Permit CITY OF TIGARD ELECTRICAL PERMIT
IIIII " PERMIT #: ELC2008 00462
COMMUNITY DEVELOPMENT DATE ISSUED: 8/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DA -05601
SITE ADDRESS: 06620 SW ALFRED ST ZONING: R -4.5
SUBDIVISION: KINGS VIEW LOT : 042 JURISDICTION: TIG
PROJECT: SARRINEN
Project Description: Installing (3) branch circuits for remodel.
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: 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:
ANNETTE SAARINEN ROBERTS ELECTRIC INC
9755 SW PEMBROOK ST 5759 SW 48TH AVE
TIGARD, OR 97224 PORTLAND, OR 97221
Phone: 503 - 619 - 1040 Contact #: FAX 503 - 244 - 0560
PRI 503 - 244 -7754
FEES
Description Date Amount Reg #: ELE 34 -23C
[ELPRMT] ELC Permit 8/11/2008 $66.80 LIC 9388
[TAX] 12% State Surchar 8/11/2008 $8.02 SUP 3886S
Total $74.82 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 •. -s of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
----- .
Issued By: /� � - ` Permittee Si / - ___".....s.
I 4110
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.
Electrical Permit Application E NED FORoFFICE usE oNLY . City of Tigard Received
�' Daten3 : �i I i Permit No.: -co •4.1,
.
, •
., �° 13125 SW Hall Blvd., Tig an Ot '
= O Pl R
Phone: 503.639.4171 Fax: 503.598 1,9 1 120 a Date/By: ��8 W Other Permit: 9� �' —�`
3 3
TIGARD Inspection Line: 503.639.4175 a ® Date Ready/By: J • ® See Page 2 for
(
•
Internet: www.tigard- or.gov 0.(3 Notified Method Supplemental Information
VA TYPE O O,d��� t� P A rt REV
�+° " Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction la Additiodp t a u Lion /replacement
❑ 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 Addition system. larger separately derived system. •
- . . -_ a _ . _ ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: " Job site address: / // I00HP or more. occupancy
(Q V - � ' ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: �t ❑ Health -care facilities. ❑ Supply voltage for more than
l ❑ 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 I Qty. I Fee. I Total L
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'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
. .. ' . DESCRIPTION OF WORK : (with above sq. ft.)
i✓�` Limited energy, multi-family ft 75 "00 2
residential (with th abbove e sq sq. ft.)
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
Name: 401 amps to 600 amps 160.60 2
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
relocation
Phone: ( ) 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 a bove service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, r 46 "85'2
first branch circuit 1 r
Address: Each add'l branch circuit 3 6.65 II, q 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
Business name: r G Signal circuit(s) or limited -
STS LC 1- � energy • Desct er a tion,or Page 2
Address: s ?S q S _
City/State /ZIP: PDT_ vl. q )22- I Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 3 ( } 3 ) ,ZL4 —725'1.4 Fax: (.t) d_ 44 - (!)„clo 0 Investigation per hour (t hr min) 62.50
CCB Lie.: ',,3 g Electrical Lie.: 23 L Suprv. Lie.: (See(,S Industrial plant per hour 73.75 •
(rt _ „ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 0 ' ��� ` �!v Subtotal N ,
Print name: 4,8 Z yh C Lt " ,� Date: g(d O Plan review (25% of permit fee):
r State surcharge (12% of permit fee): cc- Cj)_,
Authorized signature: TOTAL PERMIT FEE: - F/)-
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.
I.\ Building \Permims\ELC -PermitApp.doc 05/23/06 440 -461 ST(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
• - s
LIMITED ENERGY PERMIT FEES:
- ;, RESIDENTIAL WORK,ONLY:?t "
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK.ONLY: ;' ro;w ;'
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
•
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Building \Permits\ELC- PermitApp doe 03/23/06
CITTOEJIGARD
BUILDING *DIVISION
PERMIT #: FIC2000-00462
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Bpi wow
Phone: (503) 639-4171 sittlt
Inspection Requests (24 Hrs.): (503) 639-4175 I.
INSPECTION WORKSHEET FOR DATE: 2/20/2009 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 06620 SW ALFRED ST CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 042 TYPE OF USE:
PROJECT NAME: SAR.RINFN
DESCRIPTION: Imialling (3) branch circuits for remodel.
OWNER: SAARINFN, ANNETTE PHONE #: 503
CONTRACTOR: 1 ELECTRIC INC PHONE #: 503-244-7764
Inspection Request Scheduled For: Date: 2/20/2003 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 ElectliCDI final 000661-01 503-0059585
Corrections/Comments/ Instructions:
tr.l. 1,4 C\ t L
cl\S • c4,1 0 4-45.11-6
G--fta.to E
Jo PASS PARTIAL APPROVAL El CANCEL l] NO ACCESS
I FAIL CALL FOR INSPECTION E ADDITIONAL FEES ASSESSED
N 6
Inspector: - - Date: I:94 -C 1 Phone #: (503) 718-
CITY ;,
BUILDI .DIVISION PERMIT #: FL t'100i3 Otl4E2
. 13125 SW Hail Blvd., Tigard, OR 97223 DATE ISSUED: Bill/2008
Phone: (503) 639 -4171 ViliAl
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: t�J 15f2008 TIME: 7:OO1�M PAGE: 16
SITE ADDRESS: 06620 SW ALFRED ST CLASS OF WORK:
• - SUBDIVISION: KINGS VIEW LOT # TYPE OF USE:
_ PROJECT NAME: SARRINEN
.,.- ' •: DESCRIPTION: InslalIinq (3) branch circuits for remodel.
OWNER SAARINEN ANNETTE PHONE #: 503. 619 - 1040
CONTRACTOR: ROBERTS ELECTRIC INC PHONE # : 503-244-7754
;::_ Inspection Request Scheduled For: Date: 8/15I200 Pour Time:
r • '`Code # Inspection Description Confirm # Contact # Message
e > 125 Wall coder 074218 -01 �- 603.572 -3230 N •
corrections/comment /Instructions:
r
r'
(
i
1
Voqt 1 601,: Its t. 8b RIA . e fr'
i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G N t e Date: 41 2 , 16 - i o Phone #: (503) 718- 2 -'1 "Ft