Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00861
• COMMUNITY DEVELOPMENT DATE ISSUED: 12/24/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112CD - 00900 i
SITE ADDRESS: 16060 SW 76TH AVE ZONING: R -
SUBDIVISION: DURHAM ACRES LOT : 001 JURISDICTION: TIG
PROJECT: RIVA
Project Description: 200 amp service.
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:
RIVAS, ERNEST ROSE WINNER ELECTRIC INC
16060 SW 76TH AVE 5950 SW PROSPERITY PK
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: Contact #: PRI 503 - 638 -5028
FAX 503 - 638 -4242
FEES
Description Date Amount Reg #: ELE 34 -150C
[ELPRMT] ELC Permit 12/24/200' $80.30 LIC 14794
[TAX] 8% State Surcharge 12/24/200' $6.42 SUP 2825S
Total $86.72 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 throu•h 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: r 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: 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.
„ f 'r , ,n.:,....,
i kki ( zuf zUU4 09 : 38 FAX 5 5tillef 0 ,..r \j” ''' OF TIGARD •
F
.t. ._•-•,,.4.-- zooi
Electrical Permit ApP1icatjg * 4 4 nal FOR OFFICE USE ONI..lf
City of
13125 SW Hall Bl liec
. „ or 1 i' 11 . e
I s . . Datc/B : 2- o -- 7 4.z 3 P 2 'OD f9
ga vd., Tigard. OR 9722 e 1 - A. .... ,. , -lpi a „R eived evicw
Phone: 503.639.4171 Fax: 503.598.1960' . - TIN:110 :1G It .",•;,i'Pri,ill'i'' Daten ! Other Permit:
InspoCartren 7'3037539.4175 B 11 s.SI. , Dote Reatly/Sy: tuns, IE See Page 2 for
Internet; www.ei.tigard.or.us Notified/Method:
Supplemental information
Ii,'..1,!!!"'.,::41*IZt1.011.I.i., ' !.' , i4 11 : 1 ■!! 11 ; 1 1 : :' :..:. ' [.. i' :::':':i:.!:.'t,'. 77 . 77 .7 , 7:10; 1 V , ! ., ...:::.!::'81**1!Ilii! . :!;:'.. ::,... ' ..;,:::,.::.., :.•. ..
0 New construction 0 Addition/alteration/replacement Please check all that apply:
EIScrvice over 225 amps, comm'l CHazardous locution
0 Demolition 0 Other:
,„ , , „ OService over 120 amps - rating ['Bating over 10,000 sq. ft.,
;;I;.:IIIIIfIllifdijiiIIIII;I!:IHII.:III■liiTil 151: : ,041 00*.40fi:14 i ,i si iitiiP# 1 .0. , , .:. ' of 1 - and 2-family dwellings 4 or more new residential
0 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building DSysrem over 600 volts nominal units in one structure
ElBuilding over three stories ElFeeders, 400 amps or more
D Multi-family EJ MaSter builder 0 Other:
DOccupant load over 99 persons ElManufacturcd structures or
Iiii'li;I:.!ifr.."..;',,1:.(:.;,..10#:,r4J.00#40fit401:1044.#001:.iif.:. : ' '': ocuressaighting pi- RV park
DI-Icalth-car e facility pOther:
Job no.: Job site address: it, 6:0 3 ; '7 ,,... V4 tit,
Submit 2 sets of plans with any of the above.
City/Statc/ZIP: "7 (7 CL. 9 7; ) '.r The above are not applicable to temporary construction service,
-
1 Ilii I IIIIIII II :I I liY,' I I : • I ' : l'IlI..;'• :L.- .:
Suite/bldg./apt. no.: Project name: #\"-1- ,`‘
..,
______, Dotterlpiton 1 Qty. I Fee. j
Cross-street/directions to job site: CO e) ( '. 60.ca-,4-. :z..4- New residential single- or multi-family dweiting unit.
- ,
Includes attached garage_
- IL
lieti 3 76 1,000 sq. ft. or less 145. )5 4
Subdivision: Lot no.: Ea. addl 500 sq. 0. or portion 33.40 . 1
Limited energy, residential 75.00 2
Tax map/parcel no.: . . -
. , Limited energy, non-residential 75.00 2
II I II 4 . 00 .0041 1 0,N;I I 0 , :.*.P* ( :eTI:l1' ! •.:H Each manufactured or modular -
dwelling. service and/or feeder 90.90 2
L
hA: -t;zic4a p--1, L---... _
Services or feeders installation, alteration, and/or relocation
_
,,, \
6 ,,,) ,...,:63 2 ti.,;.4 0;-/c',--- AY, 200 OrtipS Or leSS I _ 80.30 Sc, 2
, •;,;!;![;. ; .,.:1: : •, , ,; . ,,:igwg : a..t.-01- i 06 1 .,,,,„ 1: . .'!. '1:. ;..:, - ,, ,: .. : iliIii;l c iid 201 amps to 400 amps 106.85 2
, - .H: •'-,. • • " "" • Ir ''I"I I' ""-'; • ''' , - -II: -III-"II-IlaI I IP''' 174 '''''''''' I ' ' i■
Id ''' 401-amps to 600 amps 160.60 2
-
Name:
- ..Q..../2--- c.c.„4,,...._."....._-• 601 amps to 1.000 amps 240.60 2
.
Address: • Over 1,000 amps or volts 454.65 2
-------- Reconnect only 66.85 _ 2
City/State/ZTP:
Temporary services or feeders installation, alteration, and/or
Phone: ( ) N)//3.._ Fax: ( ) , relocation
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 sal; lease, rent, or exchange, according to ORS 447, 449, 670, and 701, 401 amps to 600 amps I 133.75 2
- -
Owner signature! Date: Branch circuits - ncw, alteration, or extension, per panel
:':;.::,,,, ,:::.,:■!4:!:allgi!fo;,,,*,01,0400:11,,i.!L,:;‘:AiUt:ig:i ; ; ..,': '..: : ;i A. F o b r raZd c h der circ fe u c ita n w ch ith I
Business name: branch circuit 1 6.65 2
9. Pee for branch circuits
Contact name:
without service Or feeder fee,
each branch circuit
46.85 2
Address:
_ Each acid"j branch circuit 6.65
City/State/ZIP! Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53,40 I 2
Phone; ( ) Fax: : ( . ) ..
Sign or outline lighting 53,40 1 2
E-mail:
Signet circuit(s) or )imited-
. :I ":-I'"'II •I :- :::II00 1%7 TgACilg*::Iii IIIII:I • '..':: II'i:IIIIII:lill I- ': • r °°, or
Page 2 2
Business namc: Lu EteejLk......
. Each additional inspection over allowable in any of the above
Address: 6 6 acki 8405, . ,67,,(z.k. gi
Per inspection 62.50 I
City/State/ZIP: 71 vv o 6 1 7 0 6' 'C. Investigation per hour (1 hr min) 1 62.50
Industrial plant per hour 73.75
Phone: a p Fax: ( :5Z 638 LIZ Li 2 -
—2-0 711;!i),; ::: : trAtmcm;;PERMIT.:'PEES
CCB Lic.: /1q, Electrical Lic.: ' 56 C-- Suprv. Lic,: . :) . - .0 7 s 5S -II
Subtotal 86..56
Suprv. Electrician signature, required: 1 (:)/31,kt, Plan review (25% of perrnit fee)
--
Print name: t c A 4 1.. .i I Date! 1 2 — Z V -0 -2 State surcharge (8% of permit fee)
TOTAL PERMIT FEE i3 („ .7z.
,
Authorized signature:
This permit application expires if a permit ;8 not obtained within ISO
• days after it hstx been accepted as complete
Print name: Date! • Fee methodology set by rri-County Building Industry Service Board
" Number of insnecnnus nprnormit .11....watt
CITY OF TIGARD
BUILDING DIVISION ;- PERMIT #: ELC2007 -006 €1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/24/2007
Phone: (503) 639 -4171 d�q� iti(W
Inspection Requests (24 Hrs.): (503) 639 -4175 �_p `
INSPECTION WORKSHEET FOR DATE: 1/712003 TIME: 7 :00AM PAGE: EEO
SITE ADDRESS: 10000 3W 76TH AVE CLASS OF WORK:
SUBDIVISION: DURHAM ACRES LOT #: 001 TYPE OF USE:
PROJECT NAME: RIVA
DESCRIPTION: ;100 amp service.
OWNER: RIVAS, ERNEST ROSE, PHONE #:
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 5035313 -SQ2B
Inspection Request Scheduled For: Date: 1 f7 /2QpO Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 062615-01 503-630-5028 y V
Corrections /Comments/ Instructions:
f
J PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL ❑ C , L FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
1/ /6,4
Inspector: Date: _ 7 Phone #: (503) 718-
CITY OF TIGARD �
BUILDING DIVISION PERMIT #: ELC2007..00861
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/24/2007
Phone: (503) 639 -4171 /7i��rir��41inlp� AI�
Inspection Requests (24 Hrs.): (503) 639 - 4175±1
INSPECTION WORKSHEET FOR DATE: 12,J2712007 TIME: 7 :0I)AM PAGE: 62
SITE ADDRESS: 1.060 SW 767H AVE CLASS OF WORK:
SUBDIVISION: DURHAM ACRES LOT #: 001 TYPE OF USE:
PROJECT NAME: RIVA
DESCRIPTION: 200 amp service.
OWNER: RIVAS, ERNEST ROSE, PHONE #:
CONTRACTOR: WINNER ELECTRIC INC PHONE #: 503-638-5028
Inspection Request Scheduled For: Date: 1207/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
189 Electrical final . 062154 -01 503 - 638 -5028 Y lead) •
Corrections /Comments /Instructions:
Prigib 66444pibtd, Gi btli)f
aA-pow
/Vp vI v
PASS ARTIAL A'PROVAL 11 CANCEL n NO ACCESS
11 FAIL IRCALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: , � Date: / 7 0 Phone #: (503) 718- Y %0