Permit C ITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2005 -00352
DEVELOPMENT Tigard, OP MENTSERVICES
503 - 639 -4171 DATE ISSUED: 5/25/2005 Hall 13125 PARCEL: 1S134DA-05500
SITE ADDRESS: 11348 SW 105TH PL ZONING: R -4.5
SUBDIVISION: NODAK LOT : 003 JURISDICTION: TIG
Project Description: 1 branch circuit.
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: 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:
PITTELKO, RICHARD GRF ELECTRIC
11348 SW 105TH PL 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 620 -3864 Phone: 503 - 829 -4146
FEES Reg #: LIC 76751
SUP 1655S
Description Date Amount ELE 3 - 484C
[ELPRMT] ELC Permit 5/25/2005 $46.85
[TAX] 8% State Surcharge 5/25/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
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 -3 -2344.
Issued By: A:), `� A Permittee Signature: j ` I h.� Q
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.
May 24 05 11:08a GRF Electric 5038295747 p.1
• Electrical Permit Application FOR OFFICE USE ONLY •
•
I Received Electrical a
Date/By: 5/95705 e� Permit No.U.C, 0j " 3Sy
City of Ti and RECEIVED Planning oval Sign _
`J g Date/By: Permit No.:
,- 13125 Hall Blvd. Plan Review Other
Tigard, Oregon 97223 • MAY 2 4 2005 Date/By: PennitNo.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
t' N t tr�� 4'
Internet: www.ci.tigard.or.0 lTY OF TIGARb � �� �r�
) Date/By: Case No.:
Contact I s.` ® See Page 2 for
24 -hour Ins P Requests Ni"---" 1 - ection Re ues ��I J�SION Name/Meth Supplemental Information.
•
':I -.3 .)t; r •: w:.`��',l1 ;' .Q 1 76.. +'•- '7,.:ri4� . ,. : - i .
' , is •. ,1 ';�''P.E+� �, QRK= ,.• , '�:- ���' I :�: ° . -'r . PI;AN •REVIEW. lease chick atlthata'p 1
0 New construction 0 Demolition In Service over 225 amps - 0 Health -care facility
' commercial ❑ Hazardous location
ti Addition/alteration/re.lacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet, • •
7;- •_.,,;r0t� �,(a$l ., ('lAAjs �JCTXON 1 & 2 family dwellings four or more residential units in
[ 1 & 2- Family dwel ❑ Commercial/Industrial CI System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
Accessory Building E] Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
Master Builder ❑ Other: ❑ Egress lighting plan ❑Other:
' `'t' "'' =fSAB SA'r'�11TF11121�f i1TION:aud LO. :' " ;':.:•:. : • Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: / 1 3 `i- 5 w /6s P (. • EE *' SCHEDULE';:::', : • .;:; T : <:.. ; :'::..;':
Suite #: I Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: I2 " .j-/- e. [ le_a D.eriptioo 1 Qty Fee (ca.) Total
New residential - single or multi - family per I
Cross street/Directions to job site: dwelling unit. Includes attached garage.
. Service Included:
. • 1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: I Lot #: - Limited energy, residential 75.00 • 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
< e "it i• : .AliNi{'isii'if 'it 'elt;It'T?i{ON,,.O ':IIV.
ORK• .. ::..':4- t:i ;° , service and/or feeder 90.90 . 2
' ' Services or feeders - installation,
I (. ,, y ' i 4.GI A- C- alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
t�•!!��.t� 4, ,. : !{, , ;r. 240.60 2
;1_l tx ,t), .1; ' 1':ar'z 'u:::�i,; hi TENANT: `i•t.- % # : j r,:,.,•. 601 amps to 1000 amps
Over 1000 amps or volts 454.65 2 I
.-
Name: P i e _ / r _ .'t. e. 1 12-6• Reconnect only 66.85 2
Address: 1 3 y.. c (t' ) Q 5 rL- - Temporary services or feeders - installation,
> alteration, or relocation:
City /State/Zip: f (1 ,/L L2 f-- '7 ZZ ` 200 amps or less • 66.85 1
Phone: , 2,6 - 3 S't, ' Fax: 201 amps to 400 amps 100.30 2
.i .:.'S ,v. ,t,; ,. ..,..... Branch h circuits amps 133.75 2
�
•i`.�t .. :; %:= :•`. ; ^: G( aNTA'CTiPE'RSON� sfl c`•:.;:�,.
.� �st;;�f.'= < •'• - +' � , Brnch 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
(4i /Qt t 17' - • B. Fee far branch circuits without purchase of •
�
service or feeder fee, first branch circuit 46.85 '1 (J 2
Phone: I Fax: _ Each additional branch circuit 6.65 2
E -mail: Mise.(Service or feeder not included):
t, tl�}�rl „< torsi 1 ; <, l .. v , : , +• , ,; , ::il. ,:� : Each pump or irrigation circle 53.40 • 2
'•'' 'tii �• r 's7rr�'t'' t ; ^� =t � Nt 0 .. ' . `..' ;: ” 'fi "i Each sin or outline li htin 53.40 2
�,'
Job No: Signal g �) g g energy P
Si circuit(s) s or a limited ener panel,
alteration, or extension Page 2 2
. Business Na (S P_ c.- I r_ Description: •
Address: 15)-(p C S, p‘ l'p ri .4 a , •
City/State/Zip: Z Each additional inspection over the allowable in any of the above:
• /VI 1 r l� C h L, L 1 Per inspection per hour (min. 1 hour) 62.50
Phone: 933 7g tit / k*( f Fax: • 03 - 89 - 5 "7 4-7 Investigation fee:
#: other:
CCB Li
C. 1p �, Lic. #: 3 - �' 4 ;,:2 ,: ` _ •�, ,.... EtectiicaliP €ir *:.`:r. ?; :P .
Supervising electric C Z �� GS o subtotal $ - (,p - S'..5- sign required: - 51 Plan Review (25 /o of Permit Fee) $ ' S te-
Print Name: � f r 7) i A.,.„.., S ,.> �� Lie. #: I (r , s S $ State Surcharge (8% of Permit Fee) $ I,
TOTAL PERMIT FEE $ al
Authorized Notice: This permit application expires if a permit is not obuun
Signature: • Date: 180 days after it.has been accepted as complete.
°Fee methodology set.by'FrI- County Building Industry Service Board.
' (Please print name)
• i:\Dets\Permit Forms\ElcPerrnitApp.doc 01/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00362
13125 SW Hall Blvd., Tigard, OR 97223 k 0 ill I�11pill��I�I DATE ISSUED: 5/25!2005
503
( )
Phone: 639 -4171 �o n I\
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/10/2005 TIME: 7:14AM PAGE: 95
SITE ADDRESS: 11348 SW 105TH PL CLASS OF WORK:
SUBDIVISION: NODAK LOT #: 003 TYPE OF USE:
PROJECT NAME: PITTELKO'
DESCRIPTION: 1 branch circuit.
OWNER: PITTELKO, RICHARD, PHONE #: 503-620-3864
CONTRACTOR: GRF ELECTRIC PHONE #: 503.829.4146
Inspection Request Scheduled For: Date: 6/10/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 008898 -01 603- 233 --6566 Y
Corrections /Comments /Instructions:
•
•
` A PASS 1 pl PARTIAL ROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL CALL • OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / #: (503) 718 -
7
A 7
Inspections Required for: ELC2005 -00352
✓
Code Inspection Description PASS Date By ■ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
•
415 Grading _ 115 Electrical service /reconnect
205 Footing X 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool _
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final J
240 Exterior sheathing
245 Firewall _
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection: I
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing MEC - Mechanical Permit
810 MFG - Structure set -up
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper _
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final 325 RP/backflow preventer
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I :\Building \IVR \InspCard- AOP.doc 02/02/2005
. \ - CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00352
� �l� ,. DEVELOPMENT SERVICES DATE ISSUED: 5/25/2005
�`�'''� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171 PARCEL: 1S134DA - 05500
SITE ADDRESS: 11348 SW 105TH PL ZONING: R -4.5
SUBDIVISION: NODAK LOT : 003 JURISDICTION: TIG
Project Description: 1 branch circuit.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: PUMP /IRR!GATION:
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: 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:
PITTELKO, RICHARD GRF ELECTRIC
11348 SW 105TH PL 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503- 620 -3864 Phone: 503 - 829 -4146
FEES Reg #: LIC 76751
SUP 1655S
Description Date Amount ELE 3 - 484C
[ELPRMT] ELC Permit 5/25/2005 $46.85
[TAX] 8% State Surcharge 5/25/2005 $3.75 REQUIRED ITEMS AND REPORTS
Total $50.60
•
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 -3 2344.
� �]'� Permittee Signature: 1'>
Issued By::<JCrr 4 -i.,,,__-_,,, c _ / !i!/1.� %U 9 C 1 r,, (fit .Fr 02.v,,.._)
I/
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: Po
CONTRACTOR INSTALLATION ONLY N ito
SIGNATURE OF SUPR. ELEC'N: DATE: 0
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day. O
This permit card shall be kept in a conspicuous place on the job site until completion of the project. O
Approved plans are required on the job site at the time of each inspection. 0
tin
N