Permit A NA a � Q TY OF TIGARD
ELECTRICAL PERMIT
�'. PERMIT #: ELC2007 - 00744
0 COMMUNITY DEVELOPMENT DATE ISSUED: 11/2/2007
.T '1O;k 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BC -90020
SITE ADDRESS: 10825 SW 121ST AVE ZONING: R -
SUBDIVISION: WOODSPRING CONDOMINIUMS LOT : 020 JURISDICTION: TIG
PROJECT: MILLER
Project Description: (1) 200amp sub panel, 10 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: SIGNAUPANEL:
MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 10 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:
DAVID MILLER EJ CASSELLA
10825 SW 121ST 2000 NE 42ND. AVE #151
TIGARD, OR 97223 PORTLAND, OR 97213
Phone: 503 - 579 -3239 Contact #: PRI 503 - 233 -4563
FAX 503 - 963 -1803
FEES
Description Date Amount Reg #: ELE 26 -I 195C
IELPRMTI ELC Permit 11/2/2007 $146.80 LIC 35622
(TAXI 8% State Surcharge 11/2/2007 $11.74 SUP 21345
Total $158.54 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: 4 'j44 Permittee Signature: )--7
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.
illic
02 07 01:25p Ernest Cassel la 503 - 963 -1803 p. 2
Electrical Permit Appli t �' FOR OFFICE l SE ONLY •
t ' Received
/
City of Tigard Recciv , ; I
4 13125 SW Hall Blvd., Tigard. OR 97223
l a 07 Pcnnit No �'i DD 7� �
e
Phone: 503.639.4171 Fax: 503.598.1 %V O goo?
[ 1 DalPlan eRy: view Other Permit
Line: 5
inspection 503.639.4175 ate RcadyBy: Jurist El See Page 2 far
TIG.A S. RD P 1w � tified/Method: / Supplemental Information
. rt ,. Internet: www.tigard -or gov i
T p Yp '�' if. : . P LAN REVIEW .
i : t t t ' M 3 i � 1 • s ement Please check all that apply (submit 2 scts of plans whims checked below).
El New construction r. Adrl ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current El N4arinas and boatyards.
CATE OF 0:14,m .0.1O 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 am s for all other installations. buildings.
sa ton
' T
❑ P
Multi- family ❑Master builder ❑Other: ❑Fire pump. m.
er enc s stem ❑
larger separately derived
.- .... ... ❑Em b Y Y
I at
lily d d lest
..108 SITE 1NpORMATION AND • LOCATIO'\
13 Addition of new motor load of ❑ "A ", "E ", "I ? ", "I -� ".
lOOHP or more. occupancy.
Joh no.: Job site address: OS ')... C s L ,, 1 zI Ave ❑ six or more residemial units. ❑ Recreational vehicle parks.
`5 dQ i — a D_3 ❑ Supply volts
❑ Health -care facilities. pP voltage for mart than
(IlwStalc/ZIP: 600 volts nominal.
❑ Hatard locauons.
Suite/bldg.i apt. no.: Project name: j . ❑ Service or feeder 600 amps or more. •
:. il.'FEE: SCHEDULE
Cross strcctidircctions to job site: Description 1 Qty. 1 Fee. ; Total 1
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or less 145.15 ` l 4
_ Ea. add'1 500 sq. ft. or portion i 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00
DESCRWTION .OF WORK (with above sq. R.) ,
Limited energy, multi - family 75.00 2
5 4 ' b S f 4. ■ ' r 10,,_ residential (with above sq. ft .) _ 1
-1 Services or feeders installation, alteration, and/or relocation
Lf G, t r ,, Cx rj� ( i r 200 amps or less i 80.30? 2
❑ PROPERTY' OWNER' ' .0: ,TEN-ANT.,:.::::.„:.: . 0685
201 amps to 400 amps 1. 2
401 amps to 600 amps 160.60 j 2
Name:
-- 601 amps to 1,000 amps 240.60 f 2
Address: Over 1,000 amps or volts 454.65 2
>- Temporary services or feeders installation, alteration, and/or
C ity i State /Z.I P: relocation _
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps j 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 extension, per panel
Owner signature: Date: A. Fee for branch circuits with I
• ❑ AYYLICAAT ! CONTCT>p1LR
A, OP1 ::. a bove serv ice or feeder fee,
6.65 • 2
_ each branch circuit
Business name: 5C 1 4‘. 40.i L t. B. Fee for branch circuits . i
without service or feeder fee,
Contact name: first branch circuit � •- 46.85 f
'Address: Each add'I branch circuit 10 6.65
Miscellaneous (service or feeder not included) ,_ 4.6c,
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
2
CONTRACTOR Sign or outline lighting 53.40 2 •
1 / Signal circuit(s) or limited-
Business name: ••■•5 C / 4. _�� - i�� energy panel, alteration, or •
1 r . 2
Q ;lddress7Q� �� �S extension. Describe: Page 2 1_
(1 City /State /ZIP: - l) j _ Each additional inspection over allowable in am of the above
N A y Ol Per inspection 62.50 `
I' Phone: ( Fax: p 1
4 �e�S) 2,3 ' ! s'G p. • • • ax: (3) �G �1 Ott Investigation per hour (1 hr min) 62.50
,L CCB Lic.: 03 sb a 4 Electrical Lic, 6Z Suprv. Lie.: 2131/5 Industrial plant per hour 73.75
/ 2 n - -. ELEC'TRICAL PERMIT FEES
Suprv. Electrician signature, required: ,e/ / .0 N././. Subtotal: / ��
(/ t/ Plan review (25% of permit fee):
Print name: V' - V - Date: / ----_
( _-:211 State surcharge (8% of permit fee): / /• 7
Authorized signature: /Z TOTAL PERMIT FEE: j, /5--b 5-y i
f -- 2 - 6 -2 This permit application expires if a permit is not obi_
Print name: 'w 4iL� Date: l days after it has been accepted as complete.
+ �- • Number of inspections allowed per permit.
I' iluildine 'Permits'Et.C•PermitAppdoc 05/23i06 440 -4615T(I1105 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -007MM
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1112/2 {707
Phone: (503) 639 -4171 42, 411qI � ?I
Inspection Requests (24 Hrs.): (503) 639 - 4175 ±+ 1.L.
INSPECTION WORKSHEET FOR DATE: 11/5/2007 TIME: 7 :01AM PAGE: 34
SITE ADDRESS: 10825 SW 121ST AVE CLASS OF WORK:
SUBDIVISION: WOODS CONDOMINIUMS LOT #: 020 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: (1) 200amp sub panel, 10 branch circuits.
OWNER: MILLER, DAVID PHONE #: 503-579-3239.
CONTRACTOR: EJ CASSELLA PHONE #: 503 - 233 -4563
Inspection Request Scheduled For: Date: 11/512007 Pour Time:
Code # Inspection Description f Confirm #\ Contact # Message
thilftl• Ceiling cow \\ 058978-02 503.515.3519 N
Corrections /Comments /structions:
' rh;c) DAY0 DAY 3ic1.
- c I . ?cLov dZi atru PANS -.
S'etZ\( c. ;0 At l et, Q1,
'►/ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
(l CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N C Date: I i 0 Phone #: (503) 718- PA)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00744
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 �_� F'' I
INSPECTION WORKSHEET FOR DATE: 11d512007 TIME: 7 :Q1AM PAGE: 35
SITE ADDRESS: 10025 SW 121ST AVE CLASS OF WORK:
SUBDIVISION: WOODSPRING CONDOMINIUMS LOT #: 020 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: (1) 200amp sub panel, 10 branch circuits.
OWNER: MILLER, DAVID PHONE #: 503-579-3239
CONTRACTOR: EJ CASSELLA PHONE #: 503 - 2334563
Inspection Request Scheduled For: Date: 1115/2007 Pour Time:
Code # Inspection Description / Cohfirm -# Contact # Message
125 Wall cover 050978 -01 503 - 515.3519 N
Corrections /Comments/ Instructions:
, PAS . {l PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' 0 '• ® Date: I1 0 Phone #: (503) 718- 14