Permit A. t. CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00089
DEVELOPMENT SERVICES DATE ISSUED: 2/24/03
WP 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 109AA -02000
SITE ADDRESS: 14450 SW 130TH AVE
SUBDIVISION: WOODFORD ESTATES ° ZONING: R -
BLOCK: A u � J LOT : 008 JURISDICTION: TIG
Project Description:8144A C. OE M
Chu- ( �� � � �
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: 1 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:
CARY & TRACEY PANGARES OWNER
14450 SW 130TH
TIGARD, OR 97224
Phone: 503 - 693 - 3747 Phone:
Reg #:
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/24/03 $100.25
[TAX] 8% State Tax 2/24/03 $8.02 Rough -in
Elect'I Service
Total $108.27 Elect'I Final
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. Th.se 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 (5I. S� : -6699 or
1- 800 - 332 -2344. /
Issued By: Permit Signature: /
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:U DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit Application Received FOR OFFICE USE ONLY ,
9, ,4 Electrical r
e1 DateBy: -- i)3 —03 ' • Permit No.: LZ0 �D 0 $ 9
City Of Tigard Planning Approval Sign
Y b Date/By: Permit No.:
13125 SW Hall Blvd. • Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Awadl Post - Review Land Use
+' it\ Contact Case No.:
Internet: www.ci.tigard.or.us a (� 11 01� Contact Juris.: ® See Page 2 for
`^
24 -hour Inspection Request: 503- 639 -4175 Name/Method: Supplemental Information.
` ^�.' �.�,2F�. i—w. ,ems' ,�.. ,^, .. `e`=. ::;: �`�� ".€�:�t.�*,.,: ,� ', ;
�"`,� °. :. .,.�. fir' - � - " °�;:-^ �' ; ^s'- srs�°°� „ ,�. , ,.....�
, .ta-w _ . a �. .i;. TI'PE�OF WORK,.V,,S0 - �1--.� �;. .M ,L.z °:., PLAN*EVIEW (Please check all;;that ilVijr v �' *: ��
=v
❑ New construction ❑ Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
❑ Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
r ';` CATEGORY OF3CQNSTIVO ION ' ' a MV 1 & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: El gr ss g n plan ❑ Other:
E e /li hti g p
r ” ,rt := i= J„ O.B INFO ION,a dLOCATION „'� �' " RMAT " ` Submit sets of plans with any of the above.
_;: The above are not applicable to temporary construction service.
Job site address: 1 ( l) 1 0i" Au'e . Titer- I 62 , z .s0 "."t" , l$ fi FEE *rSCI3EDULE "'" 3's'. = • t
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: Description Qty Fee (ea.) Total
Cross street/Directions to job site: New residential - single or multi - family per i
dwelling unit. Includes attached garage.
Z m c . — Q.4,„X- ay. G „.p- t .Q4* on Service included:
t 1000 sq. ft. or less 145.15 4
l tJ� e6j , V+k OWE ( 301'" • Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: J Lot #: Limited energy, residential 75.00 2
Limited energy, non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
x, _ g . ,,,:,"'; ice 90.90 2
P W®RIC r'" ::;� °.
Services sery or and/or feeders feeder - installation,
alteration or relocation:
200 amps or less C80.30 40 2
201 amps to 400 amps f06 785 2
401 amps to 600 amps 160.60 2
itig1PR:OPERIV O WN ER " 4q0111 It. TENT w ; ,. " , - 601 amps to 1000 amps 240.60 2
� x .teems.. .e.,
Over 1000 amps or volts 454.65 2
Name: Cat L .-k -- ic cu n,� a tie S Reconnect only 66.85 2
Address: I L{ q SO Su/ t No • Temporary services or feeders - installation,
City /State /Zip: ` • 9 pt 0e . q, N
alteration, or relocation:
200 amps or less 66.85 1
Phone:_s03 > c -3 Fax: 201 amps to 400 amps 100.30 2
. T ,, 401 to 600 amps 133.75 2
u ` ' APPLCANT . �„„I N� €, CONrget ERSON ; ; " . x Branch circuits - new, alteration, or
Name: extension per panel:
A. Fee for branch circuits with purchase of 3 (� ��
Address: service or feeder fee, each branch circuit 6.65. 2
City /State /Zip: B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: Fax: Each additional branch circuit 6.65 2
E -mail: Misc.(Service or feeder not included):
,; , ;; s . -„ E , = .; c Each pump or irrigation circle 53.40 2
Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
Business Name: no EX_ Descri ti n r extension Page 2 2
Description:
Address: L M C5,,,) ern' Nf. •
City /State /Zip: — p O i- . a, '\ Each additional inspection over the allowable in any of the above:
Per inspecction on per hour our (min. 1 hour) 62.50
Phone: Fax: Investigation fee:
Other:
CCB Lic. #: Lic. #: „� •. N �
3v - _ii,� ., ;, �A �El ectrtcal`P�ermttlFe es *. a �e. t'��"r�a,�s�. AAA
Supervising electrician Subtotal $ /00 • 25.
signature required: Plan Review (25% of Permit Fee) $
Print Name: Lic. #: State Surcharge (8% of Permit Fee) $ 1 .0
TOTAL PERMIT FEE $ /d V .02
Authorized • Notice: This permit application expires if a permit is not obtained within
Signature: & ' •_., . gm , ti Date:o7 8°' 180 days after it has been accepted as complete.
*Fee methodology set.by Tri- County Building Industry Service Board.
`Facr,t L _ illflad.feS
(Please prif t name)
is \Dsts\Permit Forms \ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
El Audio and Stereo Systems
n Burglar Alarm
Garage Door Opener
n Heating, Ventilation and Air Conditioning System
n Vacuum Systems
Other
COMMERCIAL WORK ONLY:
Fee for each system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
E Audio and Stereo Systems
n . Boiler Controls •
F Clock Systems
F - 7 Data Telecommunication Installation
n Fire Alarm Installation
n FIVAC
n Instrumentation
E Intercom and Paging Systems
n Landscape Irrigation Control
n Medical
ri Nurse Calls
1 - 7 Outdoor Landscape Lighting
ri Protective Signaling
n Other • •
Number of Systems
* No• licenses are required. Licenses are required for all
other installations
i:\Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03
CITY OF TI!GARD 24 -Hour .
BUILDING 0 Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested .3- / a AM PM ' BUP
c 1
Location / ( 4(5) /3 D Suite MEC
� � '
Contact Person j)� -1�fi1 � Ph ( ) 7 7 ' - • PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 Ada ' Y7
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation ,� .r .9 ► ' ♦ f
Drywall Nailing ► �tr�� i �I !1 I� i4
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
• 417
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
is
SS PART FAIL E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
SITE El Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA --1? "
Approach /Sidewalk Date Q p 3. Ins ector7a-- < <A Ext
Other: /
d
Final DO NOT REMOVE this inspection recd from th job site.
PASS PART FAIL /)