Permit CIT i OF T CARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 - 00641
COMMUNITY DEVELOPMENT DATE ISSUED: 11/19/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104DA 22200
a:.
SITE ADDRESS: 12948 SW PRINCETON LN ZONING: R -4.5
SUBDIVISION: QUAIL HOLLOW - SOUTH LOT : 048 JURISDICTION: TIG
PROJECT: SOLMONSON
Project Description: Reconnect only
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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
PAULA SOLMONSON
3515 SW BARBUR BLVD #Q3
PORTLAND, OR 97239
Phone: 541 - 326 -1690 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 11/19/2001 $66.85
[TAX] 12% State 11/19/2001 $8.02
Total $74.87 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 f. ore .n 180 days. ATTENTION: Oregon law requires you to follow rules adoptehe Oregon Utility Notification Center.
Those rul- are set forth OA'. ' •2- 001 -0010 through OAR 952 -001 -0100. You mayobt • • . of these rules or direct questions to OUNC at
503.24..6699 or 1.800. • 2
Issue By: _`' Permitt‘e 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.
2001/ 001
11/19/2008 WED 11102 FAX 5039883160 SED
1i./.1.9/•UUll W]D 8;34 FLX 5039883 . 160 SE J2002/003
• •
. .
Electrical Permit Applicatiou. • FoR OFFICE USE ONLY
City at Tigard • • IthCEIVED Roseivt1
nalcay: . Mir Pcmit .., e -af) i /
I 11125 SW Hall Blvd.. Tigard, OR 97223
Illun Review
111 •
4 . • Phone: 503.639,4171 Fax 503.598.1 1 9 11
S K V .I. 20(13 -1"-ma./BY: odic:ft:mit:
TIGARD • • Inspection Line: 503 639.4175 Date Resilyilly.: x,o2 Ii3 Ste Net 1 for 1
Inte•nct www.tigard-m.gov . Notiffeclitvinthod: /7 /Or . Sonplementeieromnoo n •
....... - Int ,.II .. • A ' I. ......, .,-
Ria 1 1' 4.44 i I i',... :: :;: 11041titneggrR-'5i: 4 .;:•!gMe'AtickifiElf WS' al
El NCw construction 0 Addition/alteration/replaceme . Please chock oll that apply aubnit./ co of ploy w/item hccked moo,
0 ServieO or !bed er 400 amps or more CI Handing over time stories.
0 DCMOlitibil " ig Other: ' .
whre tl w oa21110 rat current 0 Marinas acid bywords.
,....„.....„.,.,..voliT......,mr-ogitfpc.i,L,,,:zpoRE.T.trigiv•01,t. sumda 13.000 amos at ISO volt3 or C3 noot0I0 bulkl
a g a4J,....__,-.,,,_...._..L0iL.4............---4a • less to gound, or exceeds 14,000 • 0 Comincrelal-tge ogricoltum1
0 J. and 2-turrily dwelling 0 Commercial/industrial 0 Accessory building amps Fox all other itutalleirans. buitdinaa
. •
0 Multi • . 0 Master builder Eg Other: 1.3 Fire pump, '01nstallesion of 75 RVA or
El Excellency ayatent
'. i : : 7_4 ' ..: " 1415*51440, V..'" r" ..illt.VRA 11 ..fRIS„ . . - 14 ID Addition anew motor lod or 0 . 1 ; 771 . ara . 07:;:c . t 1 system.
om.
Job no.: • . Job site address: 12948 SW Princeton Lane 10111' C l Ort.PnACY,
•
• El Sill or more residential units. 0 Recrintionat vehicle parkv.
City/State/ZIP: Tigard, OR 97223 I: titalth•vair Facilities, 0 sunny volbigeIbr mart than
•
. El FRantous beations. OM voltv nominal.
Suite/bldg./apt. no.: . I Projcet name: . 1:1SerViCC gr cutler 61,0 Ettiv,5 or more,
tall4 r . OW g: IMS: 10 $ 61-1 4*.bigHtkr " ,,Vit ... 0 1 ...401 ,
Cross StrOct/cIfeactiona to job site: Gaarde to Princeton in
Domrtanan ' l .0b I no I Taal ) •
. . New residential single. or molti-fimilly dwelling unit. . .
• . Includes attached garage. .
Subdivision: Quail Hollow South • 1 tot no.: 1.000 sq. R. or less 1 . 141 - 4
Ea. addi 500 sq. R. or portion ' 33.40 nig 1
Tax map/parcel no.: •
• Limited energy, residential
• .• P. MY41 • (with nbo„ eq. I) . 75.00 • 2
Limited energy, multi-family
electrical site inSpeetion to BROW electric company to turn ou electric 2
• . Services or feeders Mahal lotto nolteratIon, gltuttor relocatton
200 amps or less 80.30 2
• 241.1662„ g 11.100 MMITTaitiggiVekiig:.4.;` , M,4;i,,zd 201 =Ps to 4 0 0 2 m 2
As 106.85
s q.
Name: Paula Solmonson
Addrcss: 3515 SW Barbur Blvd..#Q3
• City/State/ZIP• Porttaud, OR 97239 '
• Phone: (541)326 1690 - Pax: (503)98R . 401 amps to 600 amps
- 601 amps to 1,000 amps '
Over I,000 amps Or volts 160.60
240,60
454.65 2
2
. Temporary services or feeders nstnilation, atter non, and, p 2
. relocatloo
200 amps or less .. 66.85 i 1
1
I
i
201 arms to 400 amps 100,34 2
' Owner installation: This iimtallation is being made on property that I own which is rot
intended far salo, lease, rent, or exchange, according to ORS 44'7 449, 670, and 701.
Ovater signature,: 401 amps to599 amps 113.75 2
Branch circuits- new, niterati par ponel •
g ___. _ . A. Fee for branch ctremir, with
4 1...7,4.: ..,.. :......„-fir-, above service or feeder lee, 6.65
2 I '
4. ' each branch circuit
Business /lame:
" .
B, Fee for branch circuit
s
•
. 4 • without service or fader fee,
Contact nomc: . •
.it branch circuit 46.85 2
Address: Each
adri'l branch circuit • 6.65 . 2
ir . _-----______ .
MinolionhobrA (service nr rock not Inelirded)
City/Statc.1ZIP:
gach monufactured or modular
dwellig , service and/or feede 90.90 r ..... 2
... \i? Phone: i ) • 1 Fax ( ( ) .
Reccomect onty I 66.85 litall1;_. •
EAr.ail!
Pump or irrigation circle L 53.40 2
- - ' • • v "vigi7jtin.:1:441Z. Si °Nettling li htin
- -1 Alinag g ', .. tj,k;i14 '--, 7p. . . , v..,..,i..A „._ , , _ gn X S 5340 2
Signal cireou(s) or limited-
Bus:nesis name: .
enettipanel, alteration, or -
I
Address:
. . . •
extension. Describe: . Page 2 2
. Each 2 difirlonal Imipettlon over allowable In any of the above
City/State/ZIP:
•
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation por hour (1 hr rnin) 62.50 --_______
CCB Lic.: . 1 Electrical Lic,: %pry. Lie.: . Industrial plant per hour 73.75 )
.. - ctrician siature, required: i l i WiliMggifgaa.M.0 , 441Miteaf•31 ;e. j
v. &IPA Eleg
Subtotal: Lp. (0. .4. -
e -- i., Print name: Datc: Plan review (25% of permit fee):'
_
g 1
Stine surcharge (12% of permit fee): ..... S c9...
*.. Authorized signature: /Mil . TOTAL PERMIT FEE: ' e7
. -
7113 permit vivito:Moo expires ff a permit is rot obtained ;in 183 I
Print name: b g , a_ . s „lit M. D y6 • Date: JO qfi th
'' trap OW It hal been aceented Qv vtornivir. '
" Nvoiber orinOpectiO114 alithved per permit. •
IdikAdiceertn1AELC-Perotlidpil.eve 03/23/80 • . 443.015T(1)/03/CONWE8
. .
•
i •
• • .
•
„.- ..
- •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: El .C:1008-00641
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/13/2008
Phone: (503) 639 -4171 44'1' i, it
Inspection Requests (24 Hrs.): (503) 639 -4175 4+L
INSPECTION WORKSHEET FOR DATE: 11/21/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 129413 SW PRINCETON LN CLASS OF WORK:
SUBDIVISION: QUAIL HOLLOW - SOUTFi LOT #: 0Q TYPE OF USE: •
PROJECT NAME: SOLMONSON
DESCRIPTION: Reconnect only
OWNER: SOLMONSON, PAUI.A PHONE #: 511 - 32( - 1690
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 11/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess..! -
199 Elect final 0783401 541. 376-1690 + /�I %•
Corrections /Comments /Instructions: "l 7(' D 1 f 1 Z '
•
'1 1
A PA j 11 1ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL %I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ r Aiw
Inspector: - Date: 11 2-- 6 Phone #: (503) 718- C.v