Permit ' !
•
CITY OF TIGARD ELECTRICAL.PERMIT
PERMIT #: ELC2009 -00075
° COMMUNITY DEVELOPMENT DATE ISSUED: 2/25/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: _2S1046A -07800
•
SITE ADDRESS: 13892 SW LIDEN DR ZONING: R -12
SUBDIVISION: CASTLE HILL NO. 2 LOT : 113 JURISDICTION : TIG
. PROJECT: PETKEVICIUS
Project Description: Install (4) branch circuits.
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:
ROMAN & M PETKEVICIUS ROSS ELECTRIC INC
13892 SW LIDEN DR 2870 SE 75TH AVE #203
TIGARD, OR 97223 HILLSBORO, OR 97123
Phone: Contact #: PRI 503 -642 -2800
FAX 503 -642 -5815
•
FEES
Description Date Amount Reg #: ELE 34 - 436C
•
[ELPRMT] ELC Permit 2/25/2009 $66.80 LIC 157891
[TAX] 12% State Surchar 2/25/2009 $8.02 SUP 4232S
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 copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
•
Issued By: O A � � Permittee Signature: 9 Q
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 02/24/2009 17:11 5036425815 ROSS ELECTRIC INC PAGE 01/-02
r Electrical Permit Applicati 1 fi•, ECEIV D FOR orh ICE USE ONI,v
• City of 'Tigard CC Received •
- ° 13125 SW Hal! Blvd., Tigard, OR 97 ,, 2',00 P R eview . o PermitNlC�Ct , � Q /1-r 5
Phone: 503.639.4171 Fax: 503.598.1960 ' at / Date/By: Other Permit: /
- r I t; A K. n Inspection Line: 503.639.4175 CITY 0 TIGA• I Date Ready/By: „Loris RI
Internet: www.tigard- or.gov I 1 I • 1 Notified/lvtethod. gee Page 2 for
n _ to reform 11
Supplemental 1
I pP as 0
!! L1° '!.F �d � ni a 1 . s,ucmcT•- .. s� I-r ' � t5 Mn -. r m �:r•...,� -, -
�, I: L r 1i'1 7 I ,, "1f,1 rf, ,Fr. 3r ,h'1 BFI l,Zr^ Ij tl '` . tihlr rll'" If 4;;;;; nhrra ; r 1 � 4'.': J. -` - ,77
, 17 , 7,r •M : .:' i tR
1,1,- hio 1 Lblm Ir ',41 l I(S d I -, t Id LSr {n i I, i2 =. i b u�� .,14 , «E1'j l .R ' 1 1, 1., "x !,; w I Yr �. .
,. rs ,i •sB,p., L:,��,t..a.6... .f.. , 4�* l .,. n.... �. r + b. w. .,.�,1 „ho..,.Tii.rt�..�:�..,1 .�1 �`,,.,,ol�tL.a,�,f�:. .:Ifl�•:I "Giblll t::�,iiri ii' �i E� n� +i IiS�s '� "�-
c ., .U:,.a��u,:TG,�a; ":c!•erl. v.la twa t �,a �1:
0
New construction Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
for all oth
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
:ui>ilru? ' "C;' "I{ar I'm _: Iyya .. I;, a r I I G 1, ,o c. Idb P.G � � ? -;: where the available fault current El Marinas and boatyards. .c:,'."', -.i ' - ; , l .. k _ i, ai' s l'.4 : V`•' l ,r r h.,
l;:u.ti /F • , � ? x:i �,aN v + .- }•, i.. ; ' i?,o n ;, j "'tJ 61 less to s ground, amps e s 1 00 or ❑ Commercial-use buildings.
1.1.4 less to mound, other exceeds 1x,0 ❑ Commercial -11$E aagricultural l- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building amps er installations. buildings.
❑ Multi family Q Master builder . ❑ Other: O Fire pump.
.1'm'r,�. ,
,ii ❑ Installation of 75 K VA or
y•'n $ is_ .. ,-a.; a.,. , .- o,• .m. 1 ,1 r :a ,1 •44: QBmer c system, °1h d r. f�l, larger separately derived syster.
' -�. u,F'Iri'�y .y; -i J rl; F 0 N W" I ���, SOaYSY3t tar
as t.i �lo jm� �el�ie._ : l!� . -i cM c I.: f�.t j. i ,i Y," 3aS ! i 1� Addition of new motor loud of ❑ "A ", E" , 1 , 1_3
1001iP or more. Deco
Job no.: Job site address : l. )C s L D e . panty.
1 Q Six or more residential wits. ❑ Recreational vehicle parks.
City/State/ZIP: 1-, ' �� El Nealth.wro facilities. ❑ Supply voltage for more than
Suite/bldg. /apt Project name: El S o Service r feeder 60o amps or e .
locations. 00 volts nominal.
no.: P j ❑ sarviee or reed p nacre,
Cross street/direetions to job site: TY i i L ; t:in z Y 4� e4 , , , '�a ',•: 4 -4 .. t `. w , - ;., °. a" i ',L ti t sR� 4 , e.9 ft
Descriptton Qty. FEE Total •
New residential single- or multi- family dwelling unit.
Includes' attached garage.
Subdivision: l Lot no.: ' 1,000 sq. ft or less 145.15 4
Tax map /parcel no.: EL add'I 500 sq. ft. or portion 33.40 1
,'ti;L' ;=c4, ,IE ' i t.4 ti rrr, r t,� ��r. -,trr �w fi r•. �7r,,,, 'o� rc .,,,• Limited en ergy, residential ' -
;iii, :i i ,t.7ilgM �`i .,.: t"i, •?I�1. ' I Id° ..,Irr. • 4;1. .
4: ..T { ..t. si .ter 1r. ��: { 75.00 2
` .h':1�:�1=a�';::; rlr .. a ";3 ;t1;t;t I'',.ts51i{4itlt�:fT� r<:,,, : „,';:. � 'rS+ • � ., %i�>� 'j i., i:; _ `� {; i , >. ''w with a sq. ft-)
rmk,- n,.
• 7 �'s":f:c;a}1a i.aGarl_�•G hd...... •, nl n 6CBu�tiillnmhli!IJa::i`,i l5ili”
t Limited energy, multi - family
S 1 .� k ." 0 ► r, •..∎ V1/411 »r& � f r C A r .34 fr�.r residential (with above sq. R) 7 5.00 2
o�k� . c 1 t «ow ale
Services or feeders installation, alt and/or relocation
l � •; ' �'Z•rr I �'•`{•' I 1 h M 1 i 11,s4� �T-11 '� I 1 a '`— u r r 1 ( ,�i,. r : ;u. 200 amps or less 80.30 2
(#
I4 ,far m o l 1 1� „
- rt�,.�ll,� -„,1 �.tll .,, �f;.�1 s M ;'tuT:�.,i :.I,t �,...rl. � .;. I � -,-- �{ r- � t .r;,.r I.r�l��'��' � 201 amps to 400 amps ,
.. Tt ,.• .. � .,z,I , ,,1,.•r."+ ,. ..., , 106 85 2
Name: - 401 amps t� 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
Owner Signature: Date: Branch circuits - new, alteration, or extension, per panel
S+ '" r 1 u'i ,l+ a i iGt �� u r A. Fee for branch circuits with
o P +CK7t3ri:i�Hl::'� . 4 5 t ,,4' 1 5 : 5 17 1:0 4 t . 17 1 iii r''• ;:: i T T, 774 11 iV441f above service o r feede f ee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 1 46.85 i /6 2
first branch circuit - 7
Address: - Each add'I branch circuit 3 6.65 1 %'5 2
Miscellaneous (service or feeder not included)
City/State/ZIP: . ' Each manufactured modular
— dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E mail:
q � - m i'!i''ii;ir::; I z,:1�= ; r - "r�� •= . ;,z:�,— �„�;�•Iz -,� - ,:�'..,.. .....- �,- �,,,�. Pump or irrigation circle 53,40 2
•, �._al.,,.ii7. It rl `> y�'1 ':' I s s•
li �a�:.r.«F}� Y. :: mod. �� �'_� )s..ci I C�, r 1� 4�LL . I T �� 1,1 i ( a^ 1 1 1 l �i:,;y Ki• di :Ll. � Sign or outline 1 2
is I r.. "5..... rt -�--- :lw , p,t ihtt fe•,1: 871 lighting 53.40
Business name: Ross Electric Inc. • Signal circuit(s) or limited -
energy panel, alteration, or
Address: 2870' 75 Ave extension. Describe:" Page 2 2 i
City /State/ZIP: Hillsboro, OR 97123 Each additional inspection over allowable in any of the above
Per inspection 62.50 •
Phone: (503) 642-2800 Fax: (503) 642-5815 investigation per hour (1 hr min) 62.50
CCB Lic.: 157891 Electrical Lic.: 34 -436C _ Suprv• Lic.: 72.32S Industrial plant per hour _ 73.75
Suprv. Electrician 1 ?L r "nnl E�ai ,. 21'. i `s �z�` t: j {Jr`' H;,_ .1;: 'r. ;
p signature, required
Subtotal: ,. 6.211 - '
- - -Print-name:-.Stephen-Ross - Date: 115/2009 - — Eian.teview•(25 %of permit fee):
State surcharge (12% of permit fee): y..0 a
Authorized signature: TOTAL PERMIT FEE: 7SY. fld:
Print name: Dam: This permit appliesdon expires if a permit is not obtained within 180
days after it has been accepted as complete, '
• Number of inspections allowed per permit.
7: 15uitdinSVPwmilr ■2LC- PermhApp,°oc 0yr13 /00 440-40I$1'(11/05/COM/WEB
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: FLC2009- 00075
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25 /2009
Phone: (503) 639 -4171 ICI
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' �._ "
INSPECTION WORKSHEET FOR DATE: 2/27/2009 TIME: 7 :01AM PAGE: 8
SITE ADDRESS: 13092 SW LIDEN DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 2 LOT #: •113 TYPE OF USE:
PROJECT NAME: PEFKEVICIUS
DESCRIPTION: Install ('1) branch circuits.
OWNER: PEIKEVICIUS, ROMAN & M PHONE #:
CONTRACTOR: ROSS ELI.=CTRIC INC PHONE #: 503 -642 -2000
Inspection Request Scheduled For: Date: 2/27f2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 EIectric:al final 080906 -0� 503.642 -2800 \ V
q€9 0033
Corrections /Comments /Instructions: vY j KL 11;30/ ha-\
o JCL v.w.to y6s- 1 ic1 �t'-
•
0 PA ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: c IN toe, LA Date: 2."7,1 • I Phone #: (503) 718- 1 /0117
I
- CITY OF TIGARD
BUILDING DIVISION V
PERMIT #: ELC2009- 00075
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/25/2009
Phone: (503) 639 -4171 i �.,, ;' � I
Inspection Requests (24 Hrs.): (503) 639 -4175 _'`
INSPECTION WORKSHEET FOR DATE: 2166/2009 TIME: 7 :03Am PAGE: 4
SITE ADDRESS: 13892 SW L.UDEN DR CLASS OF WORK:
SUBDIVISION: CASTLE HILL NO. 2 LOT #: 113 TYPE OF USE:
PROJECT NAME: PETKEVICIUS
DESCRIPTION: Install (4) branch circuits.
OWNER: PETKEVICIUS, ROMAN & M PHONE #:
CONTRACTOR: ROSS ELECTRIC INC PHONE #: 50'3
Inspection Request Scheduled For: Date: 2/2612009 Pour Time:
Code # Inspection Description 'Confirm # Contact # .Message
'
120 Electrical rough -in ,C. O8087;�-0 503 m2-2800 Y
gb900
Corrections /Comments /Instructions: -- 1 . I
0 ,),tog-' 6\6s v ac Ya) W� \) : NAT
a r\rk1,(>4")c "V 1 ‘_ q 10,
cACZ,c -)i1 F L P∎Wi ► 4� AL. tie \-t 5
Kci ")G vR4 T-.6.,d1-\.
❑ PASS XPARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G°' N66 Date: 24 1 Phone #: (503) 718- ViLitiO