Permit :''' `; , ELECTRICAL PERMIT
■ ,.* ; CITY OF TIGARD
PERMIT #: ELC2007 -00453
II
+° COMMUNITY DEVELOPMENT DATE ISSUED: 7/3/2007
r T G A RD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S103DA -04103
SITE ADDRESS: 13335 SW 107TH AVE ZONING: R -3.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: KRAFT
Project Description: (3) branch circuits for a/c and gas furnace.
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: 2 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:
KRAFT, CARY RAY AND BOB'S ACTION ELECTRIC INC
JANET INEZ 2700 NE BURTON ROAD #A
13335 SW 107TH VANCOUVER, WA 98662
TIGARD, OR 97223
Phone: Contact #: PRI 360 254 - 7200
FAX 360- 254 -8219
FEES
Description Date Amount Reg #: ELE 37 - 431C
[ELPRMT] ELC Permit 7/3/2007 $60.15 LIC 53136
[TAX] 8% State Surcharge 7/3/2007 $4.81 SUP 4322S
Total $64.96 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.
Issuedf . � ,, // Permittee Signature: 3�1 Q, A 'j c‘&'-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. ELECN: 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.
Electrical Permit Ap t It R , FOR OFFICE USE ONLY
City of Ti and -i 4 .„ - ...'.!', 1 ?: - _ " Received
Permit No.:
g Date/13y: �fi .� •O —** SI►
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 U L 0 2007 4. + t � tI Da R : Other Permit:
Inspection Line: 503.639.4175 CITY,,. .p : ,,y i L e` D ate Ready /By: ions' El See Page 2 for
Internet: www.ci.tigard.or.us ry Notified/ fethod: 6- Supplemental Information
8l1Lla "!° D';ir¢s1oNt .
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply:
❑ Demolition El Other: ❑Service over 225 amps, comm'i ❑Hazardous location
['Service over 320 amps — rating EBuildng over 10,000 sq. ft.,
. CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
L 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building [)System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder ❑Other: ['Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons EManufactured structures or
- JOB SITE INFORMATION AND LOCATION ❑Egress /lighting plan RV park
❑Health -care facility ['Other:
Job no 07_748 Job site address: 13335 SW 107th Ave. Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: t/, rat FEE* SCHEDULE
Description Qty. 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
. DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder 90.90 2
A/C and gas furnace Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
-❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: Cary Kraft 601 amps to 1,000 amps 240.60 2
Address: 13335 SW 107th Ave. Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
Fax: ( ) relocation
Phone: (
50 620 - 7388 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 j 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps I 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT • ❑ CONTACT 'PERSON • A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit / 46.85 �� F. S' 2
Address:
Each add'l branch circuit 2 6.65 3 0 I 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: tt tt Each additional inspection over allowable in any of the above
2700 NE Burton Rd. "A" Per inspection 62.50
City /State /ZIP: Vancouver, WA 98662 Investigation per hour (1 hr nun) 62.50
Phone: ( 360) 254 -7200 Fax: ( 360 ) 254 -8219 Industrial plant p 7
ELL ELECTRICAL PERMIT FEES*
S*
CCB Lic.: 53136 Electrical Lic.: 37_431C Suprv. Lic.: 4322S Subtotal
Vi n. /
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: Date: State surcharge (8% of permit fee) z-/P'
Kevin B ro Il e 6/26/07 TOTAL PERMIT FEE
/ f d /1 i � 9�
Authorized signature:` j �� This p ermit a pplication expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: ^ Fee methodology set by Tri- County Building Industry Service Board
'* Number of inspections per permit allowed.
i:\Building\Perrnits \ELC- PermitApp.doc 12/03 440- 4615T(10/02 /COM/WEB
j ,
CITY 014IGARD
BUILDING DIVISION PERMIT #: ELC2007- 00453
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/3/2007
Phone: (503) 639 -4171
A ",.
Inspection Requests (24 Hrs.): (503) 639 -4175 A.A. -__..
INSPECTION WORKSHEET FOR DATE: 7/10/2007 TIME: 7:00AM PAGE: 79
SITE ADDRESS: 13335 SW 107TH AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: KRAFT
DESCRIPTION: (3) branch circuits for a/c and gas furnace.
OWNER: KRAFT, CARY RAY AND, PHONE #:
CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360-254-7200
Inspection Request Scheduled For: Date: 7/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Mess - e -
199 Electrical final 051605 -01 360.254 -7200 a -- pti
Corrections /Comments/ Instructions:
- - l �C�
c Uii /l »
PASS I I 'ART AL APPROVAL CANCEL I I NO ACCESS
El FAIL /if FOR INSPECTION ❑ ADDITI• AL EES ASSESSED
Inspector: _ Date: 0 P hone #: (503) 718- •