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Permit Q&priIcy A8- 6 2 c ELECTRICAL PERMIT � Q C q IN CITY OF TIGARD PERMIT #: ELC2008 -00650 ° COMMUNITY DEVELOPMENT DATE ISSUED: 11/26/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S102BD -03200 SITE ADDRESS: 13075 SW PACIFIC HWY ZONING: C -G SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 035 JURISDICTION: TIG PROJECT: SPEC SPACE Project Description: TI. 2/3/2009 ADDED (1) 200 amp panel. RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 - 200 amp: 0 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: 411111.110 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: 10 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: ESTATE OF SHULER, GARRY COUEY DICKINSONS ELECTRIC 30790 NE FERNWOOD 8449 SW BARBUR BLVD NEWBERG, OR 97132 PORTLAND, OR 97217 Phone: Contact #: PRI 503 - 246 -3550 FAX 503 - 213 -6049 FEES Description Date Amount Reg #: ELE 26 -140C [ELPRMT] ELC Permit 11/26/2001 $113.35 LIC 65534 [TAX] 12% State Surchar 11/26/2001 $13.60 SUP 3100S [ ELPRMT] ELC Permit 2/3/2009 $80.30 REQUIRED ITEMS AND REPORTS (additional fees not listed here) Total $216.89 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 a • -3 ---4 • 1.800.332.2344. Issued By: 0i gi , .. i • Al • 1 _ / ] I. Permittee Signature: i 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. CITY OF TIGARD ELECTRICAL PERMIT ° PERMIT #: ELC2008 -00650 1111 ° COMMUNITY DEVELOPMENT DATE ISSUED: 11/26/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 102BD -03200 SITE ADDRESS: 13075 SW PACIFIC HWY ZONING: C - SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT : 035 JURISDICTION: TIG PROJECT: SPEC SPACE Project Description: TI 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: 10 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: ESTATE OF SHULER, GARRY COUEY DICKINSONS ELECTRIC 30790 NE FERNWOOD 8449 SW BARBUR BLVD NEWBERG, OR 97132 PORTLAND, OR 97217 Phone: Contact #: PRI 503 - 246 -3550 FAX 503 - 213 -6049 FEES Description Date Amount Reg #: ELE 26 -140C [ELPRMT] ELC Permit 11/26/2001 $113.35 LIC 65534 [TAX] 12% State Surchar 11/26/2001 $13.60 SUP 31005 Total $126.95 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 181 • - ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 95 -101 -0010 thro • • h O' • • • -0 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issue By: , , 0 Permittee Sign - :�— 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: i -_/S " / /: 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. -Elecfrical Permit Applicatid ECEIVED FOR OFFICE USE ONLY / ' III City of Tigard l 0 V 2 6 2008 Date/By: e v // �� f7 Permit No.: /`�OLC.O�* SD t�� y • 13125 SW Hall Blvd., Tigard, OR 974 Plan Review l 7 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: 1' I G A R 17 Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: luns/: RI See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: /, e... Supplemental Information TYPE OF WORK PLAN REVIEW ❑ New construction ,0'd dition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ 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 dwellingmmercial /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 system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", • IOOHP or more. occupancy. Job no.: Job site address: /32_ 4C ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than ty ❑ 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 Qtr. I Fee. I Total I • 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 DESCRIPTION OF ORK (with above sq. ft.) 75.00 2 S � Limited energy, multi - family 75.00 2 residential (with above 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: ( ) I 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, er panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, / 46.85 2 first branch circuit / Address: Each add'l branch circuit 6.65 (,(p 5 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 CONTRACT R _Sign or outline lighting 53.40 2 /` � � �� Signal panel, or limited - Business name: �1 ��/f, energy panel, alteration, or Address :89W �J , 442 extension. Describe: Page 2 2 City/State /ZIP: lei,44e,e 19, 9, /9 Each additional inspection over allowable in any of the above /1 /' Per inspection 62.50 Phone: (� j3) ( 3 cS U Fax: ( ;� R/3 Qg1 Investigation per hour (1 hr min) 62.50 CCB Lic " Electrical Li' , Suprv. ic:: , ,�QS Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, req j"+ Subtotal: // .5„ Print name: / Date: Plan review (25% of permit fee): —611"" i State surcharge (12% of permit fee): / § .64 Authorized signatu -: TOTAL PERMIT FEE: /u , Q,S Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I :' Building \Permits\ELC- PennitApp.doc 05/23/06 440-4615T( I I/05/COM/WEB • • CITY OF TIGARD BUILINNb DIVISION PERMIT #: ELC2008-00650 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/2008 Phone: (503) 639-4171 At Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 2/4/2009 TIME: 7:00AM PAGE: 13 SITE ADDRESS: 13075 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 035 TYPE OF USE: PROJECT NAME: SPEC SPACE DESCRIPTION: 21312009 ADDED (1) 200 amp panel. OWNER: ESTATE OF SHULER, GARRY COUEY, PHONE #: CONTRACTOR: DICKINSON'S ELECTRIC PHONE #: 503-246-3550 Inspection Request Scheduled For: Date: 2/4/2009 Pour Time: Code # Inspection Description Confirm-# - Contact # Message 199 Electrical final 080270.01 503-5152922 Corrections/Comments/Instructions: \I \ VB PASS fl PARTIAL APPROVAL CANCEL El NO ACCESS El FAIL CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED — Inspector: I) L. Date: 1--2 Phone #: (503) 718- CITY OF TIGARR- BUILDING DIVISION PERMIT #: ELC2008- 00050 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/20013 Phone: (503) 639 -4171 ICI Inspection Requests (24 Hrs.): (503) 639 -4175 - ..,._: 1 . . INSPECTION WORKSHEET FOR DATE: 2/2/2009 TIME: 7:00AM PAGE: SITE ADDRESS: 1307G; SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: NORTH TIGARDVILLE ADDITION LOT #: 03E TYPE OF USE: PROJECT NAME: SPEC SPACE DESCRIPTION: TI OWNER: ESTATE OF Sl- IULER, GARRY COLEY, PHONE #: CONTRACTOR: DICKINSON` ELECTRIC PHONE #: 303- 246 -36b0 Inspection Request Scheduled For: Date: 3/2/2009 Pour Time: Code # Inspection Description Confirm # Contact # ,Message 199 Electrical final 0130197 -01 503.615 -2922 \ Y Corrections /Comments /Instructions: ?RPV i OW -e4 Pte`? ■ 4 i = `o. l c-foLj v i IT \Lk.. ( 1 .K) 12 T le- 6 Nu Nu. zlo.i titosi-/ s--- ‘ ki 0 ilii - F\oylio.3 J $PA Fail 1 P K ZOO A rip. ‘'N /a.._ e b evz . L J L ALL v l cC c_tNl. Jr�' N t- IRA L��a1J W 1 fir- 010 r\RR"i'• 0 4 3 AO , Z .-- R.o \ADE 92(vNA"c 0 -. ‘c..\ - IN) Piacoa-i6 tsivt, . S-6 S 0 .'\j\j U No . to -1 I3 kc x,— The electrical installation defects noted on this report shall be carrgctArl pipit an inspection request made within 20 calendar days per 041'91 ii-271-0030 n PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS 10 FAIL j1 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED Inspector: ).—+ 0 Date: 2.'1—'1 Phone #: (503) 718- vat, f, • CITY OF TIGARD BUILDING DIVISION PERMIT #: EI C2008- 0()6,0 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11f26noo€ Phone: (503) 639 -4171 A 'I Inspection Requests (24 Hrs.): (503) 639 -4175 ,.. I INSPECTION WORKSHEET FOR DATE: 1/29/2009 TIME: 7 : 01AM PAGE: 7 SITE ADDRESS: 13076 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: NORTH TICARDVILI_E ADDITION LOT #: 035 TYPE OF USE: PROJECT NAME: SPEC SPACE DESCRIPTION: f OWNER: ESTATE OF SHULER, CARRY COUEY, PHONE #: i CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 503- 246.3!-;x,0 ', Inspection Request Scheduled For: Date: 1/29/2809 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electri final 080128-01 503-515-2922 N Corrections /Comments /Instructions: - ( it 4f0 see ( ` /4 c cos, c,om n e0-1 rc.• 4-"4 , d-1 q 3 / 0 L ek 40 A /c. no Ili -seo xc, 36 2 - - 3 i g Pot VL V 1 kik G S CAr..-et Si 11 C.e 14 s 1. 7 Q- L�A LI A c !'e. 7-'v IM�t∎1 A �j AO l)-'V1/�� -�'L� 21 4 41 j S i n S v /.�� u et cr& / e 1--o its-, y cable, p 1.- Je_o, i'-o-K pa-r 3-to -2 , /VQ acrcSS yJ4 s . q nO ud t K I p Jp-cock.`" G, , re__ .i .iV lir cl,a 1 (0 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS _ Ea AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 7 9/€44 Date: l ^ 2 4 °—/ Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC:2008- 00 €;60 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1112612008 Phone: (503) 639- 4171Atet` Inspection Requests (24 Hrs.): (503) 639 -4175 t1Lli INSPECTION WORKSHEET FOR DATE: 12122/2008 TIME: 7 PAGE: 2 SITE ADDRESS: 13076 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: NORTH TIGARDVILL ADDITION LOT #: 036 TYPE OF USE: PROJECT NAME: r;Prr SPACE ( . DESCRIPTION: Ti OWNER: ESTATE OF SHULER, CARRY CC)UEY, PHONE #: CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 503- 246 -3660 Is Inspection Request Scheduled For: Date: 1212212008 Pour Time: ,t Code # Inspection Description Confirm # Contact # Message } 120 Electrical rough -in 079187 -01 603-515.2922 N Corrections /Comments /Instructions: • f „ 0 . t ,.. ' r CAL— cheNic fi,w k,...e..`o / t o O 0 -1O, f 0 Nn " iN p fc /—& Q k 0 14 , . ppe 0 . i t dio..- tA u fri 0 ;-. Jo 0 q it-d-S 1-6-./ C41/ cc/ 6 fps (mil) Y 'Lt U CA 0-47 r ' # .c..-1,v r -0 (E - -e _. 1/J /..c .,.. kr c- L., o G ii ..p l C o . -, -' v , c lc -e , 6 l -e.- PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: / 2 '-/ 0 Y c Phone #: (503) 718 - CITY .OF TIC�ARD - • ¢: BUILDING DIVISION PERMIT #: ELC2008- 00660 13125 SW Hall Blvd., Tigard, OR 97223 i, DATE ISSUED: 11/2612008 Phone: (503) 639 -4171 // r��' It, Inspection Requests (24 Hrs.): (503) 639 -4175 !�_ `' I.. INSPECTION WORKSHEET FOR DATE: 12118/2008 TIME: 7:01AM PAGE: 5 SITE ADDRESS: 13075 SW PACIFIC HWY CLASS OF WORK: SUBDIVISION: NORTH H TIGARDVILLE ADDITION LOT #: 03i TYPE OF USE: PROJECT NAME: SPEC SPACE DESCRIPTION: 1.1 OWNER: ESTATE OF SHIJLEP, GARRY COUFY, PHONE #: CONTRACTOR: DICKINSONS ELECTRIC PHONE #: 5O3-246 3560 Inspection Request Scheduled For: Date: 12118/2008 Pour Time: Code # Inspection Description Confirm # ' Contact # Message 120 Electrical rough -in 079114 -01 503- 515 -2322 N Corrections /Comments /Instructions: 1 — ov-eA_ t cc4Ltes 14 s p . OPAL CQ c A2 v. oe' 1 t q �Q ` 6 hl 0-'9/ I 4©sti � ci 1/1 " 0 vI vl ©4= 1 () ti da b © k' i 1.1 '0.. ► CG ` Q Gk- co ut--re d ti `J W 4 c . 1 -@ , No r-,1 p.Q.1 i4. ici 6.e / 0Y s t .. ..-10041- 4 .,(4.. 1 \ tA ,s OL.----- • i 7 ) P SS PARTIAL A PPROVAL CANCEL v AtCESS n ❑ i � • AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 1 2 — /9 Phone #: (503) 718- Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined ... $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I: \ Building \Permits\ELC- PermitApp.doc 03/23/06