Permit rt CITY OF TIGARD ELECTRICAL PERMIT
� � PERMIT #: ELC2007 -00156
COMMUNITY DEVELOPMENT
DATE ISSUED: 3/14/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
. PARCEL: 2S104AA -02900
SITE ADDRESS: 12205 SW 126TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD LOT: 037 JURISDICTION: TIG
PROJECT: SAUNDERS
Project Description: 1 br. circuit to shed.
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: 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:
SAUNDERS, DAVID D WILLAMETTE ELECTRIC INC
MARY E PO BOX 230547
12205 SW 126TH TIGARD, OR 97281
TIGARD, OR 97223
Phone: 503 - 590 - 3532 Contact #: PRI 503 - 624 - 3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 3/14/2007 $46.85 LEC 75059
[TAX] 8% State Surcharge 3/14/2007 $3.75 SUP 1965S
Total $50.60 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: iz Permittee Signature: 45)1
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.
W 14 2007 7:34RM
r; WILLAMETTE ELECTRIC INC 5555555555 p.2
Paw L Ter . I i i- ; , .; , ' i •r µ , 0 f(11 fSt ` ! �. :; -' 4 37 4 7 5 � , ' ' � . - ' J `
I ?t i l'L�rl"1 ''� l{'. (,caiSlld's'+ 111 ' ,oil +' i 1;:i.7,1;;;740-;:(11
i,iliX �t : ` 3 . sl :. . ,,Fieb its a'tti ,f F • , m4' - ": c , m�, ' f, h`,v -
II. �" '114 Jj .E 1 l ,
isl 3/
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hoes: 5U i. l lo. 1 7 1 1 . .5taiS0t ; -1 %U c,: ; 6; i') , , �.�. --
MAR �OO� E t 4 -• " _a .. Da.fi :
R / by. J I s , t :1 See.
spcct on Lin SOS.(i39.4I7 a rn. al In
Notified /�9�ihod: S pple ent _ forniaki: »t - - _ - _ .
lnimuni ',vs ci.tigard onus ctrl OF i IGARD _ - -- .. --- - - - - --
- -._ -.— .. - - 451(1{4' T :)i+. • - 'e **vn 4'; -
P lease check all that apply:
[_� New construction Addition /alteratlonheplaeement rjService ever 225 amps, comm'l 01- lazaiclam location
Demolition ❑ Other: — []Service over 320 amps - rating ❑ Buildng over 10.000 sq. it..
-- -- i ; ft 61 0 „ > - t i4iiiit lit ii of 1- and 2- family dwellings 4 or more r.e.v residential
-a - ['System over 600 volts nominal units in one sirUCttu e
1 -and 2,- iarnily dwelling ❑ Commercial/industrial ❑Accessary building ❑Building over three stones ['Feeders, 400 amps or more
[] Multi - family ❑ [t/(astet builder ❑ Other: ❑Occupant load over 99 per ❑ Manufactured structures or
a3 a x= " ``s ❑Egress;lngp RV park
ightilan
c .L l j. ai i 4t'I F R
• ry � ❑Health -care facility ❑Other: •
Job no: y' Job site address: Z Z�5 5 1,,) �li� � Submit 2 sets of plans with any of the above.
C ity /State /Zl P _ - 44 , r - 6 � The above are not applicable to temporary constructon service.
l'! I f 4 *i .-,:kip eft „ &�li .,
Suite bldg. /apt. no.: Project name: u L ✓ p cripUO Qty” Fee. '1 oaf
Cross street/directinns to job site: New residential single -or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.:
Ea. add'l 500 sq. ft. or portion 33.40 1
• Limi[edenergy,residential 75,00 ' 2
Tax map /parcel no.: ° `_ ,i y Limited energy, non - residential 75.00 2
;' •, . '` _ '. .a, ? : ,. a 'i = Each manufactured or modular • Ib�
"'' ' ` // � dwellinP, service and /or feeder 90.90 2
V i pZ �i ` ji Services or feeders installation, alteration, and/or relocation
-- 200 amps or less 80 2
r t f ;t 201 amps :0400 amps 106.85 2
' _ p �; r i 'l':*Ff 5r`airAW '”" . s: =� ' , " »., .. 17- ° . `'' 401 amps to 600 amps 160.60 2
N ame: 601 amps to 1,000 amps 240.60 2
• Over 1,000 amps or volts 454.65 2
Address: 66.85 2
•
Reconnect only
City /State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: (66) . 5 - -b6 3 L , Fax: ( ) 200 amps or less 66 .$ 5 1
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
Ovmer signature: Date: Branch circuits - new, alteration, or extension, per panel
M Z r -- - = , tM1 t. - A. Fee for branch circuits with
` r `, . ? . r " s �� a r _ _....0,
i service of feeder fee, each 6.65 2
branch circuit
Business name: B. Fee for branch circuits .
— Contact name', without service or feeder fee, 1 46.85 ti-t<. f( - 2
first branch circuit
Address: Each add't branch circuit 6.65 _ 2
City /State /ZIP:
Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 _ 2
E-mail : Signal circuit(s) or limited -
a, z a,.� a t ` •- a, - -a;'• te,tr: ,°t.?;:, , ,lt 11 :•„' energ panel, alteration, or
_ :, _ ' .:_i== ;:,s :. :.�.� ,.. _. s w .. ,,�c.,. +, . ��,:...._ -r- _• r,- � ?• extension. Describe: i Page
..''• �-�:. 'f: + iii -'<' .. �,�,:.
.r. .. .
Business name: 11 e: 0., et- E a / e c re .t-' .
' Each additional inspection over allowable in any of the above
Address: 1- 0 i .3, $ S ? Per inspection 62.50
0 i lnvcstigation per hour It hr min) 6250
City /SfateiZll': � a � 0. ,..,1 Su 73.75
Industrial plant per hour _ •
Phone: (.5 ) i l�V -- 3( �gr € �,I ^a '
ectra ` - -j, Suprv. Lie.: •. • Subtotal 11/6 CCB Lic.: 7 El icl Lie.: 3 ` W..._.... O 5
` "" Plan review (25% of permit fee)
sup,. Electrician signature, required
.... . ,.-.... . - --- ..... " .
State surcharge (8% of permit fee? 3. 7.....,
Print name: '. -�
Date: 3 /3 TOTAL PERMIT FEE 5.9, GD J
This permit application expires if a permit is not obtained within ISO
/\Utllt;rized Sigtrat _. _ _,- - - --- days after it 11115 been accepted as complete
- Pri Print n - -- f - --- - - -•- - - -- Date: '' Fee nie :hodology set by Tri- County Building Industry Service Maid
!tint 9nle I
-- -_ " Number of inspections per pemntallowed.
-- 44 U- 46157(10/02 /COM /WM
I \ 13uilding, \I'e+In;R..CLC- PernutAi,l, doe 1'1/x'3
CITY OF TIGARD ► zs'i ,
, 2'7 r
BUILDING DIVISION ., PERMIT #: ELC2007 -00166
' 1 13125 SW Hall Blvd., Tigard, OR 97223 y � DATE ISSUED: 3/14/2007
Phone: (503) 639 -4171 L /�
Inspection Requests (24 Hrs.): (503) 639 -4175 - 'LL.
INSPECTION WORKSHEET FOR DATE: 3/30/2007 TIME: 7: 00AM PAGE: 17
SITE ADDRESS: 1220 5 SW 126TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD LOT #: 037 TYPE OF USE:
PROJECT NAME: SAUNDERS
DESCRIPTION: 1 br. circuit to shed.
OWNER: SAUNDERS, DAVID D, PHONE #: 503 - 590.3532 ,
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503 -624 -3631
.
Inspection Request Scheduled For: Date: 3/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 045770 -01 503 -624 -3631 Y-
"O TIA Y WI VP/iI
Corrections /Comments /Instructions:
•
' f MAFOOP,
1.10 ...ay
/
. , T
X` I I PARTIAL APPROVAL ❑ CANCEL — NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ilifiti l Date: Phone #: (503) 718