Permit -IN CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00613
COMMUNITY DEVELOPMENT DATE ISSUED: 10/31/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 101 AA -08100
SITE ADDRESS: 12480 SW 68TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT : 028 JURISDICTION: TIG
PROJECT: HAYDEN CONSULTING ENGINEERS
Project Description: TI.
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: 5 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:
FUEGY, ALLEN AND RAYMOND LIGHTHOUSE ELECTRIC LLC
12480 SW 68TH PKWY SUITE A 27750 SW 95TH AVE # 109
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 - 582 -9600
FAX 503 - 582 -8484
FEES
Description Date Amount Reg #: ELE 3 -562C
[ELPRMT] ELC Permit 10/31/2001 $80.10 LIC 154897
[TAX] 12% State Surchar 10/31 /2001 $9.61 SUP 30518
Total $89.71 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 may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: /f >A01./
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.
TIectrical Permit Application FOR OlI"1CI USE ONLY
City of Tigard Received
1 ,1 n 13125 SW Hall Blvd., Tigard, OR 97223 Platc/0 ' �� ' ' � ' .41 6 Plan Review • q QC�! Phone: 503.639.4171 Fax: 503.598 Date/3 Other Pctmit:
TIGARD inspection Lino: 503.639,4175 C Datc Ready /By: IIMI El gee Page 2 for
Internet:: www.tigard or.gov QQ Notified/Method: Supplemental information
- i ;,, : WfC • ,��I; 5 ; : o JSti, Vii" + - •. i .,,. . , �c.. u+' ,�r'a; " 'r,, c,if. °i x' "'' �' ' '4i , r u l "" r' +'7fitt �" Pl d� r
I, ; c • '+ � � -`' '� �O '. ° °!.' ? -,,., '::K; ;�,', w,1� %.,....i o.f' i (1, J1'•. t , ".ia i � v+rra�Eir�' '�`c .z..h "� .
di` t< " � � � ? " �" °, '; A' �. S L;�;';: �:�C��(� r� i rS,W '., tI�' %�.... ,�1., ..� �. ,(
n � C1 1 �:CtAI � � k a.., •,'. :. „ '.>ti' - "i � -�itt 11 Vim'
"_ , N.,.r..,......,.r Q'.. r1�J- S rta 'irP'a�'d.
0 New construction Addition /alterati011/Y ++ ° ••tr Please cheek all that apply (siihmlt 2 sets of plans w /hems checked below):
❑ Ci'g 1 VIS10N ❑ Scrvicc or feeder 400 amps or more CI Building over three stories.
ID Demolition Other: (;D where the available (hull current ❑ Marinas and boatyards.
t "''" p,�� ,yp. ` y li . , ! . i t :4 ;..m 11.:p• \ ,,: 01.,,lo'' ' excee s 10,000 s a 150 volts
N t , §n ' a S r � 0 -r o.. re„n:�.• - -1, ,. '. . to 4 d' n r � ", y ; , c I�tir . r ( •, leas to ground, or exceeds 14,00 0 Commercial - a agricultural
❑ 1 and 2 family dwelling ® Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master huilder ❑ Other: D Firc pump. CI installation of 7S KVA or
' qq r� ;fir. + lr eyi�.f qDy/ ,�, „�Sy� y4nyC� -,i�; y.� -., 9.r ,•!",,t 9 ,. ,l ❑1:mCr(;G1ley system. larger separately derived system.
i a � ; ' °N1\Ne xlx , 'f h�:1lUV1 7 'r ry;k `,;,V 1' ;V , ; r N.,. I
� �' a' .r~rr r -vr qc r .sor•n -• • 4aa.." �r r,". k:, �„ t��� .�?''� ..itt;,.t;,:i:;��r.�:.ri i1ia ['Addition of new motor load of ❑ »A••, "E °1.2» „ 1.3 ",
Job no.: HCE I ]oh site address: 12480 SW 68 T11 AVE UNIT A & B 1 OOHP or more, occupancy,
❑ Six or more residential units, ❑ Recreational vehicle parks.
City/Statc/Z1P: TIGARD, OR ❑ Health•caro faclHNes, ❑ Supply voltage for more than
❑ I•IsTmdous locations, 600 volts nominal.
Suite/bldg. /apt. no.: A/B 1 Project name: HAYDEN ❑ Service or feeder 600 amps or more. �y
, tdeja . ' ,W i ll � a' ;', -i f"''akt' C i' �� _ I,IUi rik:'n�;tt igT '�2 % ., ;:its 1 ; ire
Cross street/directions to, job site: T me , ar tleu l� •!k >i, lt i,�. ,. y y ty'
TtP I QtY, I Fee. I TOtnl •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 _ 1
Tax map /parcel no.: Limited energy, residential
g�+� p��} Y �r f1° ry `� wu ,, +1,;i` 1 4p1:i r d! 75.00
�Wl l 1 lf4wii ag :1}kl( }� 1 AACI,N 0011, .;1':. ( . ;; p� a 'f4=, (w nbova f
sq. l.) 2
�1!S FY + p .v r f611.. , m -: v r�;4,. ,Aitt3„rS�.r. , sr..!tFp. is��'d•':.,;� >..,, ��.
TENTANT IMPROVEMENT - BOTH UNiT A AND B ARE BEING Limited energy, multi-family 7500 2
COMBINDED INTO ONE BUIDLING residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
?O < > €� ri t` "ri;;lYj'4,l�y t ; ':Yrn;� , ' + yai.illl Pile s' r'i , `'l ' 20 amps to 400 amps 6.85 2
r �t t . k + X.o �,r , \ .;. .6 r' +,n \ ug I t 1, P P
s A,P �h r� +e- ,.✓: s� tMt, '§��� � , ; . r..f..;;•.:�.,r!';:e ^,; �� 10 ..
401 amps to 600 amps 160,60 2
Name: HAYDEN CONSULTIN ENGINEERS 601 amps to 1,000 slaps 240.60 — 2
Address: 8255 SW HUNZiKER ST SUITE 201 Over 1,000 amps or volts 454.65 2
Temporary services or feeders Installation, alteration, and /or
City/State/ZiP: TIGARD OREGON 97223 relocation
—
Phone: ( 503)968 -9994 Fax: (503)968 -8444 200 amps or less 66,85 I
201 amps to 400 atnps 100.30 2
Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits— new, alteration, or extensiori panel —
Owner signature: 3•r7p��� �yy.{{qq Date: A. Fee for branch circuits with
.. . ;wia7x..� t 1,fi'R: AZ J' � y '7- h•,,,r. r • •` a +. , r; !", above SC rvc or feeder fee,
each pry t�A, �v v' "" m. . -r,. .., -,. x # ` Yd i�Y Y ch brh 6.65 2
�' cbranch circuit
Business name: B. Fec for branch circuits
without service or feeder fcc, 1 46.85 46.85 2
Contact name: first branch circuit
Address:
Each add'I branch circuit 5 6.65 33.25 2
Miscellaneous (service or feeder not included)
City/State/ZIP: dwell i manufactured g e and /or modular r 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
14 ', . t r 1 r " c , r, ;• �".r.••.r Sign or outline lighting t ,:}. ..j .... 1Vi1GtiCf«{ „z�rrka t4:`e i�.4:�i w:<r fi, Signal oircuit(s) limited-
53.40 2
ted -
Business name: LIGHTHOUSE ELECTRIC 1.1.0 energy panel, alteration. or
Address: 27750 SW 95 AVE extension. Describe: Page 2 2
SUITE 109
City /State /ZIP: WILSONVILLE, OREGON 97070 Each additional inspection over allowable in any of the above
- Pcrinspection 62.50
Phone: (503) 582.9600 Fax: (503.) 582.8484 investigation per hour (1 hr min) 62.50 T
CCB Lic.: 154897 Electrical Lic.: 3 -562C Suprv, Lic.: 30518 Industrial plant per hour 73.75
I ,« i:; 1 � ft�'rT,�ll 1 sT,” r, F4�� ,�,i����•.;�lr' "•�
Suprv. Electrician signature, rcg tli ��t�( Subtotal: 80.10
j ) ( � Plan review (25% of permit fee):
Print name: RANDY 1-TILL ` Date: 10.31.08 State surcharge (12% of permit fee); 9.61
Authorized signature: TOTAL PERMIT FEE; 89.71
This permit npplicntion expires If a permit is not ebtnincd within 180
Print name: Date: days rafter it hna been accepted ne complete.
' Number of inspections allowed per permit.
l:tauilding\Permht\ tl,C•PetmitApp deo 05/23/01 4404615T(11/05/COM/WEn
CITY OF TIGARD i
BUILDING DIVISION PERMIT #: ELC2008.00613
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/3.1/2008
Phone: (503) 639 -4171 sn lol
Inspection Requests (24 Hrs.): (503) 639 -4175 1.
INSPECTION WORKSHEET FOR DATE: 11/25/2008 TIME: 7 :01AM PAGE: 41
SITE ADDRESS: 1248(1 SW 68TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 028 TYPE OF USE: ' C r
PROJECT NAME: HAYDEN CONSULTING ENGINEERS
DESCRIPTION: TI.
OWNER: KELSCOR LLC, PHONE #:
CONTRACTOR: LIGHTHOUSE ELECTRIC LLC PHONE #: 503 -582 -9600
Inspection Request Scheduled For: Date: •11/25/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 07845401 503.582 -9600 N
Corrections /Comments/ Instructions:
'ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Date: if -2 S --,JV Phone #: (503) 718-