Permit CITY OF. TIGARD ELECTRICAL PERMIT
q PERMIT #: ELC2008 -00276
.111 °. COMMUNITY DEVELOPMENT DATE ISSUED: 5/14/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DD - 14800
SITE ADDRESS: 11787 SW 128TH AVE ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT : 185 JURISDICTION: TIG
PROJECT: TEEL
Project Description: Panel change Job No. 136308
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: SIGNAUPANEL:
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: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 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:
DAVID TEEL BOONES FERRY ELECTRIC INC
11787 SW 128TH AVE PO BOX 628
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: Contact #: PRI 503 - 682 -4936
FAX 503 - 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
. [ELPRMT] ELC Permit 5/14/2008 $100.25 LIC 88482
[TAX] 12% State 5/14/2008 $12.03 SUP 4918S
Total $112.28 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'nio a nn 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those rules are set forth i O:. 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain cop o t' -se rules or direct questiois to OUNC at
503.246.6699 or 1 .800.3 /
Issue By: l , F 11Pi• ,�_�1 r Permittee Signat re: •, �, �, ,, c).----
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:
ONTRACTOR INSTALLATION ONLY
•
SIGNATURE OF SUPR. ELEC'N: ? %'(✓l" (c — 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.
. ,, 1t:XMav, 13.2008 57PM BOONES FERRY ELECTRIC No, 3682 P. 1
11CaL , Li a 5i FOR oFficF USE ONLY'
. , City of Tigard t [[p�� j C � � _- Received r 7
•
y 4 L . . �1 paws b �� 4 Permit No,. e�ae� / i
13125 SW Hall stvd,, Tigard OA ;r 1 - 11
; 3 ' Phone 503.639.4171 Fax: 503. 98.1960 Plan Revicu
Inspection Line; 503.639.4175 3 201 Date/B Other Permit:
TICnKD MAY bate Ready/By: )�u�
tigard or goo El Page 2 for
Notified/Method: //tt
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❑ New construction �Addition/a1t� t14iI/replacemetA w Please check all that apply plans �1 y > PP Y (submit 2 sets of laps w /items checked below);
❑ Demolition ❑Other ❑ Service or feeder 400 amps or more ❑ Building over three stories.
> �y k tar u r C , where the available fault current 12 Marina: and boatyards.
.. r } r n l s V ASyW.t�1 .�t� +a , gr'i't exceeds 10 ,000 amps at 150 volts or ❑ Floating buildings.
°,;,, ��j, EN E1 '" P 1 and 2 family dwelling 111 Commercial /industrial l ess to groun or exceeds 14,000 ❑ Commerdai• use agricultural
`
❑ Accessory building
❑ Multi-family amps far ail ot her installations bwldings.
❑ Master builder ❑ Other: r p ump.
{i 1K �; � '� 7 ii'S'd{z. �„� ❑Installation of 75 KvA or
® f r , 7 ` larger separately derived system.
�y l,i C� � ��5t�,7� ' �g t� f � r ❑ fimergency system.
. � �.'-` {• �' G 'R!k ��1' , ��1�S..Y;7�r*:���� »' ��'5^Ek�� _ 4�"..�� �" ,�. F ❑ Fire
c ..
ems. tea. �� t 1 SScItS� ❑ Addition of new motor load of y
Job no.: / o J o b s add ❑ "a" °fi" " 1 "2° 'l 3"
6 �/ 7 8 7 5 / e A J l0 0( -IP or more- occupancy.
City /StatC /21P; 1/ 9 {/ ❑ Six or more residential units. ❑ Recreational vehictc parks.
Pd f 4 / d'^ d O g ' 7 Z Z ❑ Health -care facilities. ❑ Supply voltage for more than
Sultefbld /e t. no.: CI H�ardous locations. 600 volts nominal.
g p Project name: T e 4 / ❑ Service or feeder 600 am ,s or mare,
Cross street/directions to job site: '3 , t
.,t . ors
Description Qty. Fee Total •
New residential single- or multi - family dwelling unit.
Includes attached ara
Subdivision: 1 Lot no.: _1,000 sq. ft. or less
145.15 4
�
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33 40
it • ..u 3 'r` �* �, r, T� Rt Limited energy, residential 1
) r , ., rE e �''A f' sft .' r . `r tt I E s d t
��� - Gi� � (with above sq, fl.) 75.00 2
�� e C Limited energy, multi-family � 2
residential (with above s . 0.)
200 75'00 2
Services or feeders installatio alteration and/o relocation
amps or less �,�, 1 2
,, �,, � a , fi ,; J 1 » t ' �1�7� r ,°t^� p C e5�
Er ti rule. • .. I r� r1.S_ad TRM , r`. it_N 20l amps to 400 amps 106.8 2
±n �+ � ,� it , . rn�F}�'� '�� a � 3 �'ti ;� ��5 ,�-"
radar q
Name. t A l T 401 amps to 600 amps 160.60 2
/dress 601 amps to 1,000 amps —1 240.60 2
Over 1,000 amps Or volts 454.65 2
tlty /State /Z1P: Temporar services or feeders instal lation, alteration, and/or
Phone: ( ) relocation
Fax: ( ) 200 amps or loss
•
Owner installation: This installation is being made on property that I own which is not p to 400 amps 100.30 1
201 amps
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps MI 133.75
i
Owner signature_
Date Branch circuits new alteration or extension, per panel
h �x� sA I t ' "t�l ,( a , t r' w•ftt• +. 1, � PS , A. Fee far branch circuits with
li I t � N a� . s . above service or fccder fee,
Business name: each branch circuit 6.65 )91-5 2
B. Fee for branch circuits
Contact name; without service or feeder fee,
first branch circuit 46.85 2
Address: Each add'1 branch circuit
6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included
Each manufactured or modular
dwellin. service and/or feeder
Phone: ( ) Fax: , ( ) 90,90 2
•
Reconnect only
E-mail: 66.85 2
_ �
�� tt, , ,z "i - u x ,la 3{ o + - Pump or irrigation circle 53.40 2
�SDEERT ' Ti ,r Iss. z��� ..a E �'} Signoroutlt 53.40
Business name; Boones Ferry Electric Signal circuit(s) or limited- 2
energy panel, alteration, or
Address: P.O. Box 628 extension, Describe:
Page 2 2
City/State /ZIP: Wilsonville OR 97070 Each additional inspection over allowable in any of the above
Phone: (503) 682 -4936 Fax: (503) 682 -7946 Per inspection 62.50
CCB Lic.; 88482 Electrical Investigation per hour (I hr rei ■ 62 50
ectrical Lic.: -223C Suprv. Lic.: II-7/ 8 r Industrial plant per hour 73.75
Suprv. Electrician si nature, required: (`/ '' ' _ +�`'` Y " d : ` -
g 9 1 4. + .ai a a Nz r :
♦ el
,nt name: '' II r
Subtotal: / dU . 2 5
�� !T �r0't Date; �� /� / U Plan review (2540 of ermit fee):
Authorized signature: / State surcharge (12% of permit fee): J 0
TOTAL PERMIT FEI.: 1 ) 2 , 2s
permit pp catlon p'
Print name: This a b expires if a permit is net obtained within 180
Dale:
days after It hes been accepted as complete,
tu9uilding■pennirs ELC- PermitApp do' OS/ZJ/Od . Number of inspections allowed per permit
440-461371 I l0s /cohUWEO
CITY OF TIGARD,
BUILDING DIVISION PERMIT #: ELC20013-00276
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 '
INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE:
SITE ADDRESS: 11787 SW 128TH AVE CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 185 TYPE OF USE:
PROJECT NAME: TEEL
DESCRIPTION: Panel change Job No. 136308
9 1 2.8
OWNER: TEEL, DAVID PHONE #:
CONTRACTOR: 1300NES FERRY ELECTRIC INC PHONE #: 503-682-4936
Inspection Request Scheduled For: ID 5/30/20013 Pour Time:
Code # Inspection Description fr onffrm# Contact # Message
199 Electrical final 070596-0 503-682-4936
Corrections/Comments/Instructions:
11 Aq100
\ s.
PA. PAS El PARTIAL APPROVAL El CANCEL El NO ACCESS
FAIL El CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: G N68 Date: Phone #: (503) 718- v-p-it