Permit CITY OF TIGARD ELECTRICAL PERMIT
74 ° PERMIT #: ELC2009 -00056
` COMMUNITY DEVELOPMENT DATE ISSUED: 2/9/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125DD-05700
SITE ADDRESS: 09880 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT : 065 JURISDICTION: TIG
PROJECT: JONES
Project Description: Replace 200 amp panel.
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: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
MARK JONES LAUGHLIN ELECTRIC LLC
9880 SW VENTURA CT 3 MONROE PARKWAY STE. P PMB205
TIGARD, OR 97223 LAKE OSWEGO, OR 97035
Phone: Contact #: PRI 503 - 449 -7389
FAX 503 - 639 -0077
FEES
Description Date Amount Reg #: ELE C86
[ELPRMT] ELC Permit 2/9/2009 $80.30 LIC 165763
[TAX] 12% State Surchar 2/9/2009 $9.64 SUP 5097S
Total $89.94 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.
. , r Permittee Signature: . ( C
Issued By: �= �\ � � . �� �` l J I � . , g QM._ N, �f \ (l at t
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.
r
''
DEC-4-2004 11:108 FROM: , ' l\/ TO:5035981960 P.1/1
Electrical Permit Application FEB 0 9 2009 1 ttl■ 111 1,11 I I ',,1 tl\i.N L. -__ _ • Ci
R eceived
of Tigard O U1 OA 2 5 SW Hall Blvd., Tigard OR 97223
C ITY a Date/ . tiM • .
' . • 13125 ., , F TIGAR
Phone. 503.639.4171 Fax: 503.598.196 Other Permit:
i lt.`n in tiUILDING DIVISI�
Inspection Line: 503.639.4175 Data Read SI See Page 2 for
Internet: www.tigard- ar.guv Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction IS Addition/alteration/replacement Please check all that apply (submit a sets of plans w /items checked below).
❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Teas 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
❑ Fmereency system. larger separately derived System.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ","E ","I- 2", "I -3",
Job no.: Job site address: 9880 SW Ventura Court IOOHP or more occupancy
❑ Six or more residential units. ❑ Recreational vehicle parks
City /State/ZIP: Portland, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than
__ ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt, no.: Project name: Abendroth -Jones ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site: onrripdon I Qtr. I Rea. 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'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq R.)
Replace existing electrical panel Limited energy, multi - family 75.00 2
P g P residential (with above sq. ft )
Services or feeders Installation, alteration, and/or relocation
200 amps or less 1 80.30 80.30 2
® PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Mark Jones & Cena Abendroth 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 9880 SW Ventura Court Over 1,000 amps or volts 454.65 2
City/State /ZIP: Portland, OR 97223 Temporary services or feeders Installation, alteration, •nd/or
relocation
Phone: (503)756.2471 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 I ❑ CONTACT PERSON above service or feeder fee, 6 65 2
each branch circuit
Business name: Laughlin Electric, LLC B. Fee for branch circuits
Contact name: Erika M Sehervem or Grant R Laughlin without service or feeder fee 46.85 2
first brunch circuit
Address: 3 Monroe Parkway, Suite P, #205 Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not Included)
City /State /ZIP: Lake Oswego, OR 97035 Each manufhctured or modular 90.90 2
dwelling, service and/or feeder
Phone: (503) 449.7389 I Fax: : (503) 639.0077 Reconnect only 66.85 2
E- mail: e.schervem(a)comcast.net or g.laughlin@eomcast.net Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Laughlin Electric, LLC a e rgy c panel alteration or
Address: 3 Monroe Parkway, Suite P, 11205 extension. Describe: Page 2 2
City /State/ZIP: Lake Oswego, OR 97035 Each additional Inspection over allowable in any of the above
Per inspection _ 62.50
Phone: (503) 449.7389 Fax: (503) 639.0077 Investigation per hour (I hr min) 62.50
CCB Lie.: 165763 Electrical Lic.• 6 Suprv. Lic.: 5097S Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 1 80.30
Print name: Grant R. Laughlin Date: 2.9.2009 Plan review (25% of permit fee):
v] )))) / / State surcharge (8% of permit fee): ,6,45'' q. t D4
Authorized signature: r � Date: l /y�/ ,�j�/ ^- J � /i, 1 �� TOTAL PERMIT FEE:
Print name: Erika M Sc ervem -C au biro (/r !f I D 2.9.2009 This permit application expires if a permit Is not obtained within I lamented 80 89
g &vs after It has been rnted an eomnlete 89
CITY OF=TIGARD
BUILDING DIVISION PERMIT #: I�I_C 2009 f1f3f1s,C�
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 219/0009
Phone: (503) 639 -4171 4 „ 1, , �1f ' 1
Inspection Requests (24 Hrs.): (503) 639-4175 A A 1_L
INSPECTION WORKSHEET FOR DATE: 2/11/2009 TIME: 7 :0OAM PAGE: 4
SITE ADDRESS: 099 () SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 065 TYPE OF USE:
PROJECT NAME: JONES
DESCRIPTION: f ?eplac€ 200 amp panel.
OWNER: JONES, MARK PHONE #:
CONTRACTOR: LAUGHLIN ELECTRIC LI._C ( � �\ L 1 PHONE #: 50 3- 449 -7389
Inspection Request Scheduled For: \ \ Date: 2111/2009 Pour Time:
Code # Inspection Description % on i •• # Contact # Message
199 Electrical final 80497 -0' 503- 449 -7389 \ Y
Corrections /Comments /Instructions:
(DE
s 3 • L rk t+N •V 1_ a
Fb cal. — o01. .,
1) Prk33.1% bia f•L\____ (
•tCCc. I I) 0 . (0
N
\ : ,
0. i\s ‘iqltk ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED -
Inspector: Cr t N66 Date: 7-41" Phone #: (503) 718- _g_q_t____
CITY OF- TIGARD
BUILDING DIVISION PERMIT #: ELC•'2OOg . 004 5_6
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 I �!'
INSPECTION WORKSHEET FOR DATE: 1,� � TIME: PAGE:
SITE ADDRESS: C S(k) V ( I.IV (?J C. CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: Pots. utu.2z,
OWNER: _ PHONE #:
CONTRACTOR: L Ak yi L% PHONE #:
Inspection Request Scheduled For: Date: loot Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
PASS) ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �d Nb tr6 Date: 1 ' ®I Phone #: (503) 718- J