Permit CITY OF F TIGARD - ELECTRICAL PERMIT
` �" PERMIT #: ELC2007 00524
COMMUNITY DEVELOPMENT DATE ISSUE 7/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DD-16500
SITE ADDRESS: 11994 SW 129TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT : 201 JURISDICTION: TIG
PROJECT: CHIN
Project Description: (9) branch circuits for kitchen /family room remodel.
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: 8 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:
LARRY & ELAINE CHIN BUCKAROO ELECTRIC
11994 SW 129TH 31601 S WRIGHT RD
TIGARD, OR 97223 MOLALLA, OR 97038
Phone: 503 - 579 -1994 Contact #: PR! 503- 880 -6326
FAX 503 - 829 -5207
FEES
Description Date Amount Reg #: ELE 34-361c
[ELPRT] ELC Permit 7/30/2007 $100.05 LIC 154750
M
[TAX] 8% State Surcharge 7/30/2007 $8.00 SUP 3954s
Total $108.05 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 2/6Aref-1Permittee Signature: /gyp /% 6 0.4--j
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.
Karen Veltman BUCKAROO E (503)829 -5207 p.1
_ le itrieai Permit AppIlea. ' r ' OFFICE USE ONLY
City of Tigard 1 * , r R 3o 0 5
= r 3 G
13125 SW Hall Blvd., Tigard OR 97223 r P i DateBv: Pe rmit No.: EL 2 �-�� • P Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/ay: Other Permit MM TozO 7 - Oa/5 V
T I G A R D Inspection Line: 503.639.4175 JUL '' 0 2007 Date Ready,By: ., - 7 6 El See Page 2 for
Internet: www.tigard- or.gov V Notified/Method: , `
Supplemental Information
TYPE 41 ORs'k 4 ) b 1 (. T A RD PLAN REVIEW
❑ New construction Ig Addi a o13JFe Please check all that apply (submit 2 sets of plans w: iterus checked below):
�0 ,� 7 �J Z I �i ❑ Service or feeder 40D amps or more ❑ Building over three stories.
❑ Demolition 0 Othe where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Vi ❑ Accessory building less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1- and 2- family dwelling ❑ Commercial /industrial ry g amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system
j ❑ Addition of new motor load of ❑ "A", "S', "1 -2 ", "l -3
Job no.: Job site address: // 99y 66, / ,29 100HP or more. Roc r e anoy.
❑ Six or more residential units. ❑ .Recreational vehicle parks.
City/State/ZIP: 77 r - d ❑ Health-care facilities. ❑ Supply voltage for more than
JY t.f- ❑ Hazardous locations. 600 volts nominal.
Suite/bldg./apt. no.: Project name: /J / n �CS / , VP r`PJ ❑ Service or feeder 600 amps or more.
/ n . sX FEE SCHEDULE
Cross street/directions to job site: /� eon i, C Description I Qty. I Fee. I Total l •
1 � 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, residential 75.00 2
DESCRIPTION OF WORK (with above sq. R.)
�
n ,/� /J Y1 Limited energy, multi- family
/ t r-! t� -rgt/Y7, l 1y {c Yt �(Qi' d residential (with above sq. ft.)
75.00 2
/ Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I 0 TENANT 201 amps to 400 amps 106.85 2
l G `/� 401 amps to 600 amps 160.60 ' 2
Name:
/t-Q 1 r / C/ /o l /] f l ! /-) 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 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 turps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670. and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: D. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit (
46.85 (..RL 2
Address: Eaeh add'l branch circuit - g 6.65 53_2'D 2
Miscellaneous (service or feeder not included)
Cily /State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) I Fax :: ( )
1 Reconnect only I 66.85 .2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
E _ L; /k / f n Signal circuit(s) or limited -
Business name: �Q riM �/ 1' - L . G/ panel, panel, alteration, or
Address: " / 60 / , J/ / - , q /.--/ �d extension. Describe: Page 2 2
City/State/ZIP: t- //?v / / / / �" ✓ a 7 ./J G� 7 j O' Each additional inspection over allowable in any of the above
!� / a Per inspection 62.50
Phone: (5 k80- 632_ Fax: (Sp 82.9 -52
e ,k ��1 Investigation per hourp lumin) 62.50
CCB Lic.: /s-Li 7 co l leetrical Lic.: 3 G /_3 a , Suprv. Lic.: 33.5 5 Industrial plant per hour 73.75
Suprv. Electrician signature, required: A /
ELECTRICAL PERMIT FEES
�rC-c -µi e=- G,li!'(i Subtotal: fU(:)- 0 S
Print name: k/ eC t/ f/ 7 a h Date: � ,�19 _ v Plan review (25% of permit fee):
��� State surcharge (8% of permit fee): r . ift
' �/�
Authorized signature: / TOTAL PERMIT FEE: J' Q S
Print name:
y ,�,� � L '� �� g This permit application expires if a permit is not obtained within 180
Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
I:1 Baltdingwermits 'aLC- PermitApp.doe 0523/06 440 1 1;05 /COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.00524
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2007
Phone: (503) 639 -4171 kootoi#
Inspection Requests (24 Hrs.): (503) 639 -4175 '=:_..
INSPECTION WORKSHEET FOR DATE: 11f26/2007 TIME: 7 :00AM PAGE: 413
SITE ADDRESS: 11994 SW 129TH Pi_ CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE:
PROJECT NAME: CHIN
DESCRIPTION: (9) branch circuits for kitchen /family room remodel.
•
OWNER: CHIN, LARRY & ELAINE PHONE #: 503- 579 -1994
CONTRACTOR: BUCKAROO ELECTRIC PHONE #: 503 -880 -6326
Inspection Request Scheduled For: Date: 11!262007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 060098 -01 503 -880 -6326 N
Corrections/Comments/Instructions:
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T&ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ( ] ADDITIONAL FEES ASSESSED
Inspector: V 0 Date: I b4 0 Phone #: (503) 718 -) YW
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ELC2007 -00624
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 � . fir' .
INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:00AM PAGE: 83
SITE ADDRESS: 11994 SW 129TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 5 LOT #: 201 TYPE OF USE:
PROJECT NAME: CHIN
DESCRIPTION: (9) branch circuits for kitchen /family room remodel.
OWNER: CHIN, LARRY & ELAINE PHONE #: 503.579 -1994
CONTRACTOR: BUCKAROO ELECTRIC PHONE #: 503 - 880.6326
Inspection Request Scheduled For: Date: 8/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 053827 -01 503- 880 -6326 N
Corrections /Comments /Instructions:
•
y f PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
iI_ 1,1 6
Inspector: • -g �V a>'
Date: Phone #: (503) 718-
1