Permit as "1q CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00020
COMMUNITY DEVELOPMENT
r, f DATE ISSUED: 1/9/2008
TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135DB-06000
SITE ADDRESS: 11540 SW GREENBURG RD ZONING: R -4.5
SUBDIVISION: MILLER LOT : 006 JURISDICTION: TIG
PROJECT: GALEANA
Project Description: Service change only, change to a meter main. (1) branch circuit.
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: 1 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:
EUNICE GALEANA PHOENIX ELECTRIC
11540 SW GREENBURG RD PO BOX 14037
TIGARD, OR 97223 PORTLAND, OR 97293
Phone: 503 - 957 -7042 Contact #: PRI 503 - 886 - 9930
FAX 503 - 266 -8394
FEES
Description Date Amount Reg #: ELL' C89
IELPRMTI ELC Permit 1/9/2008 $86.95 LIC 162753
IELPRMT1 Investigation F 1/9/2008 $86.95 SUP 5169S
I I -IRTAX I Hourly 12% Su 1/9/2008 $10.43
REQUIRED ITEMS AND REPORTS
Total $184.33
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: 414 Permittee Signature: r ‘1 •
tJ 1151 " - -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jan 09 08 12:47p CONFIDENTIAL PHOENIX ELE. 503 - 235 -4300 p.l
ry v � Rl � 4 _ t .• .
Electrical Permit A"In d e l t ,- - . ` ;t, FOR OFFICE USE O\LY . ,:ii ,_ :, e t ...vr 9,
1 Received s.
•.,:' s. City of Tigard L008 Date/By: / 910 IPennit No. (03 -•••• Z D
13125 SW Hall Blvd., Tigard 0R4A3O 9 L008 Plan Revie / r
, :' IL Phone: 503.639.4171 Fax: 50 9$.19 0 DatdBS': 1 Other Permit`
"!�!es Inspection Line: 503.639.4175 Date Ready/13y: 7 tui- J ®
Sec c Pagc 2 for
1C,Alilli P CITY ®� T1�A Notifed/Mcthod: J Supplemental Inrormaoon
1 Internet: wwtiv.tigard- or R oy BU E�!{V6J'�
TYPE OF WORK !1/ 1 PLAN REVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply (submit 2 sus of plans w(items checked below): •
❑ S:.nice or feeder 40'1 amps Or more ❑ Boil hug over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150vo1L or ❑ Floating buildings. .
less to E7ound, or exceeds 14.000 ❑ Commercial - use agiculturel
® 1- and 2 -family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: O Pirc pump. ❑ Installation 01 75 K VA or
❑ Emergency system taller separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new moror load of ❑ `A "L , "1 ? °, "1 -3'
Job no,: Job site address: 11540 sw greenburg 1001 IP or more occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard OR 97223 ❑ Health -care facilities ❑ Supply voltage for more than •
❑ Hazardous locations 600 volts nominal.
Suite /bldg. /apt. no Project name: ❑ Service or feeder 600 amp: or more.
FEE SCHEDULE j
Cross strecUdirections to job site: sw greenbu g Deccripdon 1 Qr.. 1 nee. ; Tot :,t 1 • 1
New residential single- or multi- family dwelling unit.
Includes attached garage '
Subdivision: I.ot no.: 1.000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'1 500 sq. ft. or portion 33.40 I 1
Limited energy. residential 75 00 2
DESCRIPTION OF WORK (with above sq. ft.)
mst211117- 001811 Limited energy, multi-family 7500 j 2
r .
es idential (with above sq.
. Services or feeders installation, alteration, and/or relocation I
Service Change only, Change to a meter main
200 amps or less 1 80.30 I 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 I 2
401 amps to 600 amps 160.60 2
Name: -
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, alterat and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: 'lhis installation is being made on property that I owii whic11 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 10 599 amps 133.75 j 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date: i
A. Fes for branch circuits with
❑ APPLICANT ® CONTACT PERSON above service or feeder tee. 1 I 6.65 6.65 2
each branch circuit
■
Business name: Phoenix Electric l 13. Fee for branch circuit 1
Contact name: John Jassmann
without service or'ferdet foe;
first branch circuit 46.85 2
Address: P.O. Box 14037 Each add'l branch circuit - 1 6.65 2 I
Miscellaneous (service or feeder not included)
CihlState /ZlP'. Portland, OR 97293 Each manufactured or modular
dwelling, service i
and/or feeder 90.90 2
Phone: (503) 231-8006 Fax: : (503) 235 -4300 Reconnect only 66.85 2
E - mail: johnj aphoenixpdx.com Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Phoenix Electric
energy panel, alteration, or
Address: P.O. Box 14037 extension. Describe: Page 2 2
t
City /Slatc/LIP: Portland, OR 97293 Each additional inspection overallowttbie ill ally oftlte above j
Per inspection 62.50
Phone: (503) 231 - 8006 Fax: (503)235 I
a Investigation per hour (1 hr min) 62.50
CCB Lic.: 162753 Electrical Lic.: cf39 Supra. Lic.: 5154S Industrial plant per hour 1 73.75
- 1 ELECTRICAL PER\•1IT FEES
Supra'. Electrician sigrlat e, r 44 ed : ( Subtotal: 86:95
°
Print name: John / i Jassn , 1 i Dale: 01-09-08 TA/4141 Pla it l ee): !ice q5 •
State surcharge (12'.'o of pennit fee): /n .
Authorized signature: . �..,F_-�.�..�'4a.-•-�'... 1'O'I :1L PERMIT FEE: ) e! $ � .33
}, m] This permit application expires if a permit is not obtained witlflR 180 7I
Print name: John Ja am] ' 01 -09 -08 days after it has been accepted as complete.
,
Number of inspections allowed per permit.
I. \tluildine•d'crmiIs \.ELC- Penni pp.doc 05:230 440 -n6 IST(11 /0S'C0WWI t
CITY OF TIGARD
BUILDING DIVISION PERMIT #: c7O
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/9/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 IL
INSPECTION WORKSHEET FOR DATE: 1/11/2008 TIME: 7:01AM PAGE:
SITE ADDRESS: 11540 SW GREENBURG IRD CLASS OF WORK:
SUBDIVISION: MILLFR LOT #: 006 TYPE OF USE:
PROJECT NAME: GALEANA
DESCRIPTION: Service change only, change to a.meter main. (1) branch circuit.
OWNER: GALEANA, EUNICE PHONE #: 503
CONTRACTOR: PHOENIX ELECTRIC PHONE #: 503
Inspection Request Scheduled For: Date: 1/11/2008 Pour Time:
Code # Inspection Description # Contact # Message
199 EICC:tfiCal final - 063078 50:4951-7042
Corrections/Comments/ Instructions:
0 ININ61. 2.00 0 qt
v y1/\
PASS J v \
PARTIAL APPROVAL LI CANCEL 71 NO ACCESS
FAIL ri CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: C5 't) 6 Le" Date: L - - 01 Phone #: (503) 718- 1411)