Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2009 -00048
COMMUNITY DEVELOPMENT DATE ISSUED: 2/3/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135CD
SITE ADDRESS: 11435 SW GREENBURG RD ZONING: R -4.5
SUBDIVISION: GREENBURG HEIGHTS LOT : 005 JURISDICTION: TIG
PROJECT: REED
Project Description: (1) branch circuit for furnace.
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 AREAJSPEC OCC:
Owner: Contractor:
KATHY REED OAKLEY ELECTRIC INC
11435 SW GREENBURG RD 11500 SE SUNNYSIDE RD APT N -15
TIGARD, OR 97223 CLACKAMAS, OR 97015
Phone: Contact #: PRI 503 - 855 -4712
FAX 503 - 855 -4723
FEES
Description Date Amount Reg #: ELE C456
[ELPRMT] ELC Permit 2/3/2009 $46.85 LIC 184315
[TAX] 12% State 2/3/2009 $5.62 SUP 5176S
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 -fo h 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. —
Issued By( I � i iL _ Permittee Signature: APS -'����� / j—rit
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 TIO " N ONLY
SIGNATURE OF SUPR. ELEC'N: _`•. - �� ' " C /c) 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.
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Electrical Permit Applica io
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Received ...,, •
Date/Bv: ot • a .09_ ,:.
v.4 CIROFFICE USE.ONLy • ,.. : , .
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Permit Nu
- CIO 7000 190(74
City of Tigard el JA , 9 2009
• 13125 SW Hall Blvd., Tigar , ID 97 3
lir .
Phone: 503.639.4171 Fax: 503.598.196(r Ty Or - -
r ■ ' RD Plan Review
Dale/B : Other Permit: ry : 7
Inspection Line: 503.6'39.4175 • Date Readv!Bv: turis: 121 See Page 2 for
TIGARD BUILDING DIVI --, i
_ , Notifie d/Method: C
Internet: www.tigard-o:r.gov Supplemental Information
- " ....••'•,::: ::.. -l'l ' :.; .:-', :: - 1 :--.. :::;* ' . , :. 1 iLfli't .pi',:ly0W . •::::.-.•;:i.•;,• :::: :: • - :':•::- - '-:"-- :':•.:.': •-:' • .'•?1,AN REVIEW -: : - ...r..
D New construction [8] Addition/alteration/replacement Please check all that apply (submit 2 sets of plans se/items checked below):
1:1Service er feeder 400 amps or more 0 Building over three stories.
CI Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
;:. , ''''' OF CONSTRUCTION , ,:',•,,:.,:.••:•':-‘,.•--, • . exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 0 Commercial-use agricultural
El
I - and 2-family dwelling E Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi D Master builder 111 Other: 0 Fire pump. 0 Installation of 7 5 KVA or
-- . - - - - - • . , . . , . . „ .. -, ClEmer2ericy system larger separately derived system.
..;.,.. .. 1 ::: i prOgiVIATICANID 'LOCATION :1:. ":. • ;:. . • '..:...' ...' ' n. D Addition of new motor load of ID
100HP or more. occupancy.
Job no.: Job site address: 11.4., S. t.i 7-ini, 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: -r • 1 0 Health-care Facilities. 0 Supply voltage for more than
, I .. 144 r I , e....6:......_,/....___LL.g23 0 Hazardous locations. 600 volts nominal.
Su ite/bldg/apt. no.: Project name: Q r V: inf El Service or feeder 600 amps or more.
i..it ce e t. ,4
.. :.. .• • ""'''. .-,...,:.. ..:FEE SCHEDULE •: i. :.-.,.,• .• ----- --
Cross street/directions to job site: Description I Qtr. I fee. 1 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
Ea. addl 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
,.., Limited energy, residential
75 .00 2
. ., ,-:. -; .' • '..4 • ' '1:' .: 1 OF WORK • • ::. ' .- -, ...,•:.., : (with above sq. ft.)
Limited energy, multi-family
75.00 2
)r4i2.o X. up 1 a , n., c. residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
.,. ,,.. , . .. •,. .. , 200 amps or less 80 30 2 .
. . . . :•• ,..
:..::.•,;..• ,- : •• ..,[14.FiOgit.T.Y:l9WNER - ': ...... ,' :.' -- 1: - .' l-1 1:•E ., 0 TENANT n'jn.' 201 amps to 400 amps 106.85 2
401 amps 10 600 amps 160.60 2
Name: k , h i v i l ec ..."
601 amps to 1,000 amps 240.60 2
-__)
Address: i i ‘ .35 p ts, . Over 1,000 amps or volts 454 65 2
[..) Temporary services or feeders installation, alteration, and/or
CityiS 7 / 0 g 712 3
relocation
Phone: ( ) Fax: ( ) 200 amps or less I 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps 10 400 amps 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 1 2
Branch circuits - new, alteration, or extension, .er panel
Owner signature: Date: A. Fee for branch circuits with .
. . . .. . . . .
-:; :-....2 .: ....El . ....MEACPIt. ,.:':I.:',.;:•:.r:i .:'!' .... - above service or feeder fee,
6.65 2
each branch circuit
Business name:
Oct inIZny :l::/c - trz - r - , z < - B. Pee for branch circuits
without service or feeder fee, .1
46.85 if‘. t )-5
Contact name: '-
me: , F; T i e ir / T
first branch circuit
Add n./ Each add'l branch circuit 6.65 2
ress: //s. 3 7,- . 5. / , c ',. dr i . / ,,,,,,, . -"V- .r
Miscellaneous (service or feeder not included)
City/State/ZIP: 6 4 , x / eiA i 7 7 ,,,.. 5 Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: (.) ) f 55, v7,,z F ax: : ( S. 5 ) 15.5" - 9 ' . Tz 3 Reconnect only 66.85 2
E-mail: 113d cr 'nen ee 61,2 c'.1c C /cc . ' c ,A.-, . Pump or irrigation circle 53 40 2
& :,;' Sign or outline lighting 53.40 I 2
Signal eircuit(s) or limited-
Business name: a k- / ::_y . F / ,.._ 1 L. Z 7 energy panel, alteration, or
extension. Describe: Page 2 2
Address: 11S4 ' 56 c ,, i 5 ,. , , ,O . + 1 --1.- - l -
L.I Each additional inspection over allowable in any of the above
CityiStateiZIP: i7 , .., f?,,is
Per inspection 62.50
Phone: ( j 5 ) /-5 5 - 2 ; Fax: ( .f.3 ) ;GU - - 7 z ? Invest igation per hour (1 he min) 62.50
CCB Lie.: /4 C/3/ 3 Electrical Lie.: 6 s b Suprv. Lie.: 5 i 7 ‘• .2 Industrial plant per hour 73,75
., - n'.. • . ELECTRICAL PERMIT FEES • • •
Suprv. Electrician signature, required: "
'. ; 9-----r- ?"----- Subtotal: V‘ - - --C
Plan review (25% of permit fee):
Print name: 77. •
7 ey . 7-C ate:
f r D
State surcharge (12% ofpermit fee): „... ".5- 7 -r3 5. (
Authorized signature: 7 7 ___ -- TOTAL PERMIT FEE: 57,-91 52.47
This permit application expires if a permit is not obt;ined within 180
Print name: . 7:,. ,. ./ Date: days after it has been accepted as complete.
. Number of inspections allowed per permit.
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Z'd CZL)7 999 (cog) ,
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INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: �r.��0a9 - 000 L ' REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection.Description • " PASS Date. • By • ✓ 'Code Inspection Description • • 'PASS pate - • B
BUP - Building Permit • ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 • Temporary electrical service
415 Grading 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 / 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 PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection: p g
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
j 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: \}3uilding \Forms \ lnspC ; ard- AOP- Blank.doc 02 /02/07