Permit C ITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2005 -00156
DEVELOPMENT SERVICES DATE ISSUED: 3/17/2005
I 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171
PARCEL: 2S114AD
SITE ADDRESS: 16650 SW 89TH PL ZONING: R - 12
SUBDIVISION: WAVERLY ESTATES LOT : 027 JURISDICTION: TIG
Project Description: (2) branch circuits for hot tub. Job No. T & M
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: 1 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:
KATHY BOUDREAU BEAR ELECTRIC
16650 SW 89TH PL P.O. BOX 389
TIGARD, OR 97223 DONALD, OR 97020
Phone: 503 - 473 -3797 Phone: 503 - 678 -1355
FEES Reg #: LIC 20919
ELE 24 -107C
Description Date Amount SUP 4902S
[TAX] 8% State Surcharge 3/17/2005 $4.28
[ELPRMT] ELC Permit 3/17/2005 $53.50 REQUIRED ITEMS AND REPORTS
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are orth in 1 Z 95 01 -0010 through OAR 952 - 001 -0100. You may obtain copies of thes ules or direct questions to OUNC at
503 -24 6699 or 1- 800 -33 -2 4.
Issue By: I Ag A i . � Permittee Signatu
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
�NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �D' —`-- DATE:
LICENSE NO: /■? -5
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mar.16. 2005 3:46PM No.1783 P. 2/2
• - R C EIVEE
Electrical. Permit Application FOR OFFICE USE ONLY
City of Tigard 4iN, i 2005 Received _ u as >; J PerTa No,; FI4.xx5 oo 15 -
13125 SW Flail Blvd., Tigard, OR 97223 Plan Review
Phone: 503 639.4171 pax: 503 598 1960 OF TIGA ` '' ' ''•_ "' i Date/8 : Other Permit:
Inspection Line: 503.639.4175 BUILDING DIV''= ='! '" pate Ready/$y: Y_— ^ RI See Page 2 for
Internet- www.ci tigard.or us Notired/Method: kin Supplemental Intormation
:?y '�, n , .a, ,, .r. ,�. j 4 , ; ....,,,: �,, , : " 4. c; t . 1 l „ 1 ",r p ,'° � , ^ .�J-�_', °,0e�at„ ?j: .
.
r; , -.4 ,.. x ,- 4 6 �. :. h : • .. k ., q. ix , r ' fi r ; rr. ,, . r� �' l :5 ° P ,. ..
�.ni'"t ..� .. ai :� -' ,P
. ,. �. � t5 R r..i � , . �,, .�t•.; 'w.. t. n., <:.. iGr✓n ;� .,. �... �.� � .,
❑ New construction f -Addition/alteration/replacement Please check all that apply
❑ Demolition [] Other: ❑Service over 225 amps, comm'l ]Hazardous location
p o :,',: ;1,r° , , y .," � � i t ;; I , t ❑Ser'vice over 320 amps - rating ❑ Buildng over 10.000 sq. ft.,
. ,,•. • wf s E `,...r , ` * . • .. ,, w <' �� s ° ,yT 4 -. li, '`.. ,.. ,. ,S � y t� ''�u l iw-,L,.. t, ` ,1 . ` ,., of 1 - and 2 family dwellings 4 or more new residential
53-I - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑system over 600 volts nominal units in one structure
0 Multi - family 0 Master builder ❑ Other: ❑]3uilding over three stones :Weeders, 400 amps or more
251W7 - i e � t l ❑Occupant load over 99 persons :Manufactured structures or
a , ?t ? '' ` .f e ',:'::‘......,..,...L1 s r4 � '` • �4 r , ` . 1;:� ❑E ess /i htin plan RV park
.Ja rt a,w4 � p •' gr g B
Job no,: 4, Job site address: , ., So - i q �k ja
['Health-care facility ['Other'
Submit 2 sets of plans with any of the above.
City /State/ZIP; ' � 0 • ' 7, A, Li The above are not applicable to temporary construction service.
Suite/bldg. /apt, no, project name - - . iii .w;,." , r IWat t" a 6 . . :
ncao'iption J Qty. I Pte. TOW I
Cross street/directions to job sire: > f,/ �� i, h 0/ pad y i i , New residential single- or multi- family dwelling unit.
�� iL r lb/4 ail I / Includes attached garage.
b r v
CT [ � �_"��!° 1,000 sq. ft. or }ass ia5.15 4
Subdivision: I LOt no.: Ea. add'l 500 sq. ft, or portion 33.40 t
Tax map/parcel no ( Limited energy, residential 75.00 2
r Limited energy, non - residential 75.00 2
M ir: �)1�t: r+ t : t a `t .ii �>< tigi gl iM •�yi :17,; r:. +. ^ = Each manufactured or modular
n j / dwelling, service and/or feeder 90.90 2
i ' '+V ' 4 II �' ,e • " W ea.. " 1 t ie ' 04,44 Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
w..1" r . � c ` O,.r ,,fu ,� v .� ;, at rE�it i t t , a. n s py, Zvi -5 rd,:: . art s T
.-'� 71,,i .
tYC;tl. �T d 151f'Y.� tF� , W, - eT'.m n" n•l ,,��yy C ` 'ir,∎t 201 amps to 400 amps 10685 2
.... .., •
3aS u r Gh ... . - " t� �kl. >i ± , 401 amps IO 600 amps 160.60 2
Name: taill 6 0,10 , eau, 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 /Stare/ZYP: Temporary services or feeders installation, alteration, and/or
(S . ) I/ 37 I ( ) relocation 00 amps
Phone: o °z, 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 600 amps 133.75 2
Owner Si: ature: Date: Branch circuits new, alteration, or extension, per panel
J if, 4 i- d" rV i l r W 1 1 !' r a ",, y s :N. w A. Fee for branch circuits with
r ( . a s ; ro .r t lil; ,' ( `7 'Cyi i i 1 Y e r�, '. .
atsil:ali,. „ : a t...:�:,rtta�,.bs5n..� E>...:, .a... ,. ,, t. 3ifuk, $ .. w,c, 'n rr�.,,.._:J�.Y` .!c::a: ,. service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, ` 46.65(�.ys 2
each branch circuit
Address: Each add'l branch circuit j 6.65 6 4 S 2
City /State /ZIP: .Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: ( ) Sign or outline lighting 53.40 2
E - mail: l i1 . Signal circuit(a) or limited-
F. i l': t . tiywl?. !-Zi N 1 , :r(r yj �� cl,�1 1•, . ?l ,.
�, =,b. ..�. �A- i K�.x4�., m •d, ? � .. s1, .., s ,(: sw . , 9. ,.. ax' � � , energy Panel, alteration, or
extension Describe: Page 2 2
Business name: o ., '' /, .. -
Address: Each additional inspection over allowable in any of the Above
! ° �` 4 r < Per inspection 62.50
w v
City /State/ZIP: ne 4a �ie 9 70 A Investigation per hour (t br min) 62.50
Phone' ( ,'1) - " ,- 5 Fax ( - 03) 6 7g a Industnalplant per hour 73.75
1I
i` }}li�� ..- 1 �,�� T? � y„ 1 ...
s a 1 �' - ixt,ri .4.r; .
, ....-F: r°
CCB Lic.:2 e f er Electrical Lie.: t,, _ /6 , Y Suprv. Lic.:$ " ?a 2,, Subtotal x.3, 5 0
Suprv. Electrician signature, required: Plan review (25% of permit fee)
� Date: / State surcharge (8% of permit fee) LI , 2 $
Print name:
614 Ail `a`ss f _ 3 6 _ 0 s -
TOTAL PERMIT PEE
S 7. 7k
Authorized signature: This permit application eipirea if a permit is not obtained within 180
days atter it has been accepted as complete
Print name: Date: • Fee methodology set by Tri•Cou my Building Industry Service Board
" Number of inspections per permit allowed.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200 &00156 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3117/2005
Phone: (503) 639 -4171 !0!/ I,�
Inspection Requests (24 Hrs.): (503) 639 -4175 A
INSPECTION WORKSHEET FOR DATE: 5/3/2005 TIME: 7:14AM PAGE: 54
D. !2
SITE ADDRESS: 16650 SW 89TH PL CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: 027 TYPE OF USE:
PROJECT NAME: BOUDREAU
DESCRIPTION: ( branch circuits for hot tub. Job No. T & M I
OWNER: BOUDREAU, KATHY PHO E #: 503-473 -3797
CONTRACTOR: BEAR ELECTRIC PHON • 503- 678 -1355
Inspection Request Scheduled For: Date: 5/3/2006 Po - i :
Code # Inspection Description Confirm # Contact # =ssage
199 Electrical final 005952 -01 503 -6711 -1355 N 3:00 f V .
Corrections /Comments /Instructions:
o — --. Z: a „ A-Lc e • Alv a Ili ■
NI U r�i? rZ 6WNC� K/ ,- H y � l
Adl.
' / -ASS E PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL r CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspect. A Now-
■ Date: a Phone #: (503) 718 -
AO