Permit CITY OF TIGARD' ELECTRICAL PERMIT
PERMIT #: ELC2007 -00320
COMMUNITY DEVELOPMENT DATE ISSUED: 5/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S103BD - 09700
SITE ADDRESS: 12957 SW 116TH PL ZONING: R -4.5
SUBDIVISION: HUNTERS WOODLAND LOT : 009 JURISDICTION: TIG
PROJECT: THOREN
Project Description: Panel change and (8) branch circuits with service.
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 HM/ SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10):
SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS
0 - 200 amp: 1 W /SERVICE OR FEEDER: 8 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
TED & KIM THOREN BRIDGEPORT ELECTRIC
12957 SW 116TH PL PO BOX 3037
TIGARD, OR 97223 CLACKAMAS, OR 97015
Phone: 503 - 579 - 0768 Contact #: PRI 503 - 969 - 8646
FAX 503 - 558 -8360
FEES
Description Date Amount Reg #: ELE 279 -C
[ELPRMT] ELC Permit 5/9/2007 $133.50 LIC 170294
[TAX] 8% State Surcharge 5/9/2007 $10.68 SUP 5059S
Total $144.18 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 B • /i ■ 14 A ; / Permittee Signature: 4filiczdtorl
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 09 07 11:56a Jeff Cox 503 -558 -0453 p.?
�r .i n
Flectrical Perm'i't Application � OR OFFICE OSEOl�I>�.V
City of Tigard Received J „ �L1� Perntit E .[�2o03--0032b
13125 SW Hall Blvd., Tigard, 3R 9722R EC E I V y �.' ._ Tian t�cvic.. -
Other Pentlil
Phone 503,639,4171 941 '03.5r)fi.l9f,0 ,, , f ,, ‘ Tmtr/Ry - -- -- MST4X(P (�0?`
inspection Inc. L 50'3,639.41 . U at c ttendy/ a )uric: m Sae ) 2 for
` � y• ~• a Irmen[al L,ror+ii:ltion
( Notified/Me o< rr
V S
{ � Notified e h
i
Internet: www.Ci.nRard.gr.us HAY -_ •' - - -_ -; _. - ---
,rr ,. , ..q.., . ,,,,�:,,,,,.: •a ..w�* ^r .,,.y. ,. ��•+.` 1/,•o.:, , r;'' +' ,:�`'r;'. ,•Y�t • ■ ihl "'�laa;;x j �tl . * r -1 r ' .f� r +�l - 1 14 . .
f.. ,. '.).x t I .0 'i��U . , J„ 1, Y 1 v; Q i : !j{., + „ p.' 1:,.. ':dri '' ! ii t + , . . 4 i •'.' , :' .,a,, ;,. % ' '4 „ii ii, ''••' '
,..: r ., .. n . 7il • ..h. � # - S'' k /t y ry nl�l:' V i.•.. t r ,� ( .I� . ;� -_ 'n:.i " �, %5,5n.` ... -
❑ New construction t nt Please check all that apply:
tLl�il�1�! Id�14Jt o ❑Scrvtcc over 225 amps, comm'1 ❑ltazerdoos location
❑ Demolition ❑ Other: _ []Service over 320 amps • rating ❑ttuildng over 10,000 sq. ft.,
;, T' _,."Y )< / � �1 "i . / ° ":u1; a'' '' 't`- �i' "�f,' ' "'
, , ;; ' i »1 dwellings 4 or more new residential •1/L' �,�. i k '�' , F " r; i,,, .1 ..t; 1 ,,1: Ii.� , ;,:.. , 1 . ' I: I �'' � " i. .� ', of 1- and 2-family +U
- . r •r:: i ?i. , '' � ' i. ( A'C , F fir � + , �Qt1 `�� a" S �� . �.� ' : ':Ir;' , y�';i�'�•u_, _ . ., , ..,t.
:'��5'`ltS.:,� `'s ',li }',(. ii w' . .:.,•Pj�'1�•, - �A�;�N'r,'lY.
QSystcm over 600 volts nominal units in one structure
- and 2-family dwcllitt.; ❑ CommerciaUindustrial ❑ Accessory building ❑iluildirtg over three stories QFccdcrs, 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: []Occupant load over 99 persons ❑ Manufactured structures or • r _ - r 't6 ad,f •t ^s.ntr p.J m .t.,.: ' ',. 4 ' RV park
ry� '�` n < } ' a cVx C g ress /1 hun plan
•,G i t'' t , Yi`C) f) I+G:r.Ai k.:: i`E:,i.`,, 1 ❑ s by
i:k:�'• �fi -.F 4: 0, Qthcr:
j / _ ❑T•icalth -carc facility
Job n0 -: J 76 site address: /.Z 5 �, �V , ( - I ' Submit 2 acts of plans with any nf ` the above.
City /State /ZIP: 7- O a / ' 72 3 The above arc not applicable to temporary construction service.
Suite/bldg./apt. no.: Project name: OY Description Our. Fee, 1 j Tato1 T
Cross street/directions to jet) site: y- New residential single- or multi- family dwelling unit.
• -- . • - Includes attached garage.
1,000 sq. ft. Or less 145.15 4
I a . addl 500 sq. n, or portion 33,40 1
Subdivision: Lot no,: e
-_ - Limited energy, residential 75.00 _ 2
Tax map /parcel no.: • smil energy, non _ residential 75 2
"S° ri , . . r: l a't l a{
' :'�t 7 6 ; r' : �.0rt ' 1� . � P; ,.4 . Q " c � L , ' t � �` ,,,„•,,,„ . `.:..- NM ^..,. .Bach manufactured or modular
7 C ` dwelling,, service and / feeder 90
or eeer .90
" A� Et. C C'4A {`s I R C V t 1 S Services or feeders iric[allatioo, alteration, and/or rcloca0.
200 amps or less / 80,30 GC ii '' 2
". ,,,.,, .. 4; 7 t 201 amps to 400 amps 106.ii5 2
��;(i:ir.tt`�QJ1,,�,p, .,t .,'. 1. ,F , . y "� iq'�t. F :0 t; .' 'i, , ' -. �+' ., k q' q,„ "� ( irY : „,(... i - 160.60 2 V • ` ... • - r.:,. L.. .t•••• ...: , i P, ,,, ,
•••:�,. r ,�,: 4 I . r ji t, y l`'4 l'�i : till "' 0l p _
° `ir' TMf k y ' i r,J} a ...:w 1 '1.;r � �:u, .--4." S L r :.n =,.., r� a s 4 amps to 600 amps
Name: ---Th�7 7 ► - 1 601 amps to 1,000 amps . 24040 2
�
` l Over 1,000 amps or volts 454.65 2
Address; / �' J 5 . w . `� �C- , Reconnect only _
77 66.85 2
City /State/ZIP: ` 7 '? 2_3 Temporary services or feeders installation, alteration, and/or
og. `,'
G relocation
Phone: ( ) Fax; ( ) 200 amps or less 66.85 1
Owner insta This installation is being made on property that I own which is n•,t 201 amps to 400 amps 100.30 2
intended for sale, lease, r:at, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133,75 _ 2
Owner signature: _ Date: Branch circuits - new, altcratiO t. or extension, per panel
y t r ; ���p :... 4 l i. fi ' W � ' ^' ,LL;;� � q A. Fee for branch c with
F'� h' l' C� (; + :;5; . c? , , � ` servic or feeder fee, each 11
: " . y � � g 6.65 y] 2
Business name: branch circuit
- - 13. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
each branch circuit
Address: Each add'1 branch circuit 6.65 2
City /State/ZIP; Miscellaneous (service or feeder not included)
_ Pump or irrigation circle _ 53_40 2
Fax; ) . htin 53.40 2
Phone: ( ) ( Sign or outline_hg g
Signal Circuits) or limited -
E-mail; �
iy,s n ,s�•Ff; ` ta:' s ' •
. ,y ... r$:.,..;, '' 1 ` ( t r. fi'`l� ":1w`yYrr:l. ` .M�• , t'�t' S?�Qy , ,rof,,T • ,ri. 'n,l:. ° energy panel, alteration, or
Page 2
.t' -' �;II':;s('!"ik6 {M1;n,tnk ? ;17e^',lr:.ieyg ' . ._. :, '';:, , ,,: extension. Describe:
Business name: 3 /2.t , , R•"t Z-k-e_ C -
(� O "- Each additional inspection over alluwn in any of the above
Address: 1' �r "i' = __ _ Per ins 6 2.50 ,^
City /State /ZIP: C, L. ek Ci .A? -.A '.. .:,rt co-Q, l - - - investigation per hour (t hr min) 62.50
.5-5- -`�� Industrial plant per hour 73.75
Phone: (�3) `T � � C°c ( Lc. Fax: (5�� a r P � ' . ,i t - • ∎ :�. -;MI
CCU Lic.; r7-..,,, a 9� Ele ctrical Lic.: C' Z t Su Lic.: c j � J 1 Subtotal / 33
(J Plan review (25% of permit fee)
Suprv. L�lcctrician sign;.tare, required; ` '" "�`'"�""` -' - g i
State surt:hidge 0% of permit ice
eJ�.lh Date:
Print name: S ��' 5 4 TOTAL PERMIT IMF.
✓
Authorized signature; ` / i
. f � This permit application expires if n pernrlt it nut obtpincd Within 180
Hays Auer it ham been accepted as complete
r„,.. ^ k D ) / 67-
' [ • fee methodology set by I'ri County Building Industry Service Ocala
• ^ Nutrd ct of
Print name: .r iuspectie+u per pemlit allowed.
440.4615T(10/02/C )M/WCii
iAD uildinglfarrtBUn ELC- PetnitApp! 11/03
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00320
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2007
Phone: (503) 639 -4171 4,0�1l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/13/2007 TIME: 7:01AM PAGE: 7
SITE ADDRESS: 12957 SW 116TH PL CLASS OF WORK:
SUBDIVISION: HUNTER'S WOODLAND LOT #: 009 TYPE OF USE:
PROJECT NAME: THOREN
DESCRIPTION: Panel change and (8) branch circuits with service.
OWNER: THOREN, TED & KIM PHONE #: 503.519.076I3
CONTRACTOR: BRIDGEPORT ELECTRIC PHONE #: 503 - 969.8646
Inspection Request Scheduled For: Date: 8113/2007 Pour Time:
Code # Inspection Description onfirm # Contact # Message
199 Electrical final 053872 - 503 -341 -4922 \ Y
Corrections /Comments /Instructions:
3 1 _
FlL r
. MPA,
► Li'" % OAS
ASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
IL LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G7 t' 1 I - Date: 4I( 6J Phone #: (503) 718 -
.
CITY OF TIGARD • f pfri'
BUILDING DIVISION PERMIT #: ELC2007 -00320
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/912007
Phone: (503) 639 - 4171 �ii j � l �
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ■ ..
INSPECTION WORKSHEET FOR DATE: 8110/2007 TIME: 7:00AM PAGE: 2
SITE ADDRESS: 12957 SW 116TH PL CLASS OF WORK:
SUBDIVISION: HUNTER'S WOODLAND LOT #: 009 TYPE OF USE:
PROJECT NAME: THOREN
DESCRIPTION: Panel change and (8) branch circuits with service.
OWNER: THOREN, TED & KIM PHONE #: 503 - 579 -0760
CONTRACTOR: BRIDGEPORT ELECTRIC PHONE #: 503 - 969 -868
Inspection Request Scheduled For: Date: 8/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 053810 -01 503 -34B -4922 Y !!=`
Corrections /Comments /Instructions:
CaNtAl A o £'9Q
/A1 'e `: 0 ,AAA a /A r
PASS n PARTIAL APPROVAL n CANCEL IjcNO ACCESS
N ; FAIL CALL FOR INSPECTION ❑ ADDITI NAL FEES ASSESSED
Inspector: Date: ' ( V " Phone #: (503) 718-
9
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00320
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/9/2007
Phone: (503) 639 -4171 u l l
Inspection Requests (24 Hrs.): (503) 639 -4175 ,
INSPECTION WORKSHEET FOR DATE: 5/2312007 TIME: 7 :00AM PAGE: 44
SITE ADDRESS: 12957 SW 116TH PL CLASS OF WORK:
SUBDIVISION: HUNTER'S WOODLAND LOT #: 009 TYPE OF USE:
PROJECT NAME: THOREN
DESCRIPTION: Panel change and (8) branch circuits with service.
OWNER: THOREN, TED & KIM PHONE #: 503 - 579 -0760
CONTRACTOR: BRIDGEPORT ELECTRIC PHONE #: 503 - 969 -8646
Inspection Request Scheduled For: Date: 5/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 04889•01 : 5 . 03422 -2707 N
Corrections /Comments/ Instructions:
•
PASS PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v �� '"v Date: �� 131 Phone #: 503) 718 -
(