Permit kf rt ctta 2 S -a a 4\cdcLsL� 2oa C rvt 1p .x, .
CITY O F TIGARD
COMMUNITY DEVELOPMENT ELECTRICAL RMIT
Illq ° PERMIT #: ELC2009 -00032
°
D ATE ISSUED: 1/21/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136CB -02500
SITE ADDRESS: 11130 SW 82ND AVE ZONING: R -4.5
SUBDIVISION: RANCH VALLEY LOT : 006 JURISDICTION: TIG
PROJECT: HEATH
Project Description: (1) branch circuit for solar panels.2 /25/09 ADDED 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: 411111110 W /SERVICE OR FEEDER: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 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:
ROGER & DIANNE HEATH STAPLETON ELECTRIC & SOLAR LLC
9373 SW FAST PL. 2314 SE 12TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 701 -3357 Contact #: PRI 503 - 970 -2976
FAX 503 - 236 -0410
FEES
Description Date Amount Reg #: ELE C166
[ELPRMT] ELC Permit 1/21/2009 $46.85 LIC 169059
[TAX] 12% State Surchar 1/21/2009 $5.62 SUP 4848S
[ELPRMT] ELC Permit 2/25/2009 $40.10
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $97.38
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 r
Issu d By: Od AL J111A.6 Permittee Signature: Q c % ; a q l Q v p
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.
11111111 --- OW OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2009-00032
° COMMUNITY DEVELOPMENT DATE ISSUED: 1/21/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136CB -02500
SITE ADDRESS: 11130 SW 82ND AVE ZONING: R -4.5
SUBDIVISION: RANCH VALLEY LOT : 006 JURISDICTION: TIG
PROJECT: HEATH
Project Description: (1) branch circuit for solar panels.
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: 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:
ROGER & DIANNE HEATH STAPLETON ELECTRIC & SOLAR LLC
9373 SW FAST PL. 2314 SE 12TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 701 - 3357 Contact #: PRI 503 - 970 - 2976
FAX 503 - 236 -0410
FEES
Description Date Amount Reg #: ELE C166
[ELPRMT] ELC Permit 1/21/2009 $46.85 LIC 169059
[TAX] 12% State Surchar 1/21/2009 $5.62 SUP 4848S
Total $52.47 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: �� i ,,,, j a i �A Permittee Signature: fi 1 i 41:r,!...
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.
Electric Permit Application RECEIVED FOR OFFICE USE ONLY
City of Tigard Date/By: Received I ..2.1 '�.0c4, Permit No.�i C..2 ,y • . 04:3 O 3a
lig
• 13125 SW Hall Blvd., Tigard, OR 97223 2 12QQg Plan Review /�
e SA Other Permit: M,l 2(900 ' � 5
Ph one: 503.639.4171 Fax: 503.598.1960 Date/By:
T I G A It D Inspection Line: 503.639.4175 A Qn Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard- or.gov CITY OP TIC ISIO Notified/Method: 1 Supplemental Information •
TYPE OF wOikt / -- DN PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction ,, Addition/alteration/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
RI, 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 system. larger separately derived system. A
❑ Addition of new motor load of ❑ "A ", "E ", "I- 2 ", "1 -3 ",
Job no.: I Job site address: i .3O f•' �1 n I I!\ �\E- Six or oo more re s. occupancy.
1 V / v C J v✓ ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. 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'I 500 sq. ft. or portion 33.40 1
Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
IP
p nn Limited energy, multi - family
3 U C. 6 A J 0,4 ..5 o g 4 / r A / residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relo lion
200 amps or less 4, 80.30 2
❑ PROPERTY OWNER I ❑ 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, 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: $ [ B. Fee for branch circuits
S *A f� le k,,.. L Etcc�Pr c g,3 ,4� Ld
1 without service or feeder fee,
Contact name: Pc ' 5 -EA 7 ) '. f 4 I "? C first branch circuit 46.85 2
Address: R ((r SE •2 k Ave Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: k r 1 (c,,," d. a R . q 7c2/7 // Each manufactured or modular 90.90 2
7G --- ^ � � dwelling, service and/or feeder
Pho (r03) 7 / ( Fax: : ) t only onl 66.85 2
E -mail: S 10, 3 ?Air, 0-0-ra Pump or irrigation circle 53.40 2
_ CONTRACTOR Sign or outline lighting 53.40 2
Business name: • Signal circuit(s) or limited -
energy panel, alteration, or
Address: 1.1V extension. Describe: Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (l hr min) 62.50
CCB Lic.: 16 9 6 S Electrical Lic.: C lg 6 Suprv. Lic.: 7 }8 em S Industrial plant per hour _ 73.75
tt t, ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: 1 L J A ,� " /( Subtotal: (.4 i $ B
Print name: �A r t' L K ° A p f �V pfte: /// 2 , / r Plan review (25% of permit fee): _
/ / State surcharge (12% of permit fee): 5 . (p2.
Authorized signature: TOTAL PERMIT FEE: Z, .47
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 - PermitApp.doc 05/23/06 440 -4615T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard r.
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
CITY . F TIGARD
BUILDING DIVISION PERMIT #: 2c30 I 40032,,
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2 2 0Q TIME: PAGE:
SITE ADDRESS: IJ 3O S LO IN 4V • CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: MoQ+`(k
DESCRIPTION: Souvt. p AgvcLS • • •
OWNER: PHONE #:
CONTRACTOR: trt FNS LEI e it • PHONE #:
Inspection Request Scheduled For: Date: 2 - 0 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments/ Instructions:
e� -�� ! ►Al tea. ?1JO
PASS I PARTIAL APPROVAL ❑ CANCEL NO ACCESS
LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . 'v68 Date: 1 1 -'W Phone #: (503) 718- 2.-
•
CITY,QF TIGARD
BUILDING DIVISION PERMIT #: ELC2009-00032
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U2112009
Phone: (503) 639-4171 g
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/23/2009 TIME: 7;00AM PAGE: 2
SITE ADDRESS: 11130 SW 82ND AVE CLASS OF WORK:
SUBDIVISION: RANCH VALLEY LOT #: 006 TYPE OF USE:
PROJECT NAME: HEATH
DESCRIPTION: (1) branch circuit for solar pane's.
OWNER: HEATH, ROGER & DIANNE PHONE #: 503-701-3357
CONTRACTOR: STAPLETON ELECTRIC & SOLAR LLC PHONE #: 503-970-2976
Inspection Request Scheduled For: Date: 2/23/2009 Pour Time:
Code # Inspection Description Conliffri# Contact # Message
199 F::k.,Nctrical final 080760-01 503-970-2976 Y
Corrections/Comments/Instructions:
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C4Iirse" 4 .64 () si co A 1401 ife(01-ii IN
CzA/14:
(14 4 ()('t) s 1604 ea% P ctokratt9 •
g t 04 kiLeciats t watcsititti3/ nii; ( -6 •
6%3 %,
•
n PASS cPARTIAL APPROVAL CANCEL NO ACCESS
r FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: cV / Date: 2-- 2 3 Phone #: (503) 718- 2.4qt,