Permit CITY OF F TIGARD I GA R D ELECTRICAL PERMIT
III ° PERMIT #: ELC2009 -00062
° COMMUNITY DEVELOPMENT
DATE ISSUED: 2/17/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BD-06700
SITE ADDRESS: 11655 SW. _SRRINGWOOD_DR_„ ZONING: R-4.5
SUBDIVISION: ENGLEWOOD NO.2 LOT : 155 JURISDICTION: TIG
PROJECT: ANDERSON
Project Description: Install 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: SIGNAUPANEL:
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: 1 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:
SHANE ANDERSON OWNER
11655 SW SPRINGWOOD DR
TIGARD, OR 97223
Phone: 503 - 329 - 2903 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 2/17/2009 $86.95
[TAX] 12% State Surchar 2/17/2009 $10.43
Total $97.38 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 wit : - • one : - ordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
mor- an 180 days. A . NTIO . . • regon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OA" 952 - 001 -0010 through , • 95'- 00,0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Iss • ed By: - � � • Permittee Signature:
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: 7 /6?
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.
Y•Ele Permit Application FOR OFFICE USE ONLY
City and Received Pe No
`J of Tigard Date/By: o� /7 /Q 9 E,C ptGIOQ�p.�
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' Mi .' ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready /By: to IA See Page 2 for
Internet: www.tigard - or.gov Notified/Method: "/ I a Supplemental Information
TJI�P OF WORK PLAN REVIEW
❑ New construction LvJ 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
Iij- 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 ", "1 -2 ", "I -3 ", • Job no.: Job site address: �/ SS / S I OOHP or more occupancy.
s (� may L.4 'd/ ❑ Six or more residential units. ❑Recreational vehicle parks.
City /State /ZIP: / ❑ Health -care facilities. ❑ Supply voltage for more than
4.,/,a1' / 42/°. 9� 5 ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: � /S e . ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: / /SA /S /� ' o C,c.." 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'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
\ Limited energy, multi - family 75.00 2
1 0 9 ! / 1. (, Noe e (, residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less / 80.30 Fo. 59 2
PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: .....<;47.07/2 ./0:4-1,2/3" dH 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: f/65S SU S�YJ4., 0 ,,t;...3./ *-.47 Over 1,000 amps or volts 454.65 2
City/State /ZIP: �' Temporary services or feeders installation, alteration, and/or
,-/ j c.i� r (- 9 707 - 3 relocation
Phone: (so3 ) 3 9' _Z ye's 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 I 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
g 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 f 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
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 -
energy panel, alteration, 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 (I hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: g o • Q5
Print name: Date: Plan review (25% of permit fee): "er—'
State surcharge (12% of permit fee): /O, ' Pj
Authorized signature: TOTAL PERMIT FEE: ?
Print name: Date:
This permit application expires if a permit is not obtaine within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building '.PermitsELC- PermitApp.doc 05/23/06 440-4615T(I1 /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
❑ 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 A ,
BUILDING DIVISION PERMIT #: ELC2009-00062
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/2009
Phone: (503) 639
Inspection Requests (24 Hrs.): (503) 639-4175 -
INSPECTION WORKSHEET FOR DATE: 2/18/2009 TIME: 7:00AM PAGE: 27
SITE ADDRESS: 11655 SW SPRINGWOOD DR CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.2 LOT #: 155 TYPE OF USE:
PROJECT NAME: ANDERSON
DESCRIPTION: InEetall panel.
OWNER: ANDERSON, SHANE PHONE #: 603-329-2903
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2018/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 080582-03 503.329-2903
Corrections /Comments/ Instructions:
PRe•,,kos. A at:. ,
•
0 PASS 0 PARTIAL APPROVAL 0 CANCEL ( NO ACCESS
xi FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: "9. Cr. Nat.b Date: Tyla Phone #: (503) 718- DP146
CITY OF TIGARD
� f
I BUILDING DIVISION PERMIT #: ELC2009 -0000 2
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/2009
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 . _.11 "'IL.
INSPECTION WORKSHEET FOR DATE: 2/18/2009 TIME: 7 :00AM PAGE: 29
SITE ADDRESS: 11055 SW SPRINGWOOL) DR CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.2 LOT #: 155 TYPE OF USE:
PROJECT NAME: ANDERSON
DESCRIPTION: Install panel
OWNER: ANDERSON, SHANE PHONE #: 5n 329- 2903
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 211012009 Pour Time: 1
Code # Inspection Description Confirm # Contact # Message
115 E:leriria:ai service 080582 - 01 503 329 - 2903 N
Corrections /Comments /Instructions: 4P
<7 Ptkravlor. wweA) G C i c f ?
I(Z' , 'f 10 . I CS' 110. 1.I .
U PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
N AIL • ,CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G- ' NO€ L( Date: 11 I O g Phone #: (503) 718- %IiiyD
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200300052
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /17/2(09
Phone: (503) 639 -4171 ittar'
Inspection Requests (24 Hrs.): (503) 639 -4175 IL.
INSPECTION WORKSHEET FOR DATE: 21 /9/2009 TIME: 7 :00A1 1 PAGE: 28
SITE ADDRESS: 11655 SW SPRINGWOOD DR CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.2 LOT #: 155 TYPE OF USE:
PROJECT NAME: ANDERSON
DESCRIPTION: Install panel.
OWNER: ANDERSON, SHANE PHONE #: 503- 32379Q3
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/ 18/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 EIec1ri oh in 080582 -02 503. 328 -2903
Corrections /Comments /Instructions:
01 PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Gm N 06 LC. Date: Id 1'9 Phone #: (503) 718- 7-411/6
City of Tigard, Oregon Page 1 of 2
City of Tigard, Oregon r : t. : , ;
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'I Search I Property 1 Planning 11 Crimes I Transportation I 1 Uldities 11 1 Ae ials I 1 FN.: I Street Viers (I • Print
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11655 SW SPRINGWOOD DR
Property Summary
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Property Owner Info
Tax ID Number: 1S134BD06700
Tax Account Number: R265741
Site Address: 11655 SW SPRINGWOOD DR
Site City:
Site ZIP: 97223
Owner: BROWN, GEORGETTE & MONIQUE F
Owner 2: 11655 SW SPRINGWOOD DR
Owner 3:
Owner Address:
Owner City: TIGARD
Owner State: OR
Owner ZIP: 97223
Acres: 0.18
Sq Ft: 7,840.8
Bldg SF: 1,403.00
Bldg Value: $ 102,310
Land Value: $ 184,000
Total Value: $ 286,310
Taxable Ass'd Value: $ 144,250
Sale Price: $ 0
Sale Date:
Year Built: 1976
District & Community Info
Municipality: Tigard
Tigard Urban Sery Bndry: YES
Tigard Neighborhoods:
L Name Link to Website
Area 2 Amp 2 Neighborhood New
Water Service Area: Tigard Water Service Area
http: / /tiggisiw /mox52_multimap/ index. cfm? fuseaction= property.summary &CFID= 104535 &CFTOKEN =... 2/18/2009