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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2008 -00153 IMPE! /- COMMUNITY DEVELOPMENT DATE ISSUED: 3/18/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BB -06100 SITE ADDRESS: 12600 SW 124TH AVE ZONING: R -4.5 SUBDIVISION: BROOKWAY LOT : 061 JURISDICTION: TIG PROJECT: ENGLISH • Project Description: Relocating electrical service. 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: 1 W /SERVICE OR FEEDER: 1 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: JIM ENGLISH OWNER 12600 SW 124TH AVE TIGARD, OR 97223 Phone: 503 - 810 -1799 Contact #: FEES Description Date Amount Reg #: I1LPRMT] ELC Permit 3/18/2008 $86.95 [FAX] 12% State Surchar 3/18/2008 $10.43 . Total $97.38 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 o OUNC at 503.246.6699 or 1.800.332.2344. Issued By: _ _ _ Pitt 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. Electrical Permit Application FOR OFFICE USE ONLY ' - . City of and Received Tigard Q 11111 g Date/By: ,3/.(�5c�- Permit No.: �/ / Cam` OM Si 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503 598.1960 Other Permit: A Date/By: TIGARD Inspection Line: 503.639.4175 l �N Date Ready /By: Juris ® See Page 2 for Internet: www.tigard-or.gov • VVV ��� Notified/Method: Supplemental Information 1 .'., , TYPE :OF .V,0 .1 . a,^ . ,-4.' - � ° � ,1 s - � s � � � . . x ° � ' F, . f�� ,, . _ S�ELAN REVI:oV °?'.^ . '' �{ Please check all that apply ❑ New construction ® Addition /alteration) / -epla� j�0�1��3�>t " PP Y ( submit 2 sets of plans w /items checked below). ❑ Demolition ❑ Other: cc 1 ��,6r`� � ❑ Service or feeder 400 amps or more ❑ Building over three stories. �, where the available fault current ❑ Marinas and boatyards. ry , f t - Z - GATEGORYa OF COONS6 ,F , w .a 3 _ w ° d 3 , exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pulp. ❑ Installation of 75 KVA or e =' B; "SITE =INOR FMATION AND `LOC'Sii k �p h , Amergen o new em. larger separately derived systen `� • - ATIO � ` t .... ,y ID Addition of new motor load of ❑ .`A , .E ,. "1.2 "1.3 Job no.: Job site address: 12600 sw 124 ave 100HP or more. occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks. City /State /ZIP: Tigard, OR 97223 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: Servic ntry Reloction e. `� /,T (- s6) 4 ❑ Service or feeder 600 amps or more t : '' '?" - 2 :1:) ,:, ~4 °FEEaSCHEDULEd,`" -r;. :w : x; .. Cross street/directions to job site: Walnut Description I Qty. I Fee. 1 Total i New residential single- or multi - family dwelling unit. includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, esidential DESCRIPTION,,'. "OE WOR gy 75.00 2 i ' ' " r' ; .4 . . s I ,, ° ., s ' ', (with above sq. ft. ) Relocation and undergrounding of Electrical Service enterence Limited energy, multi family 75.00 2 residential (with above sq. 11.) Services r less ders installation, � ton 8 0.30 2 alteration, and/or relocation ,i � ; ,PR ©PE RT , ',,,,ii 1VER i' ' -a i * °, ® .TENNT , . . . 201 amps to 400 amps 106.85 2 Name: Jim English 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: 12600 sw 124 ave Over 1,000 amps or volts 454.65 2 City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or relocation Phone: (503) 810 -1799 Fax: ( ) 200 amps or less 66.85 1 Owner installation: T I nstallation is being made on property that I own which is not 201 amps to 400 amps 100.30 2 intended for sale, lease, *or exch.ne, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2 Owner signature: Date: r e --05 Branch circuits - new, alteration, or extension, per panel Fee for branch ' x ' M _*Pit I ^_' ❑r C ONT A CT :PERSON :' i` e a A above service or fee / 6.65 each branch circuit 67.05-- 2 Business name: C2___A.P\f ‘f) B. Fee for branch circuits Contact name: witho service or feeder fe 46.85 2 first branch circuit Address: Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and /or feeder Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E - mail: Pump or irrigation circle 53.40 2 .. ,, %CONTR ACTOR', r nfi `"' x , :, " 7 l` . _ Sign or outline lighting 53.40 2 Business nameC� 6 Signal circuit(s) or limited- ( (J energy panel, alteration, or Address: extension. Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (i hr min) 62.50 CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75 :..';V!,;::::!' ` ELECTRICAL -I PERMIT FEES ; - , _ *`�''_ Suprv. Electrician signature, required: Subtotal: ( , 45 Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): i 0 L( 3 Authorized signature: TOTAL PERMIT FEE: G1 7 This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. l. \ Building \ Permits \ELC- PemvtApp. doe 05/23/06 440- 4615T( l l /05 /COM /WEB CITY OF TIGARD 7 BUILDING DIVISION PERMIT #: ELC2008-00153 13125 SW Hall Blvd., Tigard, OR 97223 4A DATE ISSUED: 3i18/2008 Phone: (503) 639-4171 knoliP, - At\ i„, 114bil 1 1 Inspection Requests (24 Hrs.): (503) 639-4175 --/ INSPECTION WORKSHEET FOR DATE: TIME: PAGE: 1W17/2008 7:02AM 39 SITE ADDRESS: CLASS OF WORK: 17600 sw 124TH AVE SUBDIVISION: LOT #: TYPE OF USE: BROOKWAY 061 PROJECT NAME: ENGLISH DESCRIPTION: Relocating electrical service. OWNER: ENGLISH JIM PHONE #: 5 0 3- 8 1 0 1 799 , CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 10/17/200 Pour Time: 1 Code # Inspection Description Confirm # Contact # Message 199 Electrical final 076819-01 503-810-1799 N Corrections/Comments/Instructions: i ! So A/4 1.4 Adiai,i4"4.,A..•11 - ...4e ze Al . 1-.1;4 . A _ : 41 - T. , kd' — ,....--_, .. F •• . OM 'ASS • PARTIACWPRO [ CANCEL „.......°."." AM _ .. .., , o N friofai"'we 0 ADDITIONAL FEES ASSESSED - , / ---- /7 (e....7g tzgr/ Inspector: , _ ""----- ----mar • Date: Phone #: (503) 718- —.._ ■ --- . 7 , ._ . CITY OF TIGARD 51 ( I , ' t Z v 4 44411: , „ . BUILDING DIVISION PERMIT #: ELC2008-00'153 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 311812008 Phone: (503) 639-4171 , ,,,tvitifi Inspection Requests (24 Hrs.): (503) 639-4175 e t f t . ..., ... U. .aa E. i • INSPECTION WORKSHEET FOR DATE: 4/1/2008 TIME: 7:01AM PAGE: 54 SITE ADDRESS: 12600 SW 124TH AVE CLASS OF WORK: SUBDIVISION: BROOKWAY LOT #: 061 TYPE OF USE: PROJECT NAME: ENGLISH DESCRIPTION: Relocating electrical service. I OWNER: ENGLISH, JIM PHONE #: 603-810-1799 CONTRACTOR: OWNER PHONE #: 1 Inspection Request Scheduled For: Date: 4/1/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 1lb Electrical service 067699-01 603•810-'1799 N Corrections/Comments/Instructions: r, PASS 0 PARTIAL APPROVAL 7 CANCEL 0 NO ACCESS El FAIL El CALL F' INSPECTION fl ADDITIONAL FEES ASSESSED IL ( I (0% ig711/0 Inspector: Date: q (illr ''! '‘Ir, Phone #: (503) 718-