Permit CITY OF TIGARD ELECTRICAL PERMIT
' M ° `y �[ PERMIT #: ELC2008 -00323
COMMUNITY DEVELOPMENT DATE ISSUED: 6/6/2008
;TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S104DB -03200
SITE ADDRESS: 13000 SW ROCKINGHAM DR ZONING: R -4.5
SUBDIVISION: AMESBURY HEIGHTS LOT : 032 JURISDICTION: TIG
PROJECT: LODATA
Project Description: Installing (1) branch circuit for hot tub.
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: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREAISPEC OCC:
Owner: Contractor:
LEANNE LODATA HOOD TO COAST ELECTRIC
13000 SW ROCKINGHAM DR PO BOX 793
TIGARD, OR 97223 LAFAYETTE, OR 97127
Phone: Contact #: PRI 503 - 835 -7209
FEES
Description Date Amount Reg #: ELE 36 -78C
[ELPRMT] ELC Permit 6/9/2008 $46.85 LIC 1272941
[TAX] 12% State Surchar 6/9/2008 $5.62 SUP 4877S
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 obtais of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / 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.
1
L. 2008 -06- 0613:05 » P 112
Electrical Permit A ¢�1i+ tt .h: "" ,, i 11t�` ` "„,` i't , „�t } � i z
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` City of Tigard RECEIVED Received
• _ . Dateht : 6
� ” 1 3 1 2 5 SW Hall Bl Ti gar d . OR 97223 (3 Permit No.
I
��" � g -- Plan Revie �"
f' L Phone: 503.639.4171 Fax: � 503.598.1960 p Dnteay: Other Permit
jj � ins pection Line: 503.639.4175 06 2008
JUN U N Pate ReadyBy: kris, la See Pant 3 tor
lc L*'s.c ;t5y' al' Intcmct: wwwtigard•or.guv Nwified'Method Supplemental Information
TYPE OFINIKOV PLAN REVIEW
❑ New Construction ❑ Additiong : , -,r lilt, . 1,. i t v Please check all that apply (submit isms of plans %vitemt checked below):
❑ Service or feeder 400 amps or mom ❑ Nuilding ova throe stories.
❑ Demolition ❑Other: where the available Point current [] Marinas wad boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 130 volts Ur Floating buildings.
and2 dwelling less to ground. or exceeds 14.000 IDCummercwl•use
„AS( y g 0 Commercial /industrial 0 Accessory building amps for an ocher instaualtont buildings.
❑ Multi - family ❑ Master builder ❑ Other: O Fire pip ❑ trtstallation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived syslnn.
❑ Addition of pew motor load of ❑ "A" "E" ••1 -2" ••t -1"
Job no.: Job site address: j 1 o 1001.11. or mom.
�L 1r .,r,,�I✓ 0 Six or more reresidential units. occupancy.
. ❑ Recremionel vehicle parks -
City /State/ZIP: `r O () j h� ❑ Health-care facilities. ❑ Supply' voltage Ibr more thin
(+ (.t ! ' Y ❑ Harerdow locations. 600 volts nominal.
' Suite/bldg, /apt. no.: t P roject name: 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
— uwrttpa.a 1 titer I Fee 1 Tore 1 •
New residential single- or multi - family dwelling mgt.
Includes attached garage,
Subdivision: LOT no.: 1.000 sq. It. or less 145.15 4
Ea add'l 500 sq. tI. or portion 33.40 I
Tax map/parcel no.: Limited energy, residential -
DESCRIPTION OF WORK (with above sq. it.) 75'00 ?
t / U � L ) Limited energy, multi-family 75.00 2
�J TL { +� � UaJ k t _ n residential jwith above sq. fl.)
Services or feeders ins tatlatlon and/or retocatton
_ 200 loops or less I 80.30 2
❑ ,,, PPPPROPERTY OWNER 1 ❑ TENANT 201 amps to 400 amps 106.85 2
Name. /e ^ 7 f lad 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 aervtees or feeders installation, alteration, and /or
rdoca(ton
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner Installation: This installation is being made on property that 1 own which is not 201 amps to 400 amps 10030 2
intended for sale, lease, rent, or exchange. according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner Signature: Date Branch circuits - new. alteration, or extension, per panel
A. Fee fir branch circuits nlh
0 APPLICANT ❑ CONTACT PERSON above service or feeder fee.
1 each branch circuit
Business name: 65 2
NU oc co L- t> r E. ) C C. -'i- C B. Fee for branch circuits
' without service to feeder fee,
Contact name � ! / t Nandi circuit (
firs 46.85 2
Address: - -. C Each add'I branch circuit } 6.65 j 2
Miscellaneous (service or feeder not included)
Ciry /State /ZIP: Lc, - G` C }- 4 r f e_ � Z Each manufactured or modular
dwelling. service and/or feeder 90.90 2
Phone: (5,,+,) ta _ ( y , 1 Fax: : (C 2) 3 S _ t 7�, Reconnect only 66.85 2
E -mail: 1 2.09 1 2 C °& 7 Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53,40 2
me: i>�O O(;f I1 (t.X4 571 c .f r Signalcircuit(,)orLimited-
Business na G / C ( energy panel. aliens/ton, or
Address: 1� ( J `-7 2, extension. Describe: Page 2 2
Ci /State /Z1P: ` Each additional inspection over allowable is ao of the above
Phone: (c'7L,�) a ,5 - rP I Fax: ) S .3c-r? —}��,L- _Per inspection 62.50
� 'T�-""" Investigation per hour t i hr min) 62.50
CCB Lic.: j 72, 0 j f I Electrical Li,; 44 2� 1 Suprv. Lic,: Z 7 Industrial plant per hour 73.75
('ia 11 na tree, . 7/ s�d6 - ELECTRICAL PERMIT FEES
Su prv. Ele required: - ! L/L� -
Subtotal! T (�' CO
Plan review (25% of permit fee):
Authorized signature:
State surcharge (12y of permlr ree): •j . (A1
TOTAL PERMir FEE: 92 ( 7 �
Print Hanle: Date: This hermit appneadon expires if a permit b not obtained within 160
days after it bas been accepted as complete.
. X
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008•00323
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/€f20O83
Phone: (503) 639 -4171 A b i
Inspection Requests (24 Hrs.): (503) 639 -4175. W� i
I
INSPECTION WORKSHEET FOR DATE: 11/74/ X0 08 TIME: 7:02AM PAGE: 24
SITE ADDRESS: 13000 SW'ROCKINGHAM DR CLASS OF WORK:
SUBDIVISION: AMESCBURY HEIGHTS LOT #: 032 TYPE OF USE:
PROJECT NAME: LODATA
DESCRIPTION: Installing (1) branch circuit for hot tub.
OWNER: LODATA, LEANNE PHONE #:
CONTRACTOR: HOOD TO COAST ELECTRIC PHONE
#: 5. 835.7209
Inspection Request Scheduled For: Date: •i1124/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
150 Hot tub /spa/pool 078271 -01 503.332 -5543 N
Corrections /Comments /Instructions: '
0 Aztl s r I-0 pir C r-cf C e
e OA NEC 3sz..
. 0 QPt ■ 4k. 1:4A4 , c42.4 Al [ 4e el- A 4 -
1a:1.0)((
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL LCALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
PLPid) Date: 1( - Z. V - Phone #: (503) 718 -
City of Tigard, Oregon - Microsoft Internet Exp _ lorer
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Tax ID Number: 2S104DB03200
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