Permit • i .e
y• CITY OF TIGARD RD ,� l ELECTRICAL PERMIT
OF V PERMIT #: ELC2008 -00012
COMMUNITY DEVELOPMENT DATE ISSUED: 1/7/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110AD -90062
SITE ADDRESS: 14962 SW 109TH AVE ZONING: R -
SUBDIVISION: CANTERBURY WOODS CONDOMINIUM LOT : 062 JURISDICTION: TIG
PROJECT: PASCO
Project Description: (1) branch circuit to master bath.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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 HMI 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:
JEAN PASCO PACIFIC NORTHWEST ELECTRIC INC
14962 SW 109TH PO BOX 310
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 - 372 - 5240 Contact #: PRI 503 - 657 -1188
FAX 503 - 722 -9058
FEES
Description Date Amount Reg #: ELE C6
[ELPRMT] ELC Permit 1/7/2008 $46.85 LIC 162893
HRTAXI Hourly 12% 1/7/2008 $5.62 SUP 5089S
I
Total $52.47 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: 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.
i,..-. ••'r.•: 01 /0E/2008 2@:53 5037229058
___ — -- -_ --.. , PACIFIC NW ELECTRIC
PAGE 01/02
.
I , ,
Electrical Perm CEV ED FOR' OFTICE USE ONLY •
I Received 7 , .4 V
.,, Permit No &of: 00,41r4110/g
City of Tigard
, - II 13125 SW Hall I31vd„ Tigard. OR 7 i..
I Al 0 7 2008 Dote/8v: /'/
: % ," Phone; 503639.4171 Fax: 511rilt* TIGARD . 11,,, J,7, ------ E2 ------ 1 Sc PM 2 Mr
1n5pection Line; 503,639.4175 Dale Rcody/13y!
TIGARD BUILDING DIVISION Noifiedimcthnd. —7" supo...itat Information
Internet: www.tignrd-or,pv „....
"''' ' • mi ' "togiiv.,•:;:il
..(. :,:••y;,; , .i. : ::.,:; , ,: , , ,, ;.. , i.; • •: • , ti,•:, •:! , ,l :." .1 ., tl..i :• l '"" ' - ''''''''"''''''''' ' '-v. C st t
0 New construction Y Addition/oltcration/repla PlCaSe hock ll ht apPlY (submit cement z setS of nlomi Wincill a checked le ow
12 ,
0 Service or feeder 400 amps or morc 0 Building over three stories.
Demolition 0 Other; where the available Null enrrent 0 Mnrinn and boatyards,
i ' '' "''' ' 1 10 MO mo.111 Oft or 0 Floating buildings.
•!.'' !:1:,' : ''i!•.i.''"?..::'0/4itt'''''''','-',''''''''.,--,-2,',,!'i',-,--,7---,1",;; l'; iv vk to ['ro exceeds 14,000 0 Coninerciol-usc agricultural
.. und , or ,
El 1- and 2-Camily dwelling 0 Commercial/industrial 0 Accessory building amps ror en other instelliniofl e. buildings.
ulti-tmily D Master builder Other:
1:I ore pump. 1:1Installation of '7'3 KVA or
erm 0 _ !< riyatcM.
- LI q
, , , :. 'i ;',, iti;i0, #4,i,ii*.F.,,Oh.4446....T4§,:i4,$...ii, 1040;1:7!l':!Ill:'.;;;;;L,..A(.,: Emergen Sysleill. liner epnriitcly rleriVed
' i : t. 1:1 &kW ion o inew motor Mod of 0 - • • •
1001-1P Or mire. occupancy.
Job no.: Joh site addre.ss: i (.4 q(e,;, S i Ur 0 six or morc rc5tclentiOI units. 0 ReOrentional vehicle parks,
' 1:11-1colth-care facilities. 0 Supply voltage for more Man
City/Stitt/ZIP: - 1 -' 1 \ )C4,1ed 1 0 a- 0 linzardous locations, 600 VOIra nominal.
\) 0 ScraiCe or feeder 600 iimps or tua_,,,,,,,,.
Suite/bldg./apt. no.: I Pr ntI . ,,O,' AA , , A ii .,,,4 _A _ ; we. I il ":„..., 11F1::1 .;...,•:;',..:::- ,..„g.:,,;,,,!...
Cross Street/directions to job site: • ••
•
__ _--- —
_ •••iip' an.' l (TILL_ roc Taira
- New resIdentini single- or multi-family dwelling unit. _
includes attached garage.
- - -
Subdivision: 1 000 sci ft or less r 145.15 4
LOt no.: ...__'._-----7--
- -- --- Ea, add1300 sq, fl. or portion 33.40 1
T - ax map/parcel no.: 7,1,,.,,.:‘,:i „,..,,,,.;,77,,,, limited energy re 7 00 2
,• , t......",..,•;--,:.;;',..-,•'„ ,„„i, .„,, (with nuove so, k)
• . ' IIII 5 '
. 1t.:;.i,:;ii ii; ' c il.Z.,,,Ela.11.11q Limited energy, muitmily 1111 75 2
- 0 WIMP CA fertAi4 Mak SA i'il0i-/' . residential (with above sq. 11) _—
Services or feeders installation, alteration, and/or relocatiai
.-----__
200 arrip=lIss 80,30 2
. ittuly: 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160,60 7.
Name: 7:e0t.4-N 240.60 2 2
- - -------- 601 amps to 1,000 amps — --
Address: - Over 1,000 amps or volts , ..4 6S 2
_ ----- ------------- Temporary servrecs or feeders installation, alteration, and/or
City/State/Z1P; relocation ,
Phone: 3) ) i 2_ ..- 2 i....p Fax; ( ) 200 smps or less
-- ------ 66,R5 1
.
--------. 2
Owner instalintiont This installation is being made on proper 01 amps to 400 amps 100,30 ty that I own which is not — ... .-
401 amps to 199 timi 2
intended For sale. lease, rent. or exchange, according to ORS 447. 449, 670, and 701.
Branch circuits- new. alterationor extensior_e
Owner sinature: _ Dote: __.-----..
A. Fee for branch circuits with
— ----
0 . ,.. —', , trojt,,i —• ot, . .,,,,,,,,,,‘..,.:;.,;,? above service or feeder I'm 665 2
— each branch circuit . .-----
i_
Business name:R)1e.e-6' oiciktic- Ft. Fcc for branch circuits
-------------- withal/1 service or feeder tee, i 46,83 C# 25 2
Contact name: vv o liv,i-N first branch circuit.
-- ----. __—__— --
Address: PO 31
Each add branch circuit 1 6,65 2
- , 0
, ..---- ---- - ---
Miscoanew. (service or feeder not included)
City/State/71P; Ore . n C i o (1 11 IN') E,rich manufactured or modular 90.90 2
_
—:-1 dwelling, service and/or feeder
Phone: (93 ) (61 ....lin I Fax: : ( 9 )'1Z,2_ -S , Reconnect only 66.85 2
--
E-mail: " 01‘..•• \ e Dakcji--i (....,01.A1 e.... ec i L . Go re-.1 Pump or irrigation circle
, 1 • . , .. „, , Sign or outline lighting _ 53,40 2
:::,• :.i, ,• , ..;.";!.......y.:i, ,, ' ::.•;:,'; .. , ; ; ..,; • ,•, - Ji i tt::• , i•::I,'..: •-•
Business name: .
Signal ciretni(s) or limited
energy panel; alteration, or
- — — extension. Describe: Page 2 2
Address: ,fv 4, Ck.,S a0) .
City/State/Z1P; Each additional ilispectinn over allowable in an of tly___IvC
, -------- Per inspection 62.50
Phone: ( ) .
1 Fu: ( ) (lime , .. -
•
• . .. Investigation per hour min) 62.50
C.C13 Lie.: ( ( 4 C t3 1 Electrical Lie.: Q (.9 s Liu.: .. Investigation
ci s , Industtial nlant pe hour , 73,75
; - 7-7,77-1-utermic61,,,,np,knry,.,.:',!.:44,,.
I.S tory. Electrician signature, required; . .. / /.0' I • /12 subtota tt, l: k lic)5)
v --
Print name: --7 0)A.,,l 2AI 1 ff., I - Dale: ( ,,-7 Nat'l (25% of permit Ica
---------- _----
State surcharge (12% of permit fee); 6
Authorized signature; If
Print name: ,SInc,1 -.•
Le 1 2 ,rniy.L..ox. Date: i , -- - 1 ...-- Otis This permit application expires if a permit is not obtained within 180
thly$ siffer It ims been accented
1 : us complete,
Tui !cling \ r crmi t App dee aso,Nor, " Number or inspections allowed per permit,
010-01M 1 ioNCONI/Wrm
CITY OF TIGARD
BUILDING DIVISION . PERMIT #: R.C2008-00012
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/7/2008
Phone: (503) 639-4171 71/lit
Inspection Requests (24 Hrs.): (503) 639-4175 _1-
INSPECTION WORKSHEET FOR DATE: 1/8/2008 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 14962 SW 109TH AVE CLASS OF WORK:
SUBDIVISION: CANTERBURY WOODS CONDOMINIU LOT #: 062 TYPE OF USE:
PROJECT NAME: PASCO
DESCRIPTION: (1) branch circuit. to master bath.
OWNER( BO,JEAN EAN PHONE #: 603-372-6240
CONTRACTOR: ''PAGifiG "HVVEST ELECTRIC INC \ PHONE #: RTY3 - 657 - titgr
Inspection Request Scheduled For: Date: 1/8/2008 .Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electtical final 062760-01 503-667-1188 y
Corrections/Comments/Instructions:
N
•
PASS 0 PARTIAL APPROVAL 0 CANCEL El NO ACCESS
I] FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: I ' Phone #: (503) 718- 11 13
•