Permit &ITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2007 -00202
COMMUNITY DEVELOPMENT DATE ISSUED: 4/4/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S111DB-01400
SITE ADDRESS: 15460 SW ALDERBROOK CIR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.8 LOT : 442 JURISDICTION: TIG
PROJECT: WELSH
Project Description: Service and branch circuits.
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: 1 W /SERVICE OR FEEDER: 3 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:
WELSH ACCESS ELECTRIC & CONSTRUCTION LLC
15460 SW ALDERBROOK CIR 2870 SE 75TH AVE. STE. 108
TIGARD, OR 97224 BEAVERTON, OR 97123
Phone: 541 - 764 - 3807 Contact #: PRI 503 - 642 - 4333
FAX 503 - 642 -9699
FEES
Description Date Amount Reg #: ELE C -16
[ELPRMT] ELC Permit 4/4/2007 $100.25 LIC 162666
[TAX] 8% State Surcharge 4/4/2007 $8.02 SUP 4931S
Total $108.27 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: "3 Permittee Signature: e-7-1 cg-7¢4.14- 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.
03i'2007 11:49 5036424918 ALOHA OVERHEAD DOOR PAGE 01
a
Electrical 1�'erniit A 1 11',1114C- WED hOli �►r•i' it -� i sic t >.1.‘
City of Tigard 3 20 Date/B. /01 � / Permit No. roC .,6, 0 ..
13125 SW Hall blvd., Ti and r t '' i'2
g Plen Review Other l'ennit
Phone: 503.639.4171 Fax: 5 ®
_ DatdBy: - -
Inspection Line: 503.639.417
• • ��� Date Ready /13y: Jura. ® See rage 2 for
Y I cin 1: I) n L�° N o ri fitd /M Supplemental Information
Internet: www.tigard- or.gov l 1 i� w -
TYP E•f WOR '.... I� R.. E.. / I t -.
please check all that apply (subm ite n ts checked 1 sets of plans w c a d to I ow)
❑ New construction E Addition /alteration /replacement ❑ Service or feeder 400 wnps or more Q Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
C 4 TECatfN Y. ;O C014$1****;:: excec 10 amps at 150 volts or 0 Floating buildings.
Q Commercial use agricuirural
' - - -- , less to ground, or exceeds 14,000
® 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi ❑ M builder ❑ Other: 0 Fire pump. CI Installation of 75 KVA or
y r.. " . el P,mge
erncy system. larger separately derived system •
. • . ..0B SITE INFORMAT'IiON. ! ;'LOCATION: ' i 1. .. , p Addition of new motor load of ❑ "A "t'" ' I "t j' ,
- 100HP or more. occupancy.
Job no.: Job site address: 15460 SW alderbrook Cl2 0 Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIT': Tigard, OR 97224 ❑ Health - care facilities. ❑ Supply voltage for more then
w _ - ,--, , , ❑ Hazardous locations. 600 volts nominal.
Suite /bldg /apt, no.: Project name: Welc feeder 600 Service or f amps or more. � _
. - .: • : FEE' SCHEDULE
Cross street/directions to job site: Desert .tlon latillIMM Tutu
°-^.. New residential single- or multi - family dwelling Unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. 0. or less 1 45.15 4
E'a. add'I 500 sq. 6. or portion 33.40 I
Tax map /parcel no.: I.,imited energy, residential
75.00 2
(with above s fl.
DESCRIPTION ,Qi�'•'4MQ ( 4 -, -..
..,,.•• Limited energy, multi - family 75.00 2
Room remodel residential (with above sq. 8.)
Services or feeders installation, alteration, and /or relocation
200 amps or less 1 80.30 80,30 2
' • ' i q PROPERTY OWNER , ;'❑ 474isi ir • .. . ` • . 201 amps to 400 amps
! 06.85 2
Name: amps to 600 amps 160.60
601 amps to 1,000 amps 240.60 2
Address; Over 1,000 amps or volts 454.65 2 �-
City /State /Lily: Temporary services or feeders installation, alteration, and /or
_ relocation
Phone; 4I ) `,I 3 �� Fax: ( ) 200 amps or less 66
Owner installation: This installation is being made on property that 1 own which is not _ 201 amps to 400 amps _ 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
Branch circuits- new, alteration, or ext p er p anel
Owner signature' _ ___ _T. , __ A, Fee for branch circuits with
o't above service or feeder fee, • ❑ APPLICANT • CONTACT ; PERSON . 3 6.65 19 95 2
- •.,........._..._.- -. each branch circuit
Business name: Access Electric & Construction, LLC 13. Fee for branch circuits
' -- without service or feeder fee, 46.85 2
Contact name:
Kent Zimmerman first branch circuit
Address; Each add'i branch circuit w 6.65 _ 2
. . - -�-- Miscellaneous (service or feeder not included) City /State /LIP: Each manufactured or modular 90,90 2
- dwelli service and/or feeder
Phone: (503) 642.4333 Fax: : ( ) Reconnect only 66.85 2
E -mail Pump or irrigation circle 53.40 2
• • CONTRACTOR, ' • . • • „ Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: Access Electric & Construction, LLC energy panel, alteration, or
Address: 2870 SE 75 Ave Suite 108 extension. Describe; Page 2 2
City /State /ZIP: Hillsboro q 7,/ , 3 Each additional Inspection over allowable in any of the above ,
! Per inspection 62.50
Phone: (503) 6424333 J Fax: (503) 642 -9699 Investigation per hour (I hr min) 62.50
CCB I .ic,; 162666 ■� Electrical Lie.: C16 Suprv. Lie,; 49315 Industrial plant per hour 73.75 _
. , EL,R)CT)Rrf' CAL• FERMAT FEES.
Suprv. Electrician signature, required: • Subtotal: 100.25
' Plan review (25% of permit fee):
Print name: Kent Zimmerman �+ Date: /3/07
_ -_- .. .__.. .. State surcharge (8% of permit fee): 8.02 _
Authorised signature: TOTAL PERMIT FEE: 108.27 .-
This permit application, expires if a permit is not obtained within loo
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed par per,nit.
I \nn i 5\➢ermns001.C- PermnApp doe 05/23/06 440.4615TC I i/Vf /COM /WEB
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELC2007 -00202
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4 /2007
Phone: (503) 639 -4171 :r 40/0/ 4ii 'I II
Inspection Requests (24 Hrs.): (503) 639 -4175 '
/
u
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AIV) PAGE: 33
SITE ADDRESS: 16460 SW ALDERBROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.8 LOT #: 442 TYPE OF USE:
PROJECT NAME: WELSH
DESCRIPTION: Service and branch circuits.
OWNER: WELSH, PHONE #: 541 -7M -3807
CONTRACTOR: ACCESS ELECTRIC & CONSTRUCTION LLC PHONE #: 503 - 642.4333
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description Co'nfirm # Contact # Message
120 Electrical rough-in '
050145.01 \ 503- 680.9430 . Y
Corrections /Comments /Instru ‘` \ -.5 • u\U_ V i(Z4
L---- IU ) 1%1\,s .J -1--Ls--I. Ann
._ .
/)
►A PASS n PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
❑ FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ► 0 'g Date: 1 ( O"] Phone #: (503) 718 -1AL
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELC2007 -00202
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/4/2007
Phone: (503) 639 -4171 • Ata tp
Inspection Requests (24 Hrs.): (503) 639 -4175 '' _n
INSPECTION WORKSHEET FOR DATE: 6/12/2007 TIME: 7:00AM PAGE: 82
SITE ADDRESS: 15460 SW ALDERBROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.8 LOT #: 442 TYPE OF USE:
PROJECT NAME: WELSH
DESCRIPTION: Service and branch circuits.
OWNER: WELSH, PHONE #: 541 -764 -3807
CONTRACTOR: ACCESS ELECTRIC & CONSTRUCTION LLC PHONE #: 503- 642 -4333
Inspection Request Scheduled For: Date: 6/12/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 050010-01 503- 680 -9430 N
Corrections /Comments /Instructions:
•
69/(z,
ifrpo
AA9 4
PASS ❑ PARTIAL APPROVAL f CANCEL e NO ACCESS
(FAIL (CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: qfq0----7 Phone #: (503) 718-
p )