Permit I I (c9 (1 �� EITR CAI= PERMIT
•
C I TY OF IGARD
PERMIT #: ELC2007-00778
° COMMUNITY DEVELOPMENT DATE ISSUED: 11/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 111 D D -07300
SITE ADDRESS: 15815 SW 88TH AVE ZONING: R -4.5
SUBDIVISION: STRATFORD LOT : 068 JURISDICTION: TIG
PROJECT: BROWN
Project Description: 1 200 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:
WAYNE SULLIVAN OWNER
15815 SW 87TH AVE
TIGARD, OR 97224
Phone: 503 - 349 -8005 Contact #:
FEES .
Description Date Amount Reg #:
[ELPRMT] ELC Permit 11/19/200' $80.30
[TAX] 8% State Surcharge 11/19/200' $6.42
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 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:R, 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 ApplicR fiCE' VED FOR OFFICE USE ONLY
lig City Tigard R eceived
of Ti d - Permit N.
• 13125 SW Hall Blvd., Tigard, OR 20
'1 Plan Review
Phone: 503.639.4171 Fax: 503.5 9040 Date/B : Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/13y: hoax: H See Page 2 for
Internet: www.tigard or.gov ., Notified/Method: Supplemental Information
1 i I
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
El Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories.
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
0 1- 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
❑ Emergency system. larger separately derived system.
I JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", °E ", "1 -2 ", "l -3 ",
Job no.: 1 Job site address: 15815 SW 88 AVE 10011P or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: TIGARD OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: DURHAM AND 88TH FEE SCHEDULE
.) I)osaf I Qt I Fee. I Total
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
• DESCRIPTION OF WORK '- (with above sq. ft.) 75.00 2
Limited energy, multi - family
REPLACING ELECTRICAL BOX residential (with above sq. ft) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less / 80.30 ,5o.ao 2
® PROPERTY OWNER ❑ TENANT 1MM 201 amps to 400 amps 106.85 2
Name: WAYNE SULLIVAN 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 1263 ROSEMONT RD Over 1,000 amps or volts 454.65 2
City / State/ZIP: WEST LINN OR 97068 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)349 -8005 I Fax: (503)636 -4732 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, per panel
Owner signature : • - -- � Date: \ ` \\ !; A. Fee for branch circuits with
❑ APPLICANT 1"I' ❑ CONTACT PERSO above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: 46.85 2
first branch circuit
Address: Each add'1 branch circuit 6.65 2
Miscellaneous (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
CONTRALTO ' 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) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lie.: Industrial plant per hour 73.75
Suprv. Electrician signature, required: ELECTRICAL `PERMIT`FEES
Subtotal:
Print name: Date:
Plan review (25% of permit fee):
State surcharge (8% of permit fee): 6. </a--
Authorized signature: TOTAL PERMIT FEE: 4 L , 7 r
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 ■Pennits\ELC- PemdtApp.doc 05/23/06 440- 4615T(I1 /05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1 l/ 19/:'007
Phone: (503) 639 -4171 /k+a, „��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/212007 TIME: 7 :00Am PAGE: 39
SITE ADDRESS: 15815 SW BarM AVE CLASS OF WORK:
SUBDIVISION: Se AT T R 5 LOT #: 068 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: 1 200 amp service.
OWNER: SULLIVAN, WAYNE PHONE #: 503 - 349 -9005
CONTRACTOR: OWNER \INC-N\11 PHONE #:
Inspection Request Scheduled For: Date: 11/26/x}7 Pour Time:
Code # Inspection Description Confirm # Contact# Message
115 Electric service 1060180 ) 503349-8005 Y
Corrections /Comments /Instructions: Le) r
0 1 1
/
!li PASS PA RTIAL APPROVAL CA
❑ ❑ NO ACCESS n
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G'-; t Date: L Phone #: (503) 71.1.qqij