Permit CITY OF TIGARD ELECTRICAL PERMIT •
PERMIT #: ELC2008 -00686
�` COMMUNITY DEVELOPMENT DATE ISSUED: 12/30/2008 .
4-168Ro 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110AA 03100
SITE ADDRESS: 14040 SW 105TH AVE A ZONING: R -12
SUBDIVISION: EMMET'S WEST ONE LOT : 003 JURISDICTION: TIG
PROJECT: KENDLER •
Project Description: Panel change.
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: . SIGNALJPANEL: •
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:
ILA V. KENDLER WEST SIDE ELECTRIC CO INC
19733 VOLAI RE LN 1834 SE 8TH AVE
BEND, OR 97702 PORTLAND, OR 97214
Phone: 541 - 317 -9299 Contact #: FAX 503 - 231 -9987
PRI 503 - 231 -1548
FEES .
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 12/30/2007 $80.30 LIC 13306
[TAX] 12% State 12/30/20W $9.64 SUP 46545
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
suspende,d-for more`the 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those Liles are set forth i OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.2 6.6699 or 1.800.33 34)4.7' • • . L
i f •
•
Issue By: � , ! `, `,:,/.'I' '..._.{ _ P ermittee Signature: i ael-J
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: t t� -�-� -- 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.
INSPECTOR'S SIGNATURES ARE NOT '
Inspections Required for: ,/,_z_kUci..e)i ( � ( � REQUIRED ON GREEN INSPECTION CARD.
le Code I Inspection Description PASS Date I By I I Code I Inspection Description I PASS Date I By
•
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading ›.G 115 Electrical service
205 Footing / 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural . 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors >e 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
•
340 Storm drain
•
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing _ 399 Plumbing final
'210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\ Building \Forms \InspCard- AOP- Blank.doc 02/02/07
CITY OF TIGARD ELECTRICAL PERMIT
mi 1 = COMMUNITY DEVELOPMENT PERMIT ED : ELC2008
DATE ISSUED: 12/30/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S110AA
SITE ADDRESS: 14040 SW 105TH AVE A ZONING: R -12
SUBDIVISION: EMMET'S WEST ONE LOT : 003 JURISDICTION: TIG
PROJECT: KENDLER
Project Description: Panel change.
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:
ILA V. KENDLER WEST SIDE ELECTRIC CO INC
19733 VOLAI RE LN 1834 SE 8TH AVE
BEND, OR 97702 PORTLAND, OR 97214
Phone: 541 - 317 - 9299 Contact #: FAX 503 - 231 - 9987
PRI 503 - 231 -1548
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 12/30/2001 $80.30 LIC 13306
[TAX] 12% State 12/30/200/ $9.64 SUP 46545
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 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those "les are set forth i OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.2 6.669 9 r 1.800.33 344. /
I
•
ssue By: �/ik 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: t4 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.
cla\TED �
Electrical Permit Applicll t FOR OFFICE USE ONLY
Cit y b of Tigard 2008 Received `
i n DEC Ott (� G� Date /B : 1 -,2 -_ _ _ Permit No.: eft: 0. .: ,
.t5 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.41 71 Fax: 58 J[t)sr 11GARD Date/B : Other Permit:
TIGARD Inspection Line: 503.639,4175 [ VISION Date Ready/By: iuris. la See Page 2 for
Internet: www.tigard- oebovBU�iNG D Notilied/Method: Supplemental lnfornwti „4
TYPE OF WORK PLAN REVIEW
❑ New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans wlitems 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 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" "b -2" "I -3"
Job no.: j Z y`76 Job site address: �O �-P19 SL / 0 A „, S o or more. oec na
❑ Six x or r more residential units. ❑ Recreational vehicle parks.
.. City /State /ZIP: � f �, j C� '7 2-1. [ f ❑ Heaiih•care facilities. 0 Supply voltage for more than
` 1 ❑ Hazardous locations. 600 volts nominal.
Suite /bldg.apt. no.: Project name: Y et f / 1 J1E-./ ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site:
Description 1 Qtr. I Fee. I Total I
New residential single- or nwlti- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or less 145.15 4
Ea. add'! 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
t�1
Limited energy, multi- family
75.00 2
V C( vl{..' L� ,_ residential (with above sq. tt.)
Services or feeders installation, alteration, and /or relocation
200 amps or less l 80.30 90.30 2
PROPERTY OWNER r ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ' '( (cc V�-G `^ `' (� 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: ^7 l / r
1 G '7 7 V G f Gr ivy, G L c Over 1,000 amps or volts 454.65 2
City /State /ZIP: , 2 7 7 ) U a Temporary services or feeders installation, alteration, and /or
t relocation
Phone: ($4'J) 31 -q f 9 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that 1 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,
each branch circuit 6.65 ?
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'! branch circuit 6.65 _ 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
Phone: dwelling, service and/or feeder
l hone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: GLENNG @WESTSIDEELECTRIC.COM Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: NEST SIDE ELECTRIC CO. Signal circuit(s) or limited -
energy panel, alteration, or
Address: 1834 SE 8TH AVE. extension. Describe: Page 2 2
City /State /ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 231 -1548 Fax: (503) 231 - 9987 Investigation per hour (1 hr min) 62.50
CCB Lie.: 13306 Electrical Lic.: 26 - I35C Suprv. Lie.: 4654S Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: I '"
Ci ` ✓ .. ` Subtotal: g O, Z 0
Print name: RANDALL ROBERTS Date: / L lq 03 Plan review (25 %ofpermit fee):
State surcharge (12% of permit fee): of r 6/4
Authorized signature: TOTAL PERMIT FEE: 1 e/ ,q Lr
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,
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Z/ Z 900Z - Z l 6Z 6l LZ L966I.£Z£09