Permit ELECTRICAL PERMIT
, '17.0 CITY OF TIGARD
,1 COMMUNITY DEVELOPMENT
PERMIT ED : ELC2007 -00150
� DATE ISSUED: 3/13/2007
TIGA 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 BB -00700
SITE ADDRESS: 14305 SW 100TH AVE ' ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT : 016 JURISDICTION: TIG
PROJECT: FISHER
Project Description: 12 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: 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: 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:
NICK FISHER THREE DOG ELECTRIC
14305 SW 100TH 5250 SW CAMERON RD
PORTLAND, OR 97221
Phone: 503 - 330 -5039 Contact #: PRI
FEES
Description Date Amount Reg #: ELE C188
[ELPRMT] ELC Permit 3/13/2007 $120.00 LIC 138509
[TAX] 8% State Surcharge 3/13/2007 $9.60 SUP 4613S
Total $129.60 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.
i E 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.
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Electrical Permit p FOR,OFFICE USE ONL t, Ir x
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• '' "o- ?MB City of Ti a V7 U . r Received J.
•,. 6 ; q l 1 T DateBy� / 01 3, Permit N• • - 0,07 - 16 p — • V
1 3125 SW Hall Blv Tigar , 72 3 Plan Rev' w
1,
La ' f. • '; Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permi •
ad's , 1 " 4 Inspection Line: 503.63 0 - : j ^ 007 Date Ready /By: Juri ® See Page 2 for
TIGAR.D; 1
61= :Itati Internet: www.tigard - or. by • Notified/Method: Supplemental Information
k 1 r )F F WORK' PLAN REVIEW
❑ New construction ,(f t Please check all that apply (submit 2 sets of plans w /items checked below):
�14i!t• ! ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑Other: 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.
.Multi-family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB; SITE INFORMATION AND . LOCATION ❑Emergency system. larger separately derived system.
. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
�- N 100HP or more. occupancy.
Job no.: Job site address: i� 3e) 5 5/A.) 10 ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: 6 kus �-�VL ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE . SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. I Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK _ . (with above sq. ft.)
,,,, o Limited energy, multi - family 75.00 2
1TG 41 F QJ - CS AT l-1 d 1...)0 1- l kfl- 12n-1 w\ residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
e.c1yl/Y1 VO 1 4-- 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
LA.—, , . 401 amps to 600 amps 160.60 2
Name: Ni I C te P-L,4 h.� ' 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
/AGO relocation
Phone: (43) _ 3 3 0 _ 7J 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 extension, 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
Contact name: without service or feeder fee, I 46.85 ,�� 2
first branch circuit
Address: Each add] branch circuit 1 1 6.65 , /j 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling; service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR • Sign or outline lighting 53.40 2
• T r t2 L r . Signal circuit(s) or limited -
Business name:
I j z Q. h. 73 0 6 i. L fZ. c energy panel, alteration, or
0 Address: extension. Describe: Page 2 2
City/State /ZIP: ?o(?_T L V tA O� c-- r ZZ i Each additional inspection over allowable in any of the above
\ Per inspection 62.50
Jl Phone: (5p3) 2 1.4 4 147 La, Fax: (5O3 ) 2z! (,, - Z t t 3 : Investigation per hour (1 hr min) 62.50
Lic.: 1 3 Q S D C1 Electrical Lic.: C k a$ Suprv. Lic.: 4(, l3 S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES?
Suprv. Electrician signature, required: Subtotal: /
Print name: E .1 L F. KA Date: S_ ( 00-7 Plan review (25% of permit fee):
-- State surcharge (8% of permit fee): &Q
Authorized signature: TOTAL PERMIT FEE: 49.5. too
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440 -4615T 11 /05 /COM/WEB
1-! - eA /c p / o 7
Electrical Permit Application - City of Tigard
Page 2- Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system , ,
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
n Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling •
❑ Other •
•
Total number of commercial systems: _
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Permits\ELC- PermitApp.doc 03/23/06
•
CITY OF TIGARD
' BUILDING DIVISION PERMIT #: ELC2007 -001 ,0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 iii‘I''et. .
INSPECTION WORKSHEET FOR DATE: 9/24/2007 TIME: 7 :00AM PAGE: 36
SITE ADDRESS: 14305 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 016 TYPE OF USE:
PROJECT NAME: FISHER
DESCRIPTION: 12 branch circuits.
OWNER: FISHER, NICK PHONE #: 503.33(1.5039
CONTRACTOR: THREE DOG ELECTRIC PHONE #:
Inspection Request Scheduled For: Date: 9/24/2007 Pour Time:
Code # Inspection Description Confi m # ,` Contact # Message
199 Electrical final 056173 -01 \, 503.421 -4879 N
, \
Corrections /Comments /Instructions: )
, i). .% 0:i I . l .
N
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PASS 1 I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Cr— r 'v tg) _ Date: 4121 (),09 Phone #: (503) 718- �14
4
CITY OF TIGARD
BUILDING DIVISION a PERMIT #: EL.C2007 -00160
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .,. -_. .�?I.L.
INSPECTION WORKSHEET FOR DATE: 3/20/2007 TIME: 7:00AM PAGE: 5
SITE ADDRESS: 14305 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 018 TYPE OF USE:
PROJECT NAME: FISHER
DESCRIPTION: '12 branch circuits.
OWNER: FISHER, NICK PHONE #: 5
CONTRACTOR: THREE DOG ELECTRIC PHONE #:
Inspection Request Scheduled For: Date: 3/20/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Ei ctric:al rough -in 045113 -01 503 -421 -4879 N
Corrections /Comments /Instructions:
7. PASS - PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ` A�L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
7 i ,„
_I /�--�' �_ Date: Z
Inspector: O 0 Phone #: (503) 718 - lam
CITY OF TIGAR®
BUILDING DIVISION PERMIT #: ELe:2007 -001 0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/13/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/14/2007 TIME: 7:00AM PAGE: 7
SITE ADDRESS: 14305 SW "I00TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 016 TYPE OF USE:
PROJECT NAME: FISHER
DESCRIPTION: 12 branch circuits.
OWNER: FISHER, NICK PHONE #: 503- 330.03
CONTRACTOR: THREE DOG ELECTRIC PHONE #:
Inspection Request Scheduled For: Date: 3/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 MiG:r.: inspec.tion )448204211' 503- 421 -4879 I4J
Corrections /Comments /Instructions: ~�
PASS $PARTIAL APPROVAL 7 CANCEL n NO ACCESS
FAIL 1 I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 'Z& —� 0 6 (6 Date: 3 ' I LI Oj Phone #: (503) 718 -1-