Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 - 00571
COMMUNITY DEVELOPMENT DATE ISSUED: 10/7/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 136AD -05500
SITE ADDRESS: 06710 SW PINE ST ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: HATHAWAY
Project Description: (1) service and (4) branch circuits for bathroom and smoke detectors.
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: 4 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:
DANNY HATHAWAY ELECTECH LIGHTING & ELECTRIC INC
6710 SW PINE ST 465 NE 181ST 189
TIGARD, OR 97224 PORTLAND, OR 97230
Phone: Contact #: PRI 503 - 970 - 4072
FAX 503 - 254 -6643
FEES
Description Date Amount Reg #: ELE C377
[ELPRMT] ELC Permit 10/7/2008 $106.90 LIC 168260
[TAX] 12% State Surchar 10/7/2008 $12.83 SUP 5357S
Total $119.73 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 ma obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
4 °J1IP P i
------(--)
Issued B Lam - -%� _ • • -. ∎10 .. ' A.... i'
di g.----, 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 FOR OFFICE USE ONLY
• IN t. City SW y Tigard Ti and Received 7 d► �/ _ Permit No.: -- : _ �r _ . /
� � _
q 503.639.4171 Hall Blvd., Tigard, OR ' L : � 1 Plan Plan Review C E J , �
Phone: 503.639.4171 Fax: 503. < 1 Date/By: Other Permit: f'3pfk72 w0
T I G A R D Inspection Line: 503.639.4175 Date Ready /By: Juris: ® See Page 2 for
Internet: www.tigard - or.gov 0 1 73' i Notified/Method: ZG Supplemental Information
TYPE OF WORK E t i 1 PLAN REVIEW
❑ New construction Addition/alter 7 c, a . 5 Please check all that apply (submit 2 sets of plans w /items checked below):
` /� I 1 ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: g1, where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONJIRUCTION exceeds 10,000 amps at 150 volts or ['Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
N tl 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.
❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ",
Job no.: Job site address: (o 7/ 0 s u,.: i4 t} L-- 6 i u ci I DOHP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
I
City/State /ZIP: 16 WVcD > iZ c i ( y Z. Zr- ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: 1-1 tvr p , Lo A ♦i ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description 1 Qty. 1 Fee. 1 Total 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. 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
PTI
DESCRION OF WORK (with above sq. ft.) _
Limited energy, multi - family
'j _ i U' 200 A S E A ■ i G: , N E itt l CAC TS F-o P residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
S iAb IC DE S t 10 S Ta - 111 1 . 5 F}TN 'Li-No tom( tic- • 200 amps or less i 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 I
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 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'I branch circuit 6.65 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: E t.Cv 1 � ( ..,16 � 1 4 6 A t 1 D Eat i R i C- t 4., Signal circuit(s) era to, limited-
energy panel, alteration, or
Address: 41,, J N G y$( - .* i$ 9 extension. Describe: Page 2 2
City/State /ZIP: -, o a2T - Ly A t s7 b i' 9 Z 3 v Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503 ) 9 7D -- `}p 7 Z Fax: ( 503 ) 2 - 5 4'— 6 9-3 Investigation per hour (1 hr min) 62.50
CCB Lic.: 16 $'Z(,b Electrical Lic.: ( 3 7-7 Suprv. Lic.: 5 35 7 5 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ja9+Vu ' tkt:L Subtotal: l Uw O
Print name: `` Date: Plan review (25% of permit fee):
Ji a1.l�S Jz,H - Nsc iv D i0 -"7_p o e ?
State surcharge (12% of permit fee): ( , 15
Authorized signature: ( TOTAL PERMIT FEE: 1 (Ci , �
This permit application expires if a permit is not obtained withi 80
>
Print name: , (,4i :._
. i j
A s d t..N Date: j b --) —0 $ days after it has been accepted as complete.
" Number of inspections allowed per permit.
1:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(t I /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL. WORKONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
n 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
n HVAC
❑ Instrumentation
n Intercom and Paging Systems
n Landscape Irrigation Control*
❑ Medical
n Nurse Calls
n Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1.\ Building 'Permits\ELC- PermitApp.doc 03/23/06
v L
,r cO 1)1 k" a(cj4 Ci 'rC.tivit ELECTRICAL PERMIT
V
CI OF `TIGARD
PERMIT #: ELC2008 -00571
1
° COMMUNITY DEVELOPMENT DATE ISSUED: 10/7/2008
TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136AD-05500
SITE ADDRESS: 06710 SW PINE ST ZONING: R - 4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: HATHAWAY
Project Description: (1) service and (4) branch circuits for bathroom and smoke detectors. 10/21/2008 ADDED (17) 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: 1 W /SERVICE OR FEEDER: 21 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 0 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:
DANNY HATHAWAY ELECTECH LIGHTING & ELECTRIC INC
6710 SW PINE ST 465 NE 181ST 189
TIGARD, OR 97224 PORTLAND, OR 97230
Phone: Contact #: PRI 503- 970 -4072
FAX 503 - 254 -6643
FEES
Description Date Amount Reg #: ELE C377
[ELPRMT] ELC Permit 10/7/2008 $106.90 LIC 168260
[TAX] 12% State Surchar 10/7/2008 $12.83 SUP 5337S
[ELPRMT] ELC Permit 10/21/2001 $113.05
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $246.35
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 throu.h 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.
1 ,
Issued By: �� /� Permittee Signature: `/ .j�co ' �(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.
CITY- OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00/571
13125 SW Hall Blvd., Tigard, OR 97223
AreArt400, DATE ISSUED: I 0M2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 461- 1i1.
INSPECTION WORKSHEET FOR DATE: 10122/2008 TIME: •7:00AM PAGE: 1 i
SITE ADDRESS: 06710 SW PINE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HATHAWAY
DESCRIPTION: (1) service and (4) branch circuits to bathroom and smoke detectors.. 10i21/2008 ADDED (17) branch
circuits.
OWNER: H ..,
A 1 I WAY, DANNY PHONE #:
CONTRACTOR: ELECTECH LIGHTING & ELECTRIC INC PHONE #: 503970-4072
Inspection Request Scheduled For: Date 10122r2008 Pour Time:
Code # Inspection Description ‘, Confirm Contact # Message
120 Electrical rough-in 077045-01 503-9704072 N
Corrections/Comments/Instructions:
)
PASS fl PARTIAL APPROVAL pi CANCEL n NO ACCESS
0 FAIL fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: '."--- • NO61...,C. Date: 1 01 2.3...\6-9, Phone #: (503) 718- 1L/46
e
CITE OF TICaAR® ,---, i Mr:
BUILDING DIVISION PERMIT #: ELC2008•00 ,71
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10 /7nOLL;f
Phone: (503) 639 -4171 Atepop , :1r i
Inspection Requests (24 Hrs.): (503) 639 -4175 U. A_I..
INSPECTION WORKSHEET FOR DATE: 10/21/2008 TIME: 7 :OOAM PAGE: 22
SITE ADDRESS: 06710 sww PINE ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HATHAWAY
DESCRIPTION: (l) rvice and (4) branch circuits For bathroom and smoke detectors.
OWNER: HATHAWAY, DANNY PHONE #:
CONTRACTOR: ELECTECH LIGHTING & ELECTRIC INC PHONE #: 4;03-970-4072
Inspection Request Scheduled For: Date 10/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 076976-02 503.970 -4072 N
Corrections /Comments /Instructions:
) ( I // 0 rill 4 I / ( /OM tif italkitA (/4 44) &)
t) &*-4 . 4 /4 /4/4/;),- Grn 4(--0 r ept i/ e -v /1 r)l (`i)
1V r - Zl o y �6)
a �
3) /s . p . 5i Al / ,� //
4 ,:44/ /-.e kei; Adv /de% / 2.- (37
itAz zia.5z
5) 510 pJ M 6#1,41e /Z lykiMg J *i ce (, 5l s)
9 I 1
A 1 0 = q 1 -1' � 14,04-9 ( 1 4 a k p i k o . / / 1 ; A 4 ) 2 A ) 7C ?' /G r *)
Pito 141/14-atilidke 7 li a476 =e_
n PASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL [ C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v ; Date: //Z 71 Phone #: (503) 718 - V ` 0
CITY OF TIGARD .--
BUILDING DIVISION PERMIT #: EL C2008-00671
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1017/2008
Phone: (503) 639 -4171 t Inspection Requests (24 Hrs.): (503) 639 -4175 .: ':� " ---
INSPECTION WORKSHEET FOR DATE: 10/21/2001 TIME: 7:C10A:+i PAGE:
SITE ADDRESS: 06710 SW PINE St CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: HATHAWAY
DESCRIPTION: (1) M.r�rvice and (4) branch circuits for bathroom and smoke detectors.
OWNER: HATHAWAY, DANNY PHONE #:
CONTRACTOR: ELt: CTECH LIGHTING & ELECTRIC INC PHONE #: 503. 970 -4072
Inspection Request Scheduled For: Date: 10/2/12000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 076975-01 503.970-4072 N
Corrections /Comments /Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL IN CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i&/? 1ioInspector: f Date: Phone #: (503) 718-