Permit r 'r nE CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00303
COMMUNITY DEVELOPMENT DATE ISSUED: 5/3/2007
T 114 + 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 112BD -90231
SITE ADDRESS: 14655 SW 76TH AVE 23 ZONING: R -12
SUBDIVISION: TIMBERCREST CONDOMINIUMS LOT : JURISDICTION: TIG
PROJECT: SLOCUM
Project Description: Replace 125 amp panel.
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: 1 . W /SERVICE OR FEEDER: 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:
BREA SLOCUM ABC ELECTRIC
14655 SW 76TH AVE. #23 135 NE 9TH AVE
TIGARD, OR 97223 PORTLAND, OR 97232
Phone: 360- 464 -5050 Contact #: PRI 503 - 233 -7551
FAX 503 - 233 -7552
FEES
Description Date Amount Reg #: ELE 161501
[ELPRMT] ELC Permit 5/3/2007 $80.30 LIC 26 -1226C
[TAX] 8% State Surcharge 5/3/2007 $6.42 SUP 5096S
Total $86.72 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: 1 / �i :)./../ • Permittee Signature: / / - ( �-�-i
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.
-r a3 -2007 04:34P FROM: TO:81P5035981960 P.1
' dti , + 'i I w „ a , ta
J 0�ia�41 i , la i 1 a ! a ti 7in +ilvt I �i�•Olt UI 1 IC Fill ONI 1 loo � a l [�Aq � ro r r
lectrica P erm i t Applicatio I ii; ¢ l� �. ' r M
a I , r „ a ;dI i , r.r ._ � �� , rl.i .r it. , 1i , k, + ?4,�' "w.i
City of Tigard - Rec
t, Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
ww� r i , n Date/I3 : Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 A !;,!:1'15".:. ti l t acit: m S Inspection Line: 503.639.4175 , . ,, Date Ready/By: Page 2 for
Internet: www ct h � s gard or us '/ ® Notified/Method: Supplemental Information
rr,,� :n 4: :v, I , c 1 , ,� ,.. .. i: + - ., r.. , t . F L r ^4 ii °� M
! 1 w .. as z .. : a . 1 r.z- ti a y : ;Va P. ,� h t o3v.p 14 ; 17L i,JtE'iIEW . t : . }i.,. . f�
t�:•�t±p)� da _�:�� „:!1'.'�.3f� +.a "' �:.::.�•..• -r :: e,e:�,..4c 4. ,_::�..N�l ?L t i3.,....a,.. .G
❑ New construction sQAddition /alteration/replacement Please check all that apply:
❑Service over 225 amps, comet ❑Hazardous location
El Demolition ❑ Other ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
fn4 tr r,f a hJ y c a A + x ala • ,+ r "ty
� 0 . :4 -� r sfiri ,K ,I• ... + ,dp.::.� ... �•, ' to �s iii . hkk' of 1 -and 2-family dwellin
• � CA7'Eq o �^d)� $'CR>� Tl ` �+ .4 �; , Y s 4 or more new residential g
❑ 1- and 2- family dwelling O. Commerciallindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
III Multi family ❑Master builder ❑ Other:
❑Occupant load over 99 persons ❑Manufactured structures or
• rl i ', g z 5 r r ($gP L^ ` I1 QKMiAI'iOS i IVD E s 't fWA K r i t J ❑E plan RV park
Job no: _ Job site address: ` ❑Health -care facility ['Other: •
lt. Submit 7 sets of plans with any of the above.
City/State/ZIP: The above are not applicable to temporary construction service.
Suite/bldg. /apt. na.: 4 Project name: ,_ Description Qt Fee Total ••
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
EM -11 �",�•', 5 NiFigDESC �ION,=; 1 ., , „4 • �1s x Each manufactured or modular
dwelli g, service and/or feeder 90.90 2
• t - . lillis.b. ► _ 1 Services or feeders Installation, alteration, and/or relocation -
200 amps or less / 80.30 '® ,, 2
y, r�x Y�1 � t n ) v ,t ;,^� 201 amps to 400 amps 106.85 2
Ern , 0 t , ' 4 AR, E q 4.' o [t K � ? s ,, E. . a , 4 df �' .., °_ It'ifi v`; .14
.,�����_..... _ _ 401 amps to 6 amps 160.60 2
MI ,` ` 601 amps to 1,000 amps 240.60 2
Address: t = la / Over 1,000 amps or volts 454.65 2
- Reconnect only 66.85 2
City/State/ZIP: c i ,� Temporary services or feeders Installation, alteration, and /or
relocation
Phone: ( ��` 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 600 amps , 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
t.,�� Jew.„ .�i.,` sf ; 4i'' /i t,7 ® CONT`; -trir, :E 0 nt rc i A. Fee for branch circuits with
a,.r fi '� .. a service or feeder fee, each 6.65 2
1 _ branch circuit .
B. Fee for branch circuits
Contact name: -� _ without service or feeder fee, 46.85 2
each branch circuit
Address: vs. , _ _ Each add'1 branch circuit 6.65 . 2
City/State/ZIP: i Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 ' 2
Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2
Email: Signal circuit(s) or limited -
im {. T"' I'lt' y�j'�ra,;{Q , ,_ i i)t 4r' ,*,re,•a�^'Jk L3��1�.'r_E: . `V-r[7' �Y�? 7 7 '}:,'. energy panel, alteration, or
uat� 1_ ��•., f "�' ' r extension. Dtscribex Page 2 2
Business name: i t 1
Each additional inspection over allowable In any of the above
Address: 1 cn ` 'Pa t; a . ` Per inspection 62.50
City/State/ZIP: A • \ 1111 . Investigation per bow (1 hr min) 62.50
cg Industrial last per hour 73.75
'hone: 'r A Fax (� ' -, r r, e, ;r+ RI .''PERM ',IF;CEb "`Y* F'-: MK'
• a ; Electrical Lic.6,96 _/_ , Suprv. Lic.: 10 • t Subtotal EU ,
Plan review (25% of permit fee)
Suprv. Electrician signature, required: J0--
State surcharge (8% of permit fee) Gj . � '
• Print name h `I b .. A ` Dat TOTAL PERMIT FEE
,r Authorized signature: _/ or Ties permit application expires If a permit Is not _ .. within 180
_ i ��� days after It has been accepted as complete
Print name: , at , _ � p • Fee methodology set by Tri County Building Industry Service Board
�. •
�. •• Number of inspections per permit allowed.
0Building \Permits\ELC- PermitApp.doc 12/03 440.461ST(10 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3.0007
Phone: (503) 639 -4171 E■dit'
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/20/2007 TIME: 7:00AM PAGE: 73
SITE ADDRESS: 14655 SW 76TH AVE. 23 CLASS OF WORK:
SUBDIVISION: TIMBER CREST CONDOMINIUMS LOT #: TYPE OF USE:
PROJECT NAME: SLOCUM
DESCRIPTION: Replace 125 amp panel.
OWNER: SLOCUM, t3REA PHONE #: 36�464-6050
CONTRACTOR: AF3C ELECTRIC TRIC PHONE #: 503- 233.7551
Inspection Request Scheduled For: Date: 11/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Electrical final 059923.01 503.233 -7551 N
Corrections /Comments /Instructions:
" 1 ‘41 ! \
I V
,
PASS n PARTIAL APPROVAL ❑ CANCEL NO ACCESS
n FAIL 1 1 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: & Q L' Date: it 2010:1 Phone #: (503) 718- 1-1i141.1i14)()
CITY OF TIGARD
BUILDING DIVISION
A .
, PERMIT #: 1:W2007.00303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/3f2007
Phone: (503) 639 -4171 j�I
Inspection Requests (24 Hrs.): (503) 639 -4175 �
INSPECTION WORKSHEET FOR DATE: 11/15 /2007 TIME: 7 :01AM PAGE: 67
SITE ADDRESS: 14656 SW 7GTH AVE 23 CLASS OF WORK:
SUBDIVISION: TIMBERCREST CONDOMINIUM: LOT #: TYPE OF USE:
PROJECT NAME: SLOCUM
DESCRIPTION: Replace 125 amp panel.
OWNER: SLOCUM, 13REA PHONE #: 3611464-6050
CONTRACTOR: AEC ELECTRIC PHONE #: 503 - 233 - 7551
Inspection Request Scheduled For: Date: 11/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 I: lectiic:al finial ( 059611 -0\ 503. 233 -7551 N
Corrections /Comments /Instructions: )
R.aeLikC,�, o _ -- (s€1..1 W
fi t . - ' � 1 . . . w $ 1( 13 KM . IN■As ' . V IV\
b Q .. To A LA) AN . 1../.
ka . 5 1,. kh
1 1 PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
$FAIL i x CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: TI o v vU L Date: �� Phone #: (503) 718-