Permit CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 Ut1590
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/02007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 eh_
INSPECTION WORKSHEET FOR DATE: 1/11/2008 TIME: 7:01AM PAGE: 49
SITE ADDRESS: • 08015 SW HAMLET ST CLASS OF WORK:
SUBDIVISION: STRATFORD) LOT #: 024 TYPE OF USE:
PROJECT NAME:. KOBLEGARDE
DESCRIPTION: (4) branc :h circuits for recessed lights, move lights and switches:..
OWNER: KOBL.ECARDE, B RUPERT, PHONE #: 03 - 3135
CONTRACTOR: WEST SIDE ELECTRIC GO INC PHONE #: 50:3231 -1548
Inspection Request Scheduled For: Date: 1/11/2008 Pour Time:
Code # Inspection Description rm - # Contact # Message
199 EIec:trical final 063046-01 203 231 -1&18 N
Corrections/Comments/Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL XNO ACCESS
►j1 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES.ASSESSED
Inspector: }�. N46 Date: 1 " It ' 0 Phone #: (503) 718 - *lb
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li, CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00699
COMMUNITY DEVELOPMENT
DATE ISSUED: 10/10/2007
.TLGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 DD -03400
SITE ADDRESS: 08915 SW HAMLET ST ZONING: R -4.5
SUBDIVISION: STRATFORD LOT : 024 JURISDICTION: TIG
PROJECT: KOBLEGARDE
Project Description: (4) branch circuits for recessed lights, move lights and switches.
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: 3 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:
KOBLEGARDE, B RUPERT WEST SIDE ELECTRIC CO INC
510 MAYER BUILDING 1834 SE 8TH AVE
1130 SW MORRISON ST PORTLAND, OR 97214
PORTLAND, OR 97205
Phone: 503 - 222 -3135 Contact #: FAX 503- 736 -0677
PRI 503- 231 -1548
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 10/10/200' $66.80 LIC 13306
[TAX] 8% State Surcharge 10/10/200' $5.34 SUP 4654S
Total $72.14 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.
C 1
Issued By: / (lit 1 i Permittee Signature: 6ri/(d37.07-)
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.
i ieufica1 Permit _Application tl' ; 1 , N ," y 3 "�,, T FOROI�ICP;l1SCOIRLYk . 4 , wtl h "i
t, d . taR �ii`A .�, .t ': "+k a:i4 S�i,twe, i ,,. d. : i
u 1 4. City of Tigard [l a .aaer Rt
+ Bard, �' D < /B /0 to cat ,S Permit No.
," 13125 SW Hall Blvd., Ti p R n sa pl y
Phone: 503.639.4171 Fax: 503.598.1960 an ��
` In L i ne : 50 3.63 9 .4175 t. r Dace/By: Ocher Yerndt:
• . il - au � Fn, fd See Page 2 far
. i luremen www.tigard- or,gov GC 0 Date Ready /By: Jaris: I 2�U1 Notified/Method: 77 I
y
c 3 t SuppleateatAl Info tl
TYPR .fir 1 .�.�.i.l 1 � I 7 PLAN' REVIEW (f 116 1
0 New construction Add�r�' i tilt Cnl�C ,7 Please check all that apply (submit Z sets of plans tvii ems chcc3 !'
❑ Demolition QTh � ' 1�J1 H L ° `' 1 ❑ Service or feeder 100 amps or more ❑ Building ever three a
where the available fauit currcnr ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,00 amps at 150 volts or ❑ f loating buildings.
1- and 2- family dwelling ❑ Cotrunercial /industrial ❑ Accessory building less w ground, or exceeds 14,000
y g amps for all other installations.
❑ Commercial -use agricultural
Mlulti- Family ❑ Master builder p buildings.
❑ Other: ❑ fire pump. ❑ Installation of 7S 1(VA or
❑ Emergency system. larger separately derived systcta.
JOE S[3'L INIrOR141r><T10N AND LOCATION
1 ❑Addidun motor load of
J � — 1 � J ❑ .. . _ x.
Z . ob site a g �� � c � r u ,„ �� 10011Porta occupan=cy.
lab no.:
�� ❑ Six or more residential units. ❑ Rccreationul vehicle parks.
City /Slate /ZIP: f ,7 Z-2-I-4 u❑ Hcahh -care facilities. ❑ Supply voltage for more than
� / ❑ Hardous location, riUD voles nonunal.
Suite /bldg. /apt. no.: Projecr name: 0 +« / ( / I�Le .0 � � ❑ Service or f 600 amps or more.
Cross street/directions to job site: tom[ FEE- l SC1dEDULL
Descriptloa 1 (lty, l Fee. 1 Total 1 •
New residential .single- or multi - fancily dwelling unit.
Includes attached garage.
Subdivision: I 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
DESCRIPTION OF WORK 75
k (wn h aboyr• sq. CO 2
Limited energy. multi - family
et ) c g) e ty QS:, )4-5 I„4„,„_... ( . hln rG- residential (with above sq. 6.) 75.00 2
r
Scrvicts or feeders installation alteration, andior relocation •
200 amps or less 80.30 2
. PROPERTY OWNER 0 T1=NANT • • 201 amps to 400 amps 106.85
n 2
Nam.: U _ 401 amps to 600 amps 160.60 2
CCC111V7VVV ///111P�� r 601 amps to 1,000 amps 240.60 2
Address; 39 (13(9 S(.--f (at -r`� _*
�S d v1 �� � >D Over 1,000 amps or volts [ 454.65 2
City /State /ZIP: %PC° Cr-i2-°5 Temporary services or feeders installation, alteratiou, andior
i -
relocation
Phone: (cd Z ) •2Z2 -x(35 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
Owner Signature: p aie: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT A. Fee for branch circuits with
J Q C ONTACT PERSON' above service or feeder fce, 6.65
BLSiness naive:
each branch circuit
H. Fee for branch circuits
Contact name: without service or feeder fee, l
46.85 Lit / f / RJ C
first branch circuit
Address: Each add'I branch circuit 3 6.65 f u r6< 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
Phone: ( ) Fax: : ( )
dwelling, service and/or feeder 90.90 2
LLoconnccronly 66.85
E -mail: glenng@westsideelectric.com weslsideelectric.com Pump or irrigation circle 53.40 'J
CONTRACTOR i Sign or outline lighting 53.40 2 '
Business name: West Side Electric Co., Inc. Signal circuit(s) or limited- .
energy panel, alteration, or
Address: 1834 SE Sth Ave. extension. Describe: Page 2 1 2
I
City /State /ZIP: Portland, OR 97214 Each additional inspection over allowable in any of the above
Phone;
(503) ?31 1548 Per inspection 62.50
( ) Fax: (503) 736 -0677 Investigation per hour (1 hr min) 62.50
CCB Lie.: 13306 Electrical Lie.: 26-135C Suprv. Lie,: 4654S Industrial plecu per hour 73.75
Suprv. Electrician signature, required: ./' ?/!l�t
Vgar. ELECTRICAL PERMIT FEES .
Subtotal: . g r�
Print name: Banda :1 Roberts Date: /oh ok Plan review (25% of permit tree):
Slate surcharge (5 of permit fee): i 5 �' L.
Authorized signature: TOTAL PERMIT FEE:
Print name: Date: This permit nppIi atian et pire; if a permit is not ubtaiu ° a B
days alter it has been Accepted as complete.
' Number of inspections allowed per permit.
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