Permit CITY OF TIGARD ELECTRICAL PERMIT
TIGARD #: ELC2007 -00500
COMMUNITY DEVELOPMENT DATE ISSUED: 7/20/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S133DD -01000
SITE ADDRESS: 11747 SW 129TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 LOT : 049 JURISDICTION: TIG
PROJECT: BUNCH
Project Description: Install (1) branch circuit for a/c unit.
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/0 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:
PETER BUNCH TICE ELECTRIC
11747 SW 129TH PL. 5405 N. LAGOON AVE.
TIGARD, OR 97223 PORTLAND, OR 97217
Phone: 503 - 228 - 8878 Contact #: FAX 503 - 872 - 8290
PRI 503 - 233 -8801
FEES
Description Date Amount Reg #: ELE 26 -126C
[ELPRMT] ELC Permit 7/20/2007 $46.85 LIC 166
[TAX] 8% State Surcharge 7/20/2007 $3.75 SUP 2586S
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:
• .1// i Permittee Signature: M,1972Dl� r
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.
•
. -
It ctirx Permit A1gU1<z a i >la � FOR OFFICE 1)SE ONLY .
U liI' -F;l i _ Received 1
City of Tigard Datday: '7 1, 20 ' 0'1 - S � F ELC.ZCe
13125 SW Hall Blvd., Tigard, OR 97223 JUL 1 9 2 007 Plan Review Other Permit:
Phone: 503.639,4171 Fax: 503.598.)960 l ' . `"'t•bin�',,�` 1 ' Dale/BY; _ -
Inspecrion Line: 503.639.4175 LA 6 n I rcest ► '= I Date Ready/By: Jens: ® See Page 2 for
Internet www,ci.tigard -onus BUILDi iDNB! 'IV' Notified/Method: Ti Fr Supplemental Information
r.
YPE O1? WORK
7.• PLAN REVIEW
El New construction [, Addition/alteratiortheplacement Please check all that appl
['Service over 225 amps, corona') ['Hazardous location
D Demolition ❑ Other: — ['Service over 320 amps — rating ❑Buildilg over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1 - and 2 - family dwellings 4 or more new residential
J 1- and 2-family dwelling El Commercialiindust rial ❑ Accessory building ❑System over 600 volts taonaizral units in one suucttue
[JBuilding over three stories ❑Feeders; 400 amps or more
❑ Multi - family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured Matures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lightiug plan RV p ark
❑Health. - cafe facility ❑Other:
Job no.: 8 0. 2 5 2 7 Job site address: 1 1 747 S W 129th P l a c e Submit 2 sets of plans with any of Use above.
City / State/ZIP; Tigard, OR 97 223 The above are not applicable to temporary construction service,
Suite/bldg./apt. no.: Project name: Bunch FEE* SCULE
_ Description ! Qq. _ I Doh L Tot■.I I ..
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: Lot no.: Ea. add 500 sq. ft, or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non residential 75.00 2
-
DESCRIPTION OF • Each manufactured or modular
dwelling, service and/or feeder _ 90.90 2
• Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
'11 PROPERTY 401 amps to 600 amps, ` 160.60 _ 2
• Name: Trace Bunch 601 amps to 1,000 amps 240.60 2
Address: 1 1 7 4 7 SW 1 9th Place
Over 1,000 amps or volts 454.65 2
• Rccoulect only 66.85 _ 2
City/State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
Phone: 0 3) 590-8043 Fax ( ) relocation _
_ 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 i
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
t] APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 4 6 . 85 ,
each branch circuit 46.85
Address: '
Bach add') branch c ircuit 6.65
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) F es; ; ( ) Pump or irrigation circle 53.40
Sign or outline lighting 53.40 .
E-mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
-- extension. Describe; Page 2
Business Hanle: Tice Electric Co.
Address: 540 5 N Lagoon Avenue Each additional ins over allowable in any of the above
Per inspection 62,50
City /State/ZIP: Portland, Oregon 97217 Investigation per hour (l br min) 62.50
Phone: ( 503) 233 -8801 Pax: (503) 872 -8290 Industrial plant der hour 73.75
ELECT_ RICAL PERMIT FEES*
CCB Lic.: 166 Electrical Lic.: 26-1 26C Suprv. Lic.: 2586S Subtotal 46 . 8 5
Suprv. Electrician signature, required: 4 . Plan review (25% of permit fee)
Print name: John J. Maloney Date: y j 0 7 State surcharge (8% of permit fee) 3. 7 5
• TOTAL PERMIT FEE 50.60
Authorized signature: This permit epprication expires if a permit is not obtained within 181
- days after it has been accepted as complete
Print name: Date: • Fee methodology act by Ili- County Building industry Service Board
• • Number of inspections per permit ;tl owed.
iA$ ltiktlosk 'ernits\BLC•permiIApp.doc 13/03 440 -461ST(10 /02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00500
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/20/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ,4191t
INSPECTION WORKSHEET FOR DATE: 7/27/2007 TIME: 7:03AM PAGE: 92
SITE ADDRESS: 11747 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 2 LOT #: 049 TYPE OF USE:
PROJECT NAME: BUNCH
DESCRIPTION: Inaall (1) branch circuit for alc unit.
OWNER: BUNCH, PETER PHONE #: 503 -228 -8878
CONTRACTOR: TICE ELECTRIC PHONE #: 503 - 233 - 8801
Inspection Request Scheduled For: Date: 7/27/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 052732-01 503 - 872 - 8237 Y
Corrections/Comments/Instructions:
•
R PASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL CALL FOR INSPECTION , ADDITIONAL FEES ASSESSED
Inspector: - • Date: ( 0 7 Phone #: (503) 718 -