Permit �" i OF TLC w ^ ® ELECTRICAL PERMIT
; �,,se �` HK
PERMIT #: ELC2006 -00348
Ail DEVELOPMENT SERVICES DATE ISSUED: 6/22/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133DD - 13400
SITE ADDRESS: 11866 SW 127TH PL ZONING: R - 4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT : 171 JURISDICTION: TIG
Project Description: Add sub panel & (6) circuits.
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: 6 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:
PAT & SUSA WILLIAMS CLACKAMAS ELECTRIC INC.
11866 SW 127TH AVE PO BOX 51
TIGARD, OR 97224 BEAVERCREEK, OR 97004
Phone: 503 - 524 -6494 Contact #: FAX 503 - 632 -2421
PRI 503 - 632 -2420
FEES
Description Date Amount Reg #: ELE 3 -606C
[ELPRMT] ELC Permit 6/22/2006 $120.20 LIC 161932
[TAX] 8% State Surcharge 6/22/2006 $9.62 SUP 5041S
Total $129.82 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: 7 —/ _ Permittee Signature: (?$, s (
OWNER INSTALLATION ONLY V
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.
JUN -22 -2006 12:11P FROM : CLACKAMAS ELECTRIC 5036322421 TO :5035981960 P.2/2
!J,,E ectrical 1 crmit Appiicat.en' FOR (I141( t: 1 .I (1NI 1
CI of Tigard Received �J - � ,/ Pemtit No. ••✓ 1
�' 6 2006 Date/By. �,` // �J LJ�iC ,�t/!UA l/U3 /t7
13125 SW Hall Blvd., Tigard, OR 97223�1�N F`• / • Plan Review
Phone: 503.639,4171 Fax: 503.598.1960 ' " / *> "l tvic , I 1 Date/By. Other Pemrit:
Inspection Line: 503.639.4175 , ,, , at. j- `I � kris Date Ready /By: ri / See Page 2 for
Internet: www.ci.tigard.or.us y� j 1 I 0-' 1 Ai k `-.-' Notified/Method. l ( ® 1 Supplemental Information
,."- . "'NI,
l it ] p TYPE OF WORK PLAN REVIEW
❑ New construction 2r Addition /alteration/replacement Please check all that apply:
ID Demolition 1:21 Other: ['Service over 225 amps, comm'l ❑ Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
54- and 2- family dwelling 1:1 Commercial /industrial ID Accessory building ❑System over 600 volts nominal units in one structure
['Multi-family ❑ Master builder ❑Other: ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egressllighting plan RV park
Job no.: l Job site address: J 5 � , 7 /4,y ['Health-care facility ['Other:
Sub 2 sets of plans with any of the above.
City /State /ZIP: T i,„0 i o q 7 zZ � The above are not applicable to temporary construction service.
FEE" SCHEDULE
Suite/bldg. /apt. no.: I Project name:
Description I Qty. I Bee. 1 Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 1 Lot no.: Ea. add'I 500 sq. ft. or portion _ 33.40
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
A ec p,� _t.� dwelling, service and/or feeder 90.90 , 2
+�SA/l, { `K1, <--�I� 7 Services or feeders installation, alteration, and /or relocation
200 amps or less ' 8030 7D 00 2
J2 OWNER I ❑ TENANT 201 amps to 400 amps T" 106.85 2
401 amps to 600 amps 160.60 2
Name: S
f'1f1 4 uS U I
af.) I I 'Art) 1 S 601 amps to 1,000 amps 240.60 2
Address: i t E(_ I 5 ! z`t i' Over 1,000 amps or volts 454.65 2
��P Reconnect only 66.85 2
City /State /ZIP:
J f �t� oa 7 7 Z Temporary services or feeders installation, alteration, and /or
Phone: ($*3 ) se •4 - 4G tip( Fax: ( ) relocation
200 amps or less 66.85
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
IX APPLICANT 1 ❑ CONTACT PERSON A. Fee for branch circuits with
p service or feeder fee, each ( O 6.65 3 f. c 2
Business name: � 6 de. . 01 p, iJi er x..12 • 1 � �. _ brunch circuit
�+4G� -^ � B. Fee for branch circuits
Contact name: 5c_07 Jo vi-14.S b without service or feeder fee, 46.85 2
Address: Fp 809, S I first branch circuit
Each add'l branch circuit 6.65 2
City/State /ZIP: ,Fili/ertC a 14 t e 9Z O® Miscellaneous (service or feeder not included)
Phone: (g3 (22 _ c....(4 2 D Fax: : (S'63 632_ . z t ! L Pump or irrigation circle 53.40 2
`] Sign or outline lighting 53.40 _ 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
e , extension. Describe: Page 2 2
Business name: At ejgA.�►� 4s e-0121 c_ ...37, ,
Address: rd /2,4;:,,K s r Each additional inspection over allowable In any of the above
Per inspection 62.50
City /State/ZIP: g e 4 Ck. 9Z DC / Investigation per hour (I hr min) 62.50
Phone: (r1) 6'3 Z — Z C fz.° I Fax: lk>) G 2 -L 412,1 Industrial plant per hour _ 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: 11 /` /' el Electrical Lic.: 3- , A. , („I Suprv. Lie.: `v y! s- Subtotal 120 , LO
Suprv. Electrician signature, required: . /' Plan review (25% of permit fee)
Print name: S ' J 6 rf-/J &I-73 XJ / Date: / f j0 State surcharge (8 %of permit fee) Q, I► Z
[G , I `P TOTAL PERMIT FEE 12...q .. /1
Authorized signature:
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete
Print name: Date: + Fee methodology set by Tri- County Building Industry Service Board
" Number of inspections per permit allowed
i \ aui lding\PermllsWLC- PermitApp.doc 12/03 440
CITY OF TIGARD k'u
BUILDING DIVISION 2 PERMIT #: ELC2006 -00348
13125 SW Hall Blvd., Tigard, OR 97223 t / 1 DATE ISSUED: 6/22/2006
Phone: (503) 639 -4171 �� ��
'p
Inspection Requests (24 Hrs.): (503) 639 -4175 A acct ' ' II�
INSPECTION WORKSHEET FOR DATE: 12/8/2006 TIME: 7 :01AM PAGE:
. SITE ADDRESS: 11866 SW. 177TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 171 TYPE OF USE:
PROJECT NAME: WILLIAMS
DESCRIPTION: Add sub panel & (6) circuits.
OWNER: WILLIAMS, PAT & SUSAN PHONE #: 503 - 624 -6494
CONTRACTOR: CLACKAMAS ELECTRIC INC. PHONE #: 503.632 -2420
Inspection Request Scheduled For: Date: 12/8/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040862 -01 503 - 969.5684 Y ..R
P
Corrections /Comments / Instructions:
•
•
•
. ' PASS n PARTIAL APPROVAL ❑ CANCEL ( I NO ACCESS
n FAIL ❑ CALL FO INSPECTION ❑ ADDITIONAL FEES ASSESSED
• Anspector: P Date: Phone #: (503) 718 -M
CITY OF TIGARD 04
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UILDING DIVISION PERMIT #: ELC2006.00348
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2213006
Phone: (503) 639 -4171 1),riThp
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/18/2006 TIME: 7 :06A PAGE: 86
SITE ADDRESS: 11866 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 171 TYPE OF USE
PROJECT NAME: WILLIAMS
DESCRIPTION: Add sub panel & (6) circuits. •
OWNER: WILLIAMS, PAT & SUSAN PHONE #: 503- 524 -6 494
CONTRACTOR: CLACKAMAS ELECTRIC INC. PHONE #: 503 - 632 -2420
Inspection Request Scheduled For: Date: 10/'18/2006 Pour Time:
1
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 038365.01 503 - 96%-5684 N
Corrections /Comments /Instructions:
6 1 1 / g 4
/Z/
7C/_6
_ E N7 (&.
0944
.4iy 61
-
\1 PASS I I PARTIAL APPROVAL ❑ CANCEL XNO ACCESS
n FA fl CALL FOR INSPECTION ❑ ADDITIONAL FE S ASSESSED r 016
Ins ector: Date: ! I Phone #: (503) 7182
P )
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00348
13125 SW Hall Blvd., Tigard, OR 97223 ri DATE ISSUED: 6/22/2006
Phone: (503) 639 -4171 / WWII
Inspection Requests (24 Hrs.): (503) 639 -4175 112„
INSPECTION WORKSHEET FOR DATE: 10116/2006 TIME: 7 :03AM PAGE: 21
F341(01-L, 2i5(.
SITE ADDRESS: 11866 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 171 TYPE OF USE:
PROJECT NAME: WILLIAMS
DESCRIPTION: Add sub panel & (6) circuits.
OWNER: WILLIAMS, PAT & SUSAN PHONE #: 503-524-6494
CONTRACTOR: CLACKAMAS ELECTRIC INC. PHONE #: 503 -632 -2420
Inspection Request Scheduled For: Date: 10/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 038252 -01 503 - 969.5684 N •
c
Corrections/Comments/Instructions:
)e J P _- ,?Alva t-v 1C
• bis}I 66,RD 'P
•
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
�a lenr+ar days per OAR 918 -271 -0030
5v5
❑ PASS Li PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
AIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: c.:-/WP Date: /v /C -O 6 Phone #: (503) 718- 26-4/4 --7
• -
CITY OF TIGARD
BUILDING DIVISION A PERMIT #: ELC2006-00348
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/
Phone: (503) 639-4171 „...468814fillit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/10/2006 TIME: 7:06AM PAGE: 6 -
SITE ADDRESS: '11866 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 171 TYPE OF USE: .
PROJECT NAME: WILLIAMS
DESCRIPTION: Add sub panel & (6) circuits.
OWNER: WILLIAMS. PAT & SUSAN PHONE #: 503-524-6494
CONTRACTOR: CLACKAMAS ELECTRIC INC. PHONE #: 503-632-2420
Inspection Request Scheduled For: Date: 10/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
199 Electrical final 037961-01 503969-5684
Corrections/Comrnents/Instructi•
• b APA,
•
N (04 Ak)ekr-e1a
■11/
I I PASS I] PARTIAL APPROVAL n CANCEL A NO ACCESS
n FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: N 66 Le" Date: 16 la (16 Phone #: (503) 718- 2--11114
' . CITY OF TIGARD ,.
BUILDING DIVISION PERMIT #: ELC2006 -00348
13125 SW Hall Blvd., Tigard, OR 97223 'IL A TE ISSUED: 6/22/2006
Phone: (503) 639 -4171 Jimtlit Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/7/2006 TIME: 7:02AM PAGE: 14
SITE ADDRESS: 11866 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 171 TYPE OF USE:
PROJECT NAME: WILLIAMS
DESCRIPTION: Add sub panel & (6) circuits
OWNER: WILLIAMS, PAT & SUSAN PHONE #: 503-524-6494
CONTRACTOR: CLACKAMAS ELECTRIC INC. PHONE #: 603-632 -2420
1st. b 0,4_01' A t St? all el W o ti3 .
Inspection Request Scheduled For: Date: 7/712006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
c . _ _ : _ 12I� Electrical rough -in 032820 -01 503 - 969 -56B4 Y
Corrections /Comments/ Instructions:
1 1 '
) ASS I f PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 9v W Li Date: _ I 1 0'b Phone #: (503) 718- 24
•
Inspections Required for: ELC2006 -00348 �..
✓ 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
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
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:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG Structure set-up MEC - Mechanical Permit
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 322 Shower pan
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 \Inspection Cards \Forms \AOP- InspCard- Blank.doc 12/09/2005
CITY OF TIGARD ,, , ELECTRICAL PERMIT
PERMIT #: ELC2006 -00348
DEVELOPMENT SERVICES" ' DATE ISSUED: 6/22/2006
'' -"'" 13125 SW Hall Blvd., Tigard, OR 97223 503 -639 -4171 PARCEL: 1S133DD-13400
SITE ADDRESS: 11866 SW 127TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT : 171 JURISDICTION: TIG
Project Description: Add sub panel & (6) circuits.
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: 6 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:
PAT & SUSA WILLIAMS CLACKAMAS ELECTRIC INC.
11866 SW 127TH AVE PO BOX 51
TIGARD, OR 97224 BEAVERCREEK, OR 97004
Phone: 503 - 524 -6494 Contact #: FAX 503 - 632 -2421
PRI 503- 632 -2420 t
FEES 1"
Description Date Amount Reg #: ELE 3 -606C
LIC 161932 0 la
[ELPRMT] ELC Permit 6/22/2006 $120.20 SUP 5041S
[TAX] 8% State Surcharge 6/22/2006 $9.62 ,
Total $129.82 REQUIRED ITEMS AND REPORTS
8
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: - f ( . - -, Permittee Signature: r- 1 g f `�
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.