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Permit `iati. 3 CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00145 01 COMMUNITY DEVELOPMENT DATE ISSUED: 3/9/2007 T� 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 103CC -02300 SITE ADDRESS: 13870 SW 121ST AVE ZONING: R -4.5 SUBDIVISION: COLONIAL VIEW LOT : 018 JURISDICTION: TIG PROJECT: SCHAFFER Project Description: (2) 200 amp services, (12) branch circuits, (1) low voltage all encompassing. 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: 1 MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 2 W /SERVICE OR FEEDER: 12 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: ANDREW SCHAFFER KELSO ELECTRIC INC 13870 SW 121ST AVE 545 SE 3RD TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: 503 - 515 - 6259 Contact #: PRI 503- 648 -6360 FAX 503 - 648 -2075 FEES Description Date Amount Reg #: ELE 34 -433c [ELPRMT] ELC Permit 3/9/2007 $315.40 LIC 116254 [TAX] 8% State Surcharge 3/9/2007 $25.23 SUP 4270s Total $340.63 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. Permittee Signature: Issued By: ' a �Q � � ;� D 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'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. 2007 /MAR /09 /FRI 08:27 AM Sears Hall igd ik. FAX No. 503 244 3792 P, 002 Electrical Permit App1lCSltlon 1:'41' r ; h . i a f 'l i c)1t c) t l I t L t 51 + ` U f� 1 L 1 '� ' r ''n " i t MAR 0 9 200 .a <� a.: L'�ifkrSF � A. ��7�L.�n_ ^'�Lti;±MT�hWn�¢ c. r .'a r '�'�i'��� — — t�' 13125- o � and t Received -07. (.emu _ tNNo (x,,2© �4 /yam ° 1 3125 SW Hall Blvd.,gard OR 97223 CITY OF _ 17 I IL ®NO D IVISI OID' ateJBy: Review Other Permit: � Phone: 503.639.4171 Fax: 503 aT1 � f ,P Inspection Line: 503.63 Date Ready/By; ./ Iurir. td ;"04 interact: www .ttigard -Or.gov._.. . .. ....- --.._._._....__.. N o ti tie d/ lvlet h o d ; I Sec Page 2 for Supplemental Information TYPE OF WORK PLAN REVIEW ['New const ruction ,, ddition /alteration/replaceinaent Please check all that apply (submit 2 acts of plans w /items checked below): - — _ -- -. _.. _.. _. - -_ . -- -- • •- ,❑ Service. °rimier400 amps .or.more_...EIBw7ding,oversbree stories_ - [] Demolition ❑ Other wbere the available Milt current 0 Marinas and boatyards. • CATEGORY OF CONSTRUCTION - exceeds - 10:000 amps at150 volts or 'CO Floatingbuildiagg- ..... less to ground, or exceeds 14.000 ❑ Commercial - use ag:iculaual 5 1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other instalfalions. buildings. ❑ MuM- family ❑ Master builder ❑ Other: 0 Fire pump. ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION 13 Emergency system. larger separately derived systeu ❑ ,Addition of new motor load of ❑ "A.", "E", "1 -2". - 1 -3 ", Job no.: I Job site address: i , / 0 S 17 j,2. 100111' or snore, occupancy. ❑ Six or more residential units. O Recreational vehicle parts. . City /State /ZIP: ❑ llsalth - care facilities. ❑ Supply voltage for more than QHazardous locations. 600 volts nominal Suite/bldg. /apt no.: I Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description (Qty. . D�c 1 l Fm 1 Tatal 1 " New residential single- or multi- family dwelling unit Includes attached garage. Subdivision: I Lot no.: 1,000 sq. ft or less 145.15 ' 4 Tax map/parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential /�j 75.00 2 DESCRIPTION OF WORK (with above sq. it) G ( FX �� �^! �l Limited energy, multi-family 7500 2 Y ' " E _ EL .6vsAP Mt . 1_OG4 i l i- ,u 7^e.�r residential (with above sq. R) . ✓��,, �, / ��' ! `1�� ' Services or feeders installation, alteration, and/or retocatiion �''2 '7iwf1 t/, /b4 (/f.3 200 amps or less 1 2 ( 80.30 /6Q_60 2 [rehOJ'ERTY OWNER 1 ❑ TENANT 201 amps to 400 amps 106.85 2 r< Name: 4101),/ �' v ^ y e . 1-�2 ^ 401 amps to 600 amps 160 -60 2 a f - - 601 amps to 1,000 amps 240,60 2 Address: 1 �+6 O S(jJ (2 i / v Over 1,000 amps or volts 454.65 2 City/State/ZIP: 73:C 4- 7tw 0 , , Temporary services or feeders installation, alteration, and/or '►+ (�� R � 6 q y T 22 relocation • Phone: (56 3) 5 t5 Q, 251 1 Fax; ('SO3) 5.2-4- , 4635-1 200 amps or less 66.85 1 Owner installation: This installation is being ma • e on property that I own which is not 201 amps to 400 amps 10030 2 intended f o r sale, lease e n t , • r exchan, , : • • - •a• to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2 / Bate: 7 ,4/ d 7 Branch circuits - new, alteration, or exttnsion panel Owner signature: � l ill .,(t A_ Fee for branch circuits with ❑ APPLICANT ❑ CONTA.Cr PERSON above service or feeder fee, 6.65 2 Business name: �L� et:o�' 10 O 1� each branch circuit B. Fee for branch circuits Contact name: without service or feeder tee, ?tt�l>►�KS r _ Bust branch circuit 46.85 2 Address: Eaclt add'l branch circuit j . j 6.65 7 .S0 2 Miscellaneous ( service or feeder not induded) City /State/ZIP: Each manufactured or modular dwelling, service and /or feeder x_90 2 Phone: ( ) I Fax: : ( ) Reconnect only 66,85 2 E-mail: Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: Signal circuit(s) or limited- ! /� cr Z L !� / L ....,../, energy panel, alteration. or n � Address: u r ^? 0 7 — extension. Describe: / Page 2 .75.:°'''' ` °' 2 City /State/ZIP: /7//G L tS. o. O .0 cl '7/3 Each additional Inspection over allowable in any of the above Per inspection 62.50 Phone: Lcos) a.0 0360 I Fax ( c3 ) 6 5,7_,, Investigation per hour (1 hr min) 62.50 CCB I,ie.: fi‘2 9 Electrical l ic.:3y y Supry Lie.: 92,7 ltadustriei pleat per boar 73.75 - - ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: ;15, /0 Print name: Pam_ Plan review (25% of permit fee): /�/ �L Ss � 7 O 7 State surcharge (8% of permit fee): ,,Z Authorized signature: s „,„ �� y s , 0 A _ TOTAL PERMIT FEE: • gy ed � . 5 _ - - --- -- - Th p erm plicatldp'e realTa� - 'fisP tob w - Prmt name: C/ O� /s/�G S Date ty y 4. I p has accepted ss ip �+ c „ � days seer It has been accepted as comDleta • Number of inspections allowed per permit. 9Ba s _�.iG�ecmiMa vdosaP5 /23/06— ... -._._ _. _____ .._ ._.. 4X(4.005 1∎16V's_. __— ._.._._w..__. - -- - CITY OF TIGARD BUILDING DIVISION PERMIT #: ELCZt 07 001 5 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/9/2007 Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/19/2007 TIME: 7 :03AM PAGE: 23 SITE ADDRESS: 13870 SW 121ST AVE CLASS OF WORK: SUBDIVISION: COLONIAL VIEW LOT #: 018 TYPE OF USE: PROJECT NAME: SCHAFFER DESCRIPTION: (2) 200 arnp services, (12) branch circuits, (1) low voltage all encompassing. Note: Only one 200 amp :service is required. Per GN OWNER: SCHAFFER, ANDREW PHONE #: 503. 515 - G2.59 CONTRACTOR: KELSO ELECTRIC INC PHONE #: 503 -648 -6360 • Inspection Request Scheduled For: Date: 7/19/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 1 26 Wall cover 052361 -02 503-615-6259 N Corrections /Comments/ Instructions: sp,Ac, ∎ 42 E P L.) s wa ,(;) PITL,4 w%` A \czi 2t b . i s p ion 12 . Q, u o...E The electrical installation defects noted on this report shall be corrected and an inspection request made within 20 calendar days per OAR 918- 271 -0030 PASS n PARTIAL APPROVAL CANCEL n NO ACCESS U ' 1 l CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED . Inspector:. G N Date: ' f rct 01 Phone #: (503) 718- CITY ��N�~�� W��������������� OF mun�������� 'BUILDING DIVISION PERMIT #: BLC2007-00146 13125 SW Hall Blvd., Tigard, OR 97223 - DATE ISSUED: 3J912007 Phone: (503) 639-4171 | etk Inspection Requests (24 Hrs.): (503) 639~4175 = jw� , '°A INSPECTION WORKSHEET FOR DATE: 3/15/2007 TIME: 7:O1AM PAGE: 7 • SITE ADDRESS: 13870 SW 121ST AVE . CLASS OF WORK: SUBDIVISION: COLONIAL VIEW LOT #: 010 ^ ' TYPE OF USE: PROJECT NAME: SCHAFFER • DESCRIPTION: CD2UO amp services, H2l branch moxuito.U\low voltage all encompassing. OWNER: SCHAFFER, ANDREW PHONE #: 503-515-8259 CONTRACTOR: KELSO ELECTRIC INC PHONE #: 503-548'6360 Inspection Request Scheduled For: Date: 3115/ 2007 Pour Time: Code # Inspection Description �on�au�# Message • 115 Electrical service 603-615-6259 Corrections/Comments/Instructions: cX • PASS PARTIAL APPROVAL ri CANCEL NO ACCESS n FAIL | | CALL FOR INSPECTION | 1 ADDITIONAL FEES ASSESSED • ��- � \��� ' ^ 3 � �~ �rl �� U� Inspector: `-� ' 0�/x~»�� c~�-^ Date: `� s' "*� �� � Phone #: (503) 718- ^~ /