Permit CITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2007 -00625
COMMUNITY DEVELOPMENT DATE ISSUED: 9/7/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S136CB -04900
SITE ADDRESS: 10860 SW 83RD AVE ZONING: R -4.5
SUBDIVISION: STEVE + HUGHIE'S PLACE LOT : 021 JURISDICTION: TIG
PROJECT: AMOS
Project Description: Replace existing service 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: 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:
GRACE AMOS OES LLC
10860 SW 83RD AVE 5285 NE ELAM YOUNG PKWY # A600
TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: Contact #: PRI 503 - 693 -6000
FAX 503 - 693 -8660
FEES
Description Date Amount Reg #: ELE 34 -572C
[ELPRMT] ELC Permit 9/7/2007 $80.30 LIC 159395
[TAX] 8% State Surcharge 9/7/2007 $6.42 SUP 41225
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 -00 t ' rough OAR 952 - 001 -0100. u may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued : /J /dJjil / ode Permittee Signature: \ CCU
OWNER INSTALLATION ONLfity/ICAlarl
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.
E ei c ca1 Permit Application p; FOR OFFICE USE °NLN'
City of Tigard [renewed 7 n� S L.,OJ Pe nitNo.: e_c,260 4- 00102.5
13125 SW Hall Blvd., Tigard, OR 97223 S E P 0 7 2007 Plan Review
14 % Phone 503.639A171 Fax 503.598.1960 DateB'. Other Permit
T i G A R D Inspection Line: 503.639.4175 MVO? TIGAM1 ° Ready/BB: / / RI See Page 2 for
Internet www.tigard .or.gov BUILDINGQiulgf pj Notifcd/Method: Supplemental Information
1itLLJ 1Yl� Ilt RKi: '.;:'::�: : ` .�...i:. ..... ,.. • PLAN . .
❑ New construction ❑ Addition /alteration/replacement Ply check al/ that apply (submit 2 sets of planswruenm checked below):
❑ Service or tbedor 400 amps or more ['Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
::..
C ATECORY'b' CONSTRUCTION': r: n;:::> : rue agricultural
::..: am w or ' - ; less to mend, or exceeds 14,000 ❑ Commercial-use
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other. ❑ Fire pump. O Instal/alien of 75 KVA or
:.. ..::. larger a derived system
JOO `8 INFO1tMItTIO . I LOCATION
❑Emergency system separately
- ,. , .1� „_ . ,f ❑ Addition of new motor load of ❑ °A °. °E', "1- 2 ". "1 -3 ",
U e 100HP or more. occupancy.
Job nil.: 6 9/ :. ) lob site address: / ��✓ SI J 3 ' /'1' ❑ Sin or more residential units. ❑ Rational vehicle parks.
❑ Hdth-care facilities. ❑ Supply voltage for mom than
City/State/ZIP: G L ✓ Q rZ- ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: G ✓c ,.. " fr . os - O Service or feeder 600 amps or more.
. FEE :,SCHEDULg:: . .. .
Cross street/directions to job site: Description I Orr - I Fee. I Tot 1 •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1.000 sq. R or less 145.15 4
Ea add'I 500 sq. R or portion 33.40 1
Tax map/parcel no.:: Limited energy, residential
75.00
: ; . , Dl'aSCRIPTItT1.OF WORK :: -; : : . ::::: ..:: : .. :.. • ...... (with above se,. IL) _
/� r CV,/ Limited energy. multi- family 75.00 2
c',t't 4 .4 , e A. R I `'�/ C'A.Tr Y t4.r41$7 dye residential (with above sq. ft.)
Services or feeders Installation, alteration, and/or relocation'
200 amps or less / 80.30 g7),,30 2
.
:. - 201 amps to 400 amps 106.85 2
...::. :._ `'' ❑ PROPERTY:; OWNER::.:; :::< ".. =`.:: �,:;. �' r ,.'- : ` ::_
401 amps to 600 amps 160.60 2
Name:
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, p er panel
Owner signature: Date: A. Fee for branch circuits with
: .. feeder fee, 6.65 2
........ ...:.
0 : API!LtCANI< ...... = ❑'' 3'ACi FERSf?1V ' ":: t . ::
• .. , . .. .. service or
each branch circuit
Business name: B. Fee for branch circuits .
without service or feeder fee, . • 46.85 2
Contact name: • first branch circuit
Address: Each add'I branch circuit 6.65 , 2
Miscerlancous (service Or feeder not included)
City/State/ZIP: Each manufactured or modular • . 90.90 2
dwelling, service and/or feeder •
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
,•C
O � 53.40 2
.. PPhR?1C1 OR, .. Sign lighting
:.....
. _ outline
. ._ Signal circuit(s) or limited-
Business name: 0 t .$' ZZ - energy panel, alteration, or
Address: S R., i- S Ne g/ ,, y 4 1,, e ,4 ✓�G✓ A /1-‘-'
extension. Describe: Page 2 2
City/State/ZIP: ,/,4,; ;itrL. / E aeh additional inspection over allowable In any of the above
Per inspection 62.50
Phone: (503) f 3 . ‘,L) (.' . ] Fax: (.yJ3) 6:1 i ' d e. C Investigation per hour (I hr min) 62.50
CCB Lic.: /s3 & I Electrical Lic.:3y j, G I Suprv. ic.: I / ?,5 Industrial plant per hour 73.75
r . EGE,..CFRICAL PERMIT FEES..
Suprv. Electrician signature, required: ."�' Subtotal: Fa,,j(j
64/es r Plan review (2_5% of permit fee): -
Print [lame: / �J/� // G hu ,fit / Dom:` / fr/i), State surcharge (8% of permit fee): ‘, y ...
Authorized signature: TOTAL PERMIT FEE: gi, 9 2,,
Ibis permit app&eation expires its permit is net obtained within 180
Print name: I Date: days after it has been accepted as complete
' Nnmber of inspections allowed per permit.
I'd 0998 -e69 (COS) avunH RPnC + WCC eLO :80 LO GO daS
CITY OF TIGARD
BUILDING DIVISION PERMIT #: EL4:2007- 00625
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/-1120:)7
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 .�'!�i
INSPECTION WORKSHEET FOR DATE: 10/19/2007 TIME: 7 :01AM PAGE: 56
SITE ADDRESS: 10860 SW 83RD AVE CLASS OF WORK:
SUBDIVISION: STEVE + HUGHIE'S PLACE LOT #: 021 TYPE OF USE:
PROJECT NAME: AMOS
DESCRIPTION: Replace existing service panel.
OWNER: AMOS, GRACE PHONE #:
CONTRACTOR: DES LLC 1.)b PHONE #: 503. 693.6000
Inspection Request Scheduled For: Date: 10/19/2007 Pour Time:
Code # Inspection Description C Contact # Message
199 Electrical final ( 503-693-6000 \ Y
Corrections /Comments /Instructions:
9' Aom
1
r
. i i v :
, v
_ ____
1
1
1
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr 1 Nobt E Date: I0 0 Phone #: (503) 718 - 1)44.K
' CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00625
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 917 /100)
Phone: (503) 639 -4171 4'44%
Inspection Requests (24 Hrs.): (503) 639 -4175 , _ ..
INSPECTION WORKSHEET FOR DATE: 10/5/2007 TIME: 7:01AM PAGE: 1
SITE ADDRESS: CLASS OF WORK:
i0f36U SW 83RD AVf�'
SUBDIVISION: STEVE + HUGHIIf S PLACE LOT #: 021 TYPE OF USE:
PROJECT NAME: AMOS
DESCRIPTION: Replace existing service panel.
OWNER: AMOS. GRACE PHONE #:
CONTRACTOR: OES LLC PHONE #: 503 693.6000
Inspection Request Scheduled For: Date: . 10/512007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 057064 -01 503 710 -7986 N
Corrections /Comments /Instructions:
Co - p v 1 p-4- S T 1 c. p v' Let Vgt—, w= a11-{
Sv 'VIS S.g ,
11 NP
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
^FAIL j,g1 CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
' Inspector: CY , t Qg L-1C Date: 1. 0 510'1 Phone #: (503) 718 -1-+`Pc•