Permit J Tq OF IGA(4D 11 .;`00 PECTRICAL PERMIT
PERMIT #: ELC2006 -00720
COMMUNITY DEVELOPMENT • • DATE ISSUED: 12/20/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136DD-01200
SITE ADDRESS: 11600 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT : 002 JURISDICTION: TIG
Project Description: (1) branch circuit for generator. 02/08/2007 Add 200amp feeder.
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: 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 AREA/SPEC OCC:
Owner: Contractor:
SEAN MATHEWS OWNER
11600 SW 69TH
TIGARD, OR 97223
Phone: 503 - 804 - 7642 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 12/20/200( $46.85
[TAX] 8% State Surcharge 12/20/200( $3.75
Total $50.60 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:
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.
j T OF TI G AC4D ';-°D411119 PARICAL PERMIT
• 4 PERMIT #: ELC2006 -00720
COMMUNITY DEVELOPMENT DATE ISSUED: 12/20/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136DD-01200
SITE ADDRESS: 11600 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT : 002 JURISDICTION: TIG
Project Description: (1) branch circuit for generator. 02/08/2007 Add 200amp feeder.
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: 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 AREA/SPEC OCC:
Owner: Contractor:
SEAN MATHEWS OWNER
11600 SW 69TH
TIGARD, OR 97223
Phone: 503 - 804 -7642 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 12/20/200( $46.85
[TAX] 8% State Surcharge 12/20/200( $3.75
Total $50.60 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:W 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:
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.
CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2006 -00720
COMMUNITY DEVELOPMENT
DATE ISSUED: 12/20/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136DD
SITE ADDRESS: 11600 SW 69TH AVE ZONING: MUE
SUBDIVISION: WEST PORTLAND HEIGHTS LOT : 002 JURISDICTION: TIG
Project Description: (1) branch circuit for generator.
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 AREA/SPEC OCC:
Owner: Contractor:
SEAN MATHEWS OWNER
11600 SW 69TH
TIGARD, OR 97223
Phone: 503 - 804 -7642 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 12/20/200( $46.85
[TAX] 8% State Surcharge 12/20/200( $3.75
Total $50.60 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: '7 f 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:
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 ApplicatioRECRVED volt orvicr. t)sE o\l.N.
City of Tigard f ' jived /
3` � C � �� /�
q 13125 SW Hall Blvd, Tigard, OR 9722 Permit No C. t /!
Plan Review
Phone: 503.639.4171 Fax: 503.598.1 E/T, B . Other Permit:
Inspection Line: 503.639.4175 U 1 t' ® 3 �8(;Al1D D y/gY ® See Page 2 for Iii= T I c A I: D te BUILDINe DIVISION
Internet: www.tigard- or.gov Noti6ed/Method Supplemental Information
. TYPE OF WORK PLAN REVIEW
❑ New construction 'Addition/ alteration /replacement Please check all that apply (submit a sets of plans wftems checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other:
w the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
1- and 2- family dwelling ❑ Commercialimdustrial ❑ Acces buildin 1escto ground, e exceeds ons. ❑ Commercial -use agricultural
�'y g amps f« all other installations. buntings.
❑ 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 ", "1-2 ", "1 -3 ",
Job no.: Job site address: 11 / 6 SW 69 k ❑ loot>P or more. ue�oY• parks.
Six «more residential units. ❑ Recreational vehicle
City /State/ZIP: J.1/ , ( 72'J ❑ Health-care facilities. ❑ Supply voltage for than
./"" ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt no.: 1 Project name: 0 Evveetj letr ❑ Service or feeder 603 amps or more.
FEE SCHEDULE
Cross street/directions to job site: bo yht D,.a+pdua 1 Qy. 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
Tax map /parcel no.: Ea. add'I 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
.
)"$¼11 su 6 pim eP i AtS fn gei, Am k/r residential (with above sq. ft.)
Services or feeders installation,alteration, and/or relocation
200 amps or less 80.30 2
PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: sec, H rmGlfrt ew f 401 amps to 600 amps 160.60 2
Address: 1 600 So / Q 601 amps to 1,000 amps _ 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: lf„r,,,,l Ott q711.3 Temporary services or feeders installation, alterat ion, and/or
/"' " relocation
Phone: (SO3 ) gO e./ 76 tit I Fax: 603 ) U? ) ?71 200 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, or exchange, wording to ORS 447, 449, 670, and.701. 401 amps to 599 amps _ 133.75 2
/ / Branch circuits — new, alteration, or extension, p e - r panel _
Owner signature: Date: `r' ( 4 � A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
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 2
Miscellaneous (service or feeder not included)
City/ State /Z1P: 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 (1 hr min) .
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 -
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Date:
Plan review (25% of permit fee):
State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE: 3 k. 6 a
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.
I:' Building\Pamia\ELC- PermitApp.doc 05/23/06 440- 4615T(11/o3ICOM/wEa
•
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for X11 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 earl commercial $75.00
system
(SEE OAR 918 -260 -260)
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:\Bui ding\Pamit \ELC- PamitApp.a« 0323/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 00720
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: '12/20/2006
Phone: (503) 639 -4171 1 ' AOI
Inspection Requests (24 Hrs.): (503) 639 -4175 ` .
INSPECTION WORKSHEET FOR DATE: 2/21 /2007 TIME: 7 :OOAM PAGE: 53
SITE ADDRESS: 11600 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 002 TYPE OF USE:
PROJECT NAME: IWATHEWS
DESCRIPTION: (1) branch circuit for generator. 02/08/2007 Add 200amp feeder.
OWNER: MATHEWS, SEAN PHONE #: 503-804 -7642
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/2112007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 043555 -01 503-804 -7642 N
Corrections /Comments /Instructions:
x i PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1.--t" Date: 2 � �'� -6 7 Phone #: (503) 718-
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: ELC200G -00720
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/20/2006
Phone: (503) 639 -4171 �'
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/7/2007 TIME: 7:01AM PAGE: 46
SITE ADDRESS: 11600 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: WEST PORTLAND HEIGHTS LOT #: 002 TYPE OF USE:
PROJECT NAME: MATHEWS
DESCRIPTION: (1) branch circuit for generator.
OWNER: MATHEWS, SEAN PHONE #: 5038047642
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Misc. inspection 043068-01 503-804 -7642 Y
Corrections /Comments /Instructions:
D Q R. c�arv1 F - ri FlUC.. 0 N l- bz . 0-2-00A
hMtiNU 6F c - ( 6 0 \ ) ( ' 1 E S ( l . p o `U bval c) /
•v� �2� 318�1�b, 4 12 kit, 14 1111 Ft ICAmps.
® si kA p CA- -7k p
141 cRio 040 \J t bi3azt4
f1/41 G-4 s oct_. GoN
*PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL yj CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` ��� Date: 69 Phone #: (503) 718-