175 � ti O 200 Date Ready/By: fa See Page 2 for
gTICARD; p U NoritizdMethod: B/ Supplemental Information
4,,,,,,,..„,.. Internet: www.tigard- or.gov
TYPE I • . 'f TIGARD PLAN REVIEW
Additi t 1 Please check all that apply (submit 2 sets of plans w!items checked below): • ['New construction ❑ Q ��li ; bi ®N ❑ Service or feeder 400 amps or more 0 Building over three stories.
El Demolition ❑ OtheBUIL , Ivy where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
M builder ❑ Other: Fire pump. ❑ Installation of 75 KVA or
II] Multi ❑ aster ❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1- 2 ","I -3 ",
Job no.: Job site address: 11830 SW 125 COURT 10011P or more. occupancy.
eno Par ne'rnta ❑ Six or more residential torus. 0 Recreational vehicle parks.
❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP: TIGARD, OR. 97223 ❑ Hazardous locations. 600 volts nominal.
Suite /bldgiapt. no.: Project name: ❑ Service or feeder 600 amps or more.
_ - FEE SCHEDULE
Cross street/directions to job site: Desert ton It . Fes. Total
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision:
Lot no.: 1,000 sq. ft. or less 145.15 4
_ - Ea. add'( 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
75.00 2
DESCRIPTION OF WORK (with above sq. 6.)
Limited energy, multi-family 75.00 2
WIRE A LIGHT AND SWITCH FOR A NEW OUTSIDE DOOR residential (with above sq. 6 )
Services or feeders installation, alteration, and/or relocation
200 amps or less 1 80.30 2
-
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: MARY BROWN 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 11830 SW 125 COURT Over 1,000 amps or volts 454.65 2
City /State/ZIP: 'TIGARD, OR. 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not - 201 amps to 400 amps 100.30 2
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 ex ten sion, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 1 46.85 46.85 2
Contact name: • first branch circuit
Each add'( branch circuit 6.65 2
Address:
Miscellaneous (service or feeder not included)
City /Slate/ZIP: Each manufactured or modular 90.90 2
dwelling. service and /or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: CHANCO, INC dba CHANDLER ELECTRIC energy panel. alteration. or
Address: 3521 SW CARSON ST
extension. Describe: Page 2 2
City / State/ZIP: PORTLAND, OR. 97219 Each additional ins ection over allowable in any of the above
Per inspection _ 62.50
Phone: (503) 245.7774 Fax: (503) 244.4804 Investigation per hour(1 hr min) 62.50
CCB Lic.: 171892 Electrical Lic.: C209 Suprv. Lic.: 688S Industrial plant per hour 73.75
_. ELECTRICAL PERMIT FEES c _
Suprv. Electrician signature, required:
- Subtotal: rj( d , 5
Plan review (25% of permit fee):
Print name: DAVID W CHANDLER
Date: 6/19/2008
g � �1 State surcharge (12% of permit fee): 5.62
Authorized signature: TOTAL PERMIT FEE: 52.47
This permit application expires if a permit is not obtained within 180
Print name: DAVID W CHANDLER Date: 6/19/2008 days after it has been accepted as complete.
* Number of inspections allowed per permit.
I1Building \Permits\ELC- PemlilApP.dos 0523106 446-4611M11 /05 /COM/WE0
i ,
CITY OF TIGARD ' .
BUILDING DIVISION ~J PERMIT #: ELC2008- 00365
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/20/2008
Phone: (503) 639 -4171 A , ^1�'�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/25/2008 TIME: 7 :OOAM PAGE: 30
SITE ADDRESS: 11830 SW 125TH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 140 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Installing (1) branch circuit for new outside light.
OWNER: BROWN, MARY PHONE #:
CONTRACTOR: CHANCO INC W\-\ 1■-€ 1 PHONE #: 50a- 245-7T/4
Inspection Request Scheduled For: Date: 6425/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
125 Wall cover 071806-01 503-209-7448 N Y
Corrections /Comments/ Instructions:
AM
Re c.-Y1 • 00 GZicOV i i &)g 6C & 'T PA A)6' ga
b 4 UFAv4 o 0( FiANL-
A ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G 1\1()8(....-) Date: 6 Phone #: (503) 718- 1■14 '
CITY OF TIGAR®
BUILDING DIVISION PERMIT #: F_LC2008.00355
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2012000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 i j, 1 �I
INSPECTION WORKSHEET FOR DATE: 6124/2008 TIME: 7:O3AM PAGE: 33
SITE ADDRESS: 11830 SW 125TH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 140 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: . Installing (1) branch circuit for new outside light.
OWNER: BROWN, MARY PHONE #:
CONTRACTOR: CHANCO INC ( \'K- ') PHONE #: 503- 245.7774
Inspection Request Scheduled For: Date: 6/24/2008 Pour Time:
Code # Inspection Description — Confirm # Contact # Message
120 Elocirical rough -in ' 071784 -01 503. 203 -4778 Y
VM I K,E
Corrections /Comments /Instructions:
g- N oolV
to & NS &-
❑ PASS ❑ PARTIAL APPROVAL \CANCEL I N NO ACCESS
n FAIL 71 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v V '' Date: 6 ; at Phone #: (503) 718- MA"
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