Permit �� QITY OF TIGARD 1 yy ELECTRICAL PERMIT
PERMIT #: ELC2007 -00739
- COMMUNITY DEVELOPMENT DATE ISSUED: 11/1/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114AB-01202
SITE ADDRESS: 16305 SW 92ND AVE ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TAG
PROJECT: STEWART
Project Description: (3) branch circuits for a /c, furnace and outlet.
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: 2 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:
HAROLD STEWART GRF ELECTRIC
16305 SW 92ND AVE. 15460 S PARADISE LN
TIGARD, OR 97224 MU LINO, OR 97042
Phone: 503 - 598 -2362 Contact #: PRI 503 - 829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 11/1/2007 $60.15 LIC 76751
[TAX] 8% State Surcharge 11/1/2007 $4.82 SUP 1655S
Total $64.97 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Munidpal 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 -. - -n 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules =re set forth ' • • - 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at
503.246.6.a 9 or 1 .800.33 =.2344
Issued B I /‘. CQij/'er P ermittee Signatur " '�►'�'c�.��
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: 1 % ;?1Wi' 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.
4 - , C" t- •?..•
:.• - P:
Electrical Per t,i 1
'..., 'Ion - Received FOR OFFICE USE. ONLY
llif . . • t. Electrical r
, . - Date/By: /0 3/ 47 X 1 i y , Permit No.: cm ao 7.-er07,5
1 ' 011 Planning Approval Sign
City of Tigard pC.1 S of) Date/By: Permit No.:
\•-• ' 13125 SW Hall.Blvd. Plan Review Other
Tigard, Oregon 97223 0 0044 Date/By: Permit No.:
Phone: 503-639-4171 • ' Fax: t,;.0, il„ riii i' a? Post-Review Land Use
Internet: www.eItigard.or.us 4 k fix
4 2-11 A Contact I 1 Date/By: 7/ Supplemental rts.: 1 ID See Page 2 for
24-hour Inspection Request: 503-639-4175 "' Name/Method: / ep, 1 Supplemental Information.
' " '‘: , I.:: : : .-'','•:!• , ..•:, - :i . .:',,:i': AY1P,E1.0E-WORK.n''':-:t:;::' :',. :''''. ... ' . : -' :, , .:1•: ‘:..,., ' 'E PLAN REVIEW (Please cheek all that 80010 '''. '• - - •'
El New construction 1:=1 Demolition 0 Service over 225 amps- 0 Health-care facility
commercial 0 Hazardous location
Addition/alteration/replacement ri Other:
_ 0 Service over 320 amps-rating of 0 Building over 10,000 square feet,
• ': '.-- • ' ..'';'7' CATEGORY • :••• .'" 4 • • •----' 1 & 2 family dwellings four or more residential units in
la. 1 & 2-Family dwelling El Commercial/Industrial El System over 600 volts nominal one structure
0 Building over three stories E:1 Feeders, 400 amps or more
0 Accessory Building E Multi-Family 0 Occupant load over 99 persons 0 Manufactured structures or RV park
0 Master Builder El Other: D Egressilighlj,ig plan 0 Other:
';•.-JOBSITEINFORMATIONiitid.LOCATION,.,...; '., - . :•. : Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: i (,,,,, 3 O L:,,..) I ?..- Alpe , :-, .. 1 ,...i,.. , ..,.:.. , ,..- , ., ..:.. /, :'.':.: '-'..•:-.'',-'.'---'; ''• • • ' -
Suite #: I Bldg./Apt.#: Number of inspections per permit allowed
Project Name: .S te4A)et v-t rzcacriptioi. I Qty Fee (es.) 1 Tots'. 1 1 ,
New residential-single or multi-family per
Cross street1Directions to job site: dwelling unit. Includes attached garage.
Service included:
• 1000 sq. R. or less 145.15 4
' -
Each additional 500 sq. ft or portion thereo 33.40 1
Subdivision: I #: Limited energy, residential 75.00
Limited energy, non residential
75.00 2
Lot
2
_,, ,
Tax map/parcel #: F Each manufactured home or modular dwelling
.,
. 7 .'" ''?'.-:".:. ':-1"DESCRIPTION :OWORIt!i• :: . ....1.,„:!,. . .. service Services a n f r ofreefdseeedrer 90.90 2
installation,
C.1,./^ ri,....... A< C 1 fi4,÷ JA<_-P —I alteration or relocation:
80.30
at...t. — 200 amps or less
201 amps to 400 amps . - -
106.85 - 2
-11 el _
2
401 amps to 600 amps 160.60 2
-
-
.' EYI• EITENOT ''..'''':,-4 - 1 . •:!.- i' . ;.''' -• ' .::.':-' 601 amps to 1000 amps 240.60 2
Over 1000 amps or volts 454.65 2
N ame: 1 ( 0 i 4 , Reconnect only 66.85 _
2
Address: 1 Lo -Z 0 5 - i,IJ 2- AlIC . Temporary services or feeders - installation,
alteration, or relocation: i
City/State/Zip: r /, . c7 ) 7.... 2- t-f- 200 amps or less 66.85 I
Phone: cei ? - ,.,. 5 to 2- 1 Fax: 201 amps to 400 amps , 100.30 , 2
C3 iAPPLICANT: i".'. : .4:1:-:0:CONTACZPERS'ON?;,1:::Y :.::-',.., '.. .
Branch circuits - new, alteration, or
Name: . extension per panel:
A. Fee for branch circuits with purchase of
Address: - - service or feeder fee, each branch circuit 6.65 , 2
City/State/Zip: B. Fee for branch circuits without purchase of
. 1 46.85 t ele'. g C 2
service or feeder fee, first branch circuit
Phone: I Fax: . Each additional branch circuit -"*L. 6.65 13 3 C 2 •.
E-mail' . Misc.(Service or feeder not included):
53.40 2
.!:!.-7.?,'"i,1:14q;i:;;-.MI!i',..?iit.igeohuRkorois.2.,•;.1,*,4,F,:, ..: .., . ;4•. i; Ea pump or irrigation circle
sign or outline lighting - 53.40 2
Job No: Signal circui(s) or a limited energy panel, r
alteration, or extension Page 2 2
Business Name: t ILE e e,..4-„- , Descripti. i
Address: 1 ckl-La 0 S PA )-- 0 r 1 A4.-e. L-n , .
Each additional inspection over the allowable in any of the above:
City/State/ZIP. , p: A/1 I , L ; ( ) i f — 6 7 'TO L i 1 Per inspection per hour (min. 1 hour) i_ 1 62.50 I
Fax: 51)3- 81,9 - 5 - 7 4--7 Investigation fee: 1_ .
Other:
CCB Lie. #: 7 b - 7 q Lie. ti: 3 cf. et+ C % ''.'..:. ''.': . -'4,•:BIeCtiltal.Perittle,Feeif:'z'•'.77..-.-.7.:..1':::i'.. ,.:..:::••". • -. _
Supervising electrician - ri; Cj 0 Subtotal $ ft, 6 • I 57
signature required: .--rs,..z\--t:-;„,... 11i N‘ . Plan Review (25% of Permit Fee) $
Print Name: WO _
1; A„,, c I Lic. #: i L 5 C -$ State Surcharge (8% of Permit Fee) S
1- -
;71
'• Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it.has been accepted as complete.
*Fee methodology set by Tri-County Building Industry Service Board.
. (Please print name) . •
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CITY OF TIGARD P4� /d I 1r1w ��'� A
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BUILDING DIVISION PERMIT #: ELC2007 -00733
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/1/2007
Phone: (503) 639 -4171 4..1'
A.
3I
Inspection Requests (24 Hrs.): (503) 639 -4175 `IL•
INSPECTION WORKSHEET FOR DATE: 11/5/2007 TIME: 7 :01AM PAGE: 56
SITE ADDRESS: 16305 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: STEWART
DESCRIPTION: (3) branch circuits for a/c, furnace and outlet.
OWNER: STEWART, HAROLD PHONE #: 603-538 -2362
CONTRACTOR: (3RF ELECTRIC PHONE #: 503- 9294146
Inspection Request Scheduled For: Date: 11/5/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
159 Electrical final 05€ 831 -01 503-557-2220 Y I(Nt 1051
Corrections /Comments /Instructions:
09V ).< a 61CR
' �� cam
_----
pq PASS I] PARTIAL APPROVAL El CANCEL NO ACCESS
l FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1
Inspector: Date: ` Phone #: (503) 718-
,