Permit CITY O F TIGARD ELECTRICAL PERMIT
II •l PERMIT #: ELC2008 -00515
COMMUNITY DEVELOPMENT DATE ISSUED: 9/5/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S134AC 04100
• SITE ADDRESS: 10863 SW 111TH AVE ZONING: R -4.5
SUBDIVISION: HARTS LANDING LOT : 012 JURISDICTION: TIG
PROJECT: HIGGINS
Project Description: Reconnect only. Meter removed to reside house.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
BILL & SUNK! HIGGINS
10863 SW 111TH AVE
TIGARD, OR 97224
Phone: 503 - 793 -1053 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 9/5/2008 $66.85
[TAX] 12% State 9/5/2008 $8.02
Total $74.87 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 rule re set fort fn • - •52- 001 -0010 through OAR 952 -001 -0100. You may obtain copies f these rules or direct questions to OUNC at
503.246 699 or 1.800.
Issued By: ■ _ / � � ' , L • Perm ittee Signa,i/ 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:
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.
, SEP -05 -08 13:26 From:PELLA VINYL PORTLAND OPERATIONS 5036676030 T-103 P.01/02 Job -076
c .. ..-.., .. r*la-�rsaa.nuva■ 1111t Il I. I �I tt \I
City 1 k <e�ett'cd '1
tY Of B $ cElvE ' 9 08
q 13125 DatvBl' Parrot No aa -
SW Hall Blvd., Tigard, O 7
Plan Review ® C'
• � " �
Phone: 503.639.4171 Farr. 503.598.1960 Datc/13%., Other Penult
t t Inspection Line: 503.639.4175 SEP - 5 ?O L''':3 Date tteady.By- i '" et See page z ror
Internet: www.tigard- or.sov Notified/Method;
m r7- S iePP lementa I Information
• ❑ New construction Additi - - o VIv Please check all that apply (submit 2 sets of plans w/items chocked below)',
1:1 der
❑ Demolition nt a Service or fee 400 amp& a,- more C] Roild o ver tt>
in
— where the available fault curre
Me rin and boatyards.
_ ' ; — t`A7I'1& GOY. Qb' C Ns>R1J ic l' exceeds 10,000 amps at 150 volts or [a Floating buildings.
►+ 1 and 2- family dwelling ❑ ComnterciaUinalL4h78I Q Accessory building lass to ground, or exceeds 14.000 El Commercial -use agricultural
0 amps for all other installations. buildings.
U ❑ Mesta builder ❑ Other ❑ 1'ire pump. ❑ Inid- altation of 75 I:VA or
TI ❑Emergency system larger separately dem system
�� ❑ Addition of neW motor load of
Q ..A....F" »1_2,...1,3 ",
Job no.: Job site address: pq �r loottP or more. occupancy 60 u �' t i (.4. „ oi l::
❑ Sut or more n5ident al units. ❑ Recreational vehicle park:,
City /StateI T G.,:), (40 c, A El Health -core facilities. 0 Supply voltaRC for more than
l� 0 Hazardous locations. 600 volts nominal.
Suitelbldg. /apt. no.: Project name: '-I(I L t,.'1 N S ID service or feeder 600 amps or more.
Cross strec/directions to job site: ,,,a No (LI K, 0 /..44 IA S t4.,) I o'r r 1+ d ... .. �� .
- Fee. total •
New rentlenttlal ain¢e- or a aoJd-lmnlly dwelling unit.
•
Includes attached g uage.
Subdivision: L no -: 1,000 sq. lt- or loss 145.15 __Ili
Tax map/parcel no.: Es add'I 500 sq. fl. or portion 33.40 I
l WSt'k PUON. 08 *Mg Limited energy, residential 73 -00 7
(Roth atx.ns 1
Limited energy, mutti- family
I A.5 f c C-kg„.` ¢ G A V dG a'k %,... o r lC ta•. L't t rt r4. r residential (with :shore sq ft ) 75-00 2
a �'k' e r '� 4-4.-J 5 t r t • t c. • Services or feeders iust Madan. alteration, and/or relocation
• a - 200 amps Of less 80.30 2
s9ni v OWNER' • Ci. T TANT '. 201 a mps to 400 amps 106.85
. - 2
Name: e 1 1 401 amps to 600 amps 160.60 2
5, v rt k
Aaares 601 amps to 1,000 amps 240 60 2
t t r 1� j S:r _ Over 1.000 amps or volts 45465 2
City /Sta 1 c. v . i h 7 Z 3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( - v ) — 1 1) s 3 Fax: ( ) 200 amps or less '
66,$5 I 1
Owner installation: This installation is being made on property that I milt which is not 201 amps to 400 amps 100,30 f l 2
intended far sale. hone, rent. or exchange, according to ORE 447, 449, 670, and 7(11. 401 amps to 599 am 133.75 I 2
(. w= signature: Date: 1it71nch circuits -ace. alteration o extension. r anal -
0 Ali ur-tr' - -
I
= . A. Fee 1br branch circuits with ❑'CONTAC TER N ' above service or feeder fee,
Blisitt name: each branch circuit 6.65 2
K. Fee for branch circuits
Contact name: without service or feeder fee,
_ Graf branch circuit 46.85 2
Address: Each add'I branch circuit 6.65
Miscellaneous 2
City/State/Z P: _ Each manufactured or modular
not lncluded��
Phone: ( ) Fax : : ( dwellin service and/or feeder 9090 2
-mail Reconnect only / 66.85 — 2
d a ^ w Pump or inigalion ties 1n 53.40 2
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
pection over allowable in anvof the above
Phone: ( ) Fax: ( ) Per inspection 62.50
Investigation per hour (1 hr min) 11 I 62.50
1
CCB Lie.: Electrical Lie.: ! Supty. Lie.: Indu per hour
73.75
Suprv. Electrician signature, required: .bC�Tt;iCA i'�PJi . � `T”
— - Subto $ J
Print name: Date: Plan review (25 %ofpermit fee): _ ®—''
(
Autharizad signature, State surcharge (12 %of permit foe): O D
Q� TOTAL PERMIT FEE: 74.
Print 11011te. ' t L 1, 1 SS -, : q � �� p This Permit epplkatioo e;pirrs if emit 6d not obta within 1ti11
1
J Date (a days after it has been accepted as complete.
CITY OF TIGARD,
BUILDING DIVISION PERMIT #: ELC2008-00515
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: 9P,V20013
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 „Ts
INSPECTION WORKSHEET FOR DATE: 9/10/2008 TIME: 7:00AM PAGE: 32
SITE ADDRESS: 10863 SW 111TH AVE CLASS OF WORK:
SUBDIVISION: HARTS LANDING LOT #: 012 TYPE OF USE:
PROJECT NAME: HIGGINS
DESCRIPTION: Reconnect only, Meter removed to reside house.
OWNER: HIGGINS, BILL & SUNK' PHONE #: 503-793-10
CONTRACTOR: PHONE #:
CAKOIA 10
Inspection Request Scheduled For: Date: 9/10/2008 Pour Time:
Code # Inspection Description CofifiTh# Contact # Message
fici9 nal .75247-01 503-793-1053
Corrections/Comments/Instructions: J0:10
\
•
E PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
0 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: 'Ili O Phone #: (503) 718- 1)14