Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00404
COMMUNITY DEVELOPMENT DATE ISSUED: 7/17/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104AB -06200
SITE ADDRESS: 12184 SW 131ST AVE ZONING: R - 4.5
SUBDIVISION: MORNING HILL NO. 4 LOT : 091 JURISDICTION: TIG
PROJECT: HIGGINS
Project Description: Installing (1) branch circuit for NC.
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 CRC: 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:
GREG HIGGINS ELECTRICAL SPECIALTY CONTRACTORS
12184 SW 131ST AVE PO BOX 2853
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 - 524 -4772 Contact #: PRI 503- 723 -0371
FAX 503 - 656 -4537
FEES
Description Date Amount Reg #: ELE C126
[ELPRMT] ELC Permit 7/17/2008 $46.85 LIC 168161
[TAX] 12% State Surchar 7/17/2008 $5.62 SUP 1558S
Total $52.47 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 B ! ` / / Permittee Signature: �' G
// 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.
.._._._... � � � i 5� S zs'fi•. r: ra. N , 1 L.. 3 )' r V YrFi
Electrical Permit Application �' , ° a T f r� Vi "Y; t{ t ) r `°� } - -. t ,,
� � ,. ": I, r yJ '! ,� tl �'url�itd � ''' 4^ �7
m ! ' City of Tigard ‘ V 7 OS'C77'
13125 SW Hall Blvd., Tigard, OR 97223 V � y GY ►' 1ii e• n iew ' „.,a � -/
_` �' , p.
11 14
C Phone: ; ,503,619,4 171 Cox: 903 595.1960 A � w i)alc /By: OIhcr a `Cfl O
11
• . Inspection Line: 503.639.4175 6 i ale Ready /By: Jurix: E See Paget for
Internet: www.tigilyd- ol'.gov C \ � Notified/Method: PA Supplemental Information
t tiCli'E =.4' WQRK'
'�e Addition /alleralion /rC laCeineri( : t Pieate check all Mat apply a �' RESEW
❑ New construction lyi P 1I111111 sets 0f plans w /IICt119 checked below):
TT”" ❑ Service or feeder 400 amps or more ['Building over duce stories.
❑ Demolition ❑ Other; where the evadable mull Currunl ❑ Mariuu and ho:dyarc s.
CATEGORY OR. CONSTRUCTION: ". rlxcdods 10,01)0 ;imp%al 150 stills or n Flouting buildings,
' less to ground. or exceeds 14,000 ❑ Comm ercinl -usc agricultural
I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building I lamps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Piro pump. ❑ Iosndlation 475 KVA or
. . . • eltoy syx elll. larger sepnr:uely derived system.
• • JOB SITE INFORMATION: AND LOCATION'.: >
❑ /Within]) anew motor toad of ❑ n °I* ° l •�° ° La ,
Job no_: Job site address; 1Q �1 /j �� �) j s 100f it' manors. occupancy.
V 1 ��/V t Ave, / , v ❑Six nr more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: El I le:di -earo lauilities ❑ Supply voltage For more than
❑ I-Ii4r 1CIn115 Inc;ula)rls, Tina vn {L•, mum loot.
Suite /bldg. /apt. no_: Project name; /„ii^ Ile /_S ❑ Service or Icetler600 amp% or more.
'1'01;SCHEDULC:.: .
Cross street /directions to job site: _ uesel'lpuon 1 Qty. I I:ev 11091
Now residential single- or multi- family (livening unit.
Includes attached garage,
Subdivision: Lot no.: 1,100 sq, R. ur less 145.15 4
— La. add'I 500 sq. It. or portion 33,40 1
Tax , nap / parcel no.: Limited energy,
D1sSaiii :ION i 00+,,WORK '' . • ' : l i' . 'i (with shove s f c� residential 75.00 2
t energy, t vGunily 75.00 2
l „n ----- residential (with h above sq. ft.) TAW j
Services or feeders installation alteration, an /or relocation
0 OAERTY 0 : 2(l) amps or less 80 3(1 2
OWNER I ®TENANT• 201 amps 1o amps 106.85 2
Name: T 40 ;imps to 600 amps 160.60_ 2
60I amps to 1.000 amps 240,6 _.
Address: Over 1,000 amps or volts 454.65 2
City /Slate /ZIP: 'Temporary services or feeders installatlen, alteration, and /or
._, . _..
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is no 201 Imps In 400 amp Iu0.30 2
intended for sale, lease, rend, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 590 amps 133,75 , 2
Branch circuits - new, alteration, or extension, per panel _
Owner signature: Date: A, see fa' branch circuits with
S
d''APPLICAN'T 1: L '' CONTACT' PER
. UN';' •;-. cnlwvc service nr feeder fee, 6,65 2
cacti branch circuit _
Business nom(: B, Fee for branch circuits
nithou /s ervice nr feeder fce,
Contact name: — filar hooch circuit , 40,05 . as 2
Address: Each atltl'1 blanch circuit 6.65 2
_Miscellaneous (service or feeder not Included)
City /State /ZiP: mach manulacturcd or modular
dwelling, service and /or feeder 90,90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 .-- ' -. 77. -
E - mail: Pump or in-igution circle 53.40 2
. '' C C O " ... NTkI`ACTOIt ' , Sign or outline lighting .53 - 2
_
Business name: ' �t�Q/{ q ( ( /t ^y / yr r te - signal cireuit(s) or limited.
/) I r r CI.�A �.�pee.t (,S 1L e.o 1 ►/ !/Ll.�lU r �„� energy panel, alienlllon, ()r
Address: Y _ a µ-m/1 i( �/!1 1� extension. Describe: Page 2 2
Cily/State/Z1P: V• Lft1 /�. ass Each addi tional Inspection over allowable in auto( tic above l
y I'P Grl OR. °I ?p4 �'
�
Per inspection 62,$0
Phone: (?)o) « Z 3 . I 1 1 J Fax: ) ( Si r ii_ .3.7 Investigation per hour (1 In min) 62.50 _.. .
CCB Lie.; I OS I to I Electrical Li C, It Suprv. Lie.: indiustrial plant per' hour 73.75 .
I J � i'ELECTRICAL7PERIGII'1' TEES :
Suprv- Electrician Signature, required: 1 ,.
` tq�r /
N _ , I ../.[ • Subtotal:
( I
25 °A, of
Plan review permit tae);
Print name' EO 0-, C L D, .' ( tos O
State sucv ilargc (i 2% of permit fee): 5, i
Authorized signati l , i! /F . TOTAL PERMIT' hla..: 52 r 4/ -
"1141% plrrnrit 'implication cxpl If n permit Is not nalallled ,vill,in IX()
Print name pp
„�� Z L Date: I f ( ( . O days after it has been accepted as eoulpletc,
* Number of inspections allowed per permit.
I:\1 uildineU'rnnits \GLe.aem u npp,dnc n /2V11t, 44 t lh 15'[( I 1/05/CUM/WEB
/1. # 0961,865005 09:9.'80- 91, —LO
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
i. ELC2008.00404
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7 /17/200i' a
Phone: (503) 639 -4171 l uiv A 4m ii
Inspection Requests (24 Hrs.): (503) 639 -4175 —hi'
INSPECTION WORKSHEET FOR DATE: 7/25/2008 TIME: 7:00AM PAGE: 36
SITE ADDRESS: 12184 SW 131ST AVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO 4 LOT #: 081 TYPE OF USE:
PROJECT NAME: HIGGINS
DESCRIPTION: Installing (1) branch circuit for A/C.
OWNER: HIGGINS, GREG PHONE #: 503-524 -4772
CONTRACTOR: ELECTRICAL SPECIAL - Pt CONTRACTORS 1 PHONE #: 503 - 723 -0371
v
Inspection Request Scheduled For: Date: 7/2 2008 Pour Time:
Code # Inspection Description Confirm # •n'I:ct # Message
199 Electrical final 073193-01 503.557- .20 N
Corrections /Comments /Instructions:
PASS n PART L APPROVAL El CANCEL El NO ACCESS
❑ FAIL let / !; - I ` • ❑ ADDITIONA EES '. SSESSED j o,
Inspector: 1K Date: � *S-- i Phone #: (503) 718' 1,,<„0_