Permit 'j CITY O TIGARD
ELECTRICAL PERMIT
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PERMIT #: ELC2008 -00097
°_` , COMMUNITY DEVELOPMENT DATE ISSUED: 2/25/2008
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IGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 111 AB -08000
SITE ADDRESS: 14435 SW 93RD AVE ZONING: R -4.5
SUBDIVISION: PENROSE TERRACE LOT : 025 JURISDICTION: TIG
PROJECT: BILGERE
Project Description: (2) branch circuits for bathroom remodel.
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: 1 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:
GERALD &DANIELLE BILGERE OWNER
14435 SW 93RD
TIGARD, OR 97224
Phone: 503 - 639 -3466 Contact #:
FEES
Description Date Amount Reg #:
IELPRMTI ELC Permit 2/25/2008 $53.50
!TAXI 12% State Surchar 2/25/2008 $6.42
Total $59.92 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 95 1 - 0010 •ugh 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.
Iss d By: \ �� Permittee Signature: k �
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent. (�
OWNER'S SIGNATURE: — ■ _ � � s 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 §7,..1 " .a TOR OFFICE USE ONLY 0 •
� e., Received ,. :r. n/ i
'k �,'y' City of Tigard Date /By: i " . / ,` p g Permit No.: 1.� -6210-
a' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
® Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
otG A R 1t:
-a; Inspection Line: 503.639.4175 - _.- . Date Ready /By: �furl � � ® See Page 2 for
mi*�i�C"•� Internet: www.ti and - or. g g ov Not ified/Method: / ! 6 Supplemental Information
Su PP
- TYPE OF WORK PLAN REVIEW .
❑ New construction 0 Addition/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
El 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 ", "I -2 ", "I -3 ",
Job no.: Job site address: 14 4 3 vJ el 3'` f/„5.— 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: ( (c. 4) ,.d 1' € - 7 Z z 'i ❑ Health facilities.
. 600 Supply volts voltage for more than
❑ Hazardous locations. volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE-SCHEDULE
Cross street/directions to job site: J:J JE z_ 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. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 l
Tax map/parcel no.: Limited energy, residential
. DESCRIPTION OF WORK. (with above sq. ft.) 75.00 2
Limited energy, multi - family 75.00 2
Rat; )ec- 3t4 H'l TOc y+-, , j' -' residential (with above sq. ft.)
- Services or feeders installation, alteration, and/or relocation
C J t ` - C_ t • .
r?
a-v
rv■ • OX 200 amps or less 80.30 2
. ® PROPERTY OWNER ❑. TENANT 201 amps to 400 amps 106.85 2
Name: l �t =�'At 1J �j(LC�,ec 401 amps to 600 amps 160.60 2
A 601 amps to 1,000 amps 240.60 2
Address: j s- 4 3 '5 A) 9 rd / ` ✓c= Over 1,000 amps or volts 454.65 2
City/State /ZIP: 'r(, {a z1 v 9 Z Z. `f Temporary services or feeders installation, alteration, and/or
relocation
Phone: ($a3 ) 6 - 3% C 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
6==',a).--)._2> Branch circuits - new, alteration, or extension, per panel
Owner signature: W Date: 2 %25/Ie 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 14.15 2
first branch circuit
Address: Each MO branch circuit / 6.65 6 45 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: Signal circuit(s) or limited -
F ex erny pan aleetion, or
Address: 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 (1 he min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES - _t_ —:__
Suprv. Electrician signature, required: Subtotal: 3' �
Print name: Date: Plan review (25% of permit fee): -er
5 State surcharge (12% of permit fee): Co . q ( p
Authorized signature: TOTAL PERMIT FEE: / J. 9 3
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
" Number of inspections allowed per permit.
It\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(1t /05 /COM/WEB
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
n 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 OF TIGARD
BUILDING DIVISION PERMIT #: EL 02008.00097
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2I25/2001F1
Phone: (503) 639 -4171 • i p 1� -it
Inspection Requests (24 Hrs.): (503) 639 -4175 .. =,
INSPECTION WORKSHEET FOR DATE: 2I26'2008 TIME: 1:00AM PAGE: 10
SITE ADDRESS: 14435 SW 93RD AVE CLASS OF WORK:
SUBDIVISION: PENROSE TERRACE LOT #: 025 TYPE OF USE:
PROJECT NAME: f3II.GERE
DESCRIPTION: (2) branch circuits for bathroom remodel.
OWNER: f3ILGERE, GERALD &DANIELLE PHONE #: 50.3.639-3466
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/26/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 065660 -01 503633.3466 ` Y
Corrections /Comments /Instructions:
P-
•
PAS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: G ----- . Iv ti6 L.-G Date: )-- Phone #: (503) 718- 1-41-40
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