Permit CITY O F TIGARD CAA R D ELECTRICAL PERMIT
" PERMIT #: ELC2007 -00555
''� ° COMMUNITY DEVELOPMENT DATE ISSUED: 8/7/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 DC -03000
SITE ADDRESS: 15625 SW ALDERBROOK CIR ZONING: R - 7
SUBDIVISION: SUMMERFIELD NO.8 LOT : 477 JURISDICTION: TIG
PROJECT: LYSTER
Project Description: Install (3) branch cricuits for furnace, a/c and GFI.
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: 2 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:
LYSTER, MARJORIE J SUNSET HEATING & COOLING
15625 SW ALDERBROOK CIR 0607 SE IDAHO
TIGARD, OR 97224 PORTLAND, OR 97239
Phone: Contact #: PRI 503 - 234 -0611
FAX 503 - 234 -0439
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 8/7/2007 $60.15 LIC 161085
[TAX] 8% State Surcharge 8/7/2007 $4.81 SUP 4638S
Total $64.96 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. .0 ay obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
/
Issued By Permittee Signature: 4 hChal
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.
Aug 07 07 01:40p p.
Electrical Permit Application 100 (11.1..1( r: I .r. C1'.I.N
Received • Permit No.: �i
City of Tigard ; r Dates : G�
13125 S W Hall Blvd., Tigard, OR 9722 ,�,� �° Plan Review Other Pamir.
Inn„ tlry0.,;iv Date/13 : 1
Phon 5n Line: 5 71 Fax: 503.598.1960 111 Date Ready/By IS See Page 2 for
Int n w w . 503.639.4175 Notified/Method Supplemental Information
Internet: www ct ugard or its p «s ,9 21 I � � . �„ *» t + �,}'�s $y � T �!+� b � r " k ,,,,� J "'"�. �'°�� 1 `�w4� �g. �, ��T�K'
"`". «; _ 4 " ' t . a„ r ;' �' lk e I ' !,..'.i ;i 3 G t - .::,,) .. k ,
' '' � ,1 §y s r . iiri "� nl.. :�. c i r , :rfg1 , � ,. .,,,,.- .. :.. t ,„ s.
, .'x.A4• ,< i __st5,... 1 ri".+fSU.'L �aik"}.`:w*.. _ .,� ..� . �3.,.rY .
„ r.� �� �� , � 2G � n / ,t � eu1 � e Please check all that apply:
❑ New construction ®Ac igtJ f u I eP ❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other � gi � 4 t ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
t IIIKI MAZ W ` fi ' ' f . lt ' V .. ,.i.. of 1- and 2- family dwellings 4 or more new residential
• ,i , ,Ake, r ... ..., r,o �s�
.�.. 1 z .su units in one structure
gil 1 and 2 family dwelling ❑ Commercial/industrial over 600 volts nominal
industrial ❑Accessory building DBuilding over three stories- ❑Feeders, 400 amps or more
0 Multi- family ❑ Master builder ❑ Other: Occupant load over 99 persons OManufactured structures or
7. mta , c R > 1 + - ,P 5 I t lam` � y ^°r # - S ",'`,� : "' q DEgressllighting plan RV park
" airs ' . £ !iacc iai'.,�M rigour
.�:: .,"°' ".., ° :�,`'x` :° "ts�`�°"".��"°': s"' ❑Flealth -care facility Submit Job no.: i .: ,
E ' 3 Job site address: A:: ._'' l t 0'l% 1' (' 4• Submit 2 sets of plans with any of the above.
The above are not applicable to temporary construction service. e:;\ G I'1 ?..4 ? . I g rF,R. :; :_;.,.:
r �:.;�tH.r��� � yam •. " � ", - =•� �; -
fir. . .�..
Suite/bldg. /apt. no VProject name: , ( -- - --1 , i ? , : y ription Q� •
I Fcc. c Total 1 -.7 t
New residential single- or multi-family dwelling unit.
Cross street/directions to job site: Includes attached garage.
1,000 sq. ft. or less 145.15 4
I Lot no.: Ea. add'! 500 sq. ft. or portion 33.40 1
Subdivision; Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 1 2
"ia'r:'o - :�; 3C ;t a'P€
Each ':- t °3?d..' ^S; ,iY:S ; t. l ,s'_ ,:•xxnt4 .vu.'v': _.�?.':"r* ^:= £ v ., ,�Y 1'':•'w ;s
,r;;,t.;<;: ' °pt�.. :;��,. ,,;�., ,�s� ;`�,<. - % � =u -�� . -� <« ,,�.rr�� : -. :$:;:..».. ach manufactured or modular
: :' r "r';v.,� „ .r<.,�,,.r
.. , ti,`''> >_ ���'�;,� � , *•� � , dwelling, service and/or feed er 90.90 2
'., ( • t...I, ,,.. - ^, f E;1 t `t - r }-- Services or feeders installation, alteration, and/or relocation
200 amps, or less 80.30 2
,.:v,,;:. L1.� ' 0 201 amps to 400 amps 106.85 2
- : : = 4 : 1 a - y.,f,,. , n %x '' . ,x.. $i', ;' � %' a` .,,f. iY # ra t i `talla ti b � � ^5.3,-, - 2
pry ” a a l > y : x•• C -.. Q ,s 160.60
.:: �` : :i�sti L'�Zw�x�� :�Y�� � " � �iri � ..+., s•. .. .`.a 401 amps to 600 amps
- ' 601 amps to 1,000 amps 240.60 2 y
7 _. Name: Mil. t t..0/ I -. -`:
Over 1,000 amps or volts
Address: 1 _ -S :q,-4-; i'<l (.ii...i f k.'-. r Z`‘ tilt:, Reconnect only 66.85 2
City/State /ZIP: 1 47c L•'f' ,+ LI- Temporary services or feeders installation, alteration, and/or
i� 4, _ relocation
Phone: ( l',_ �,) c' .,..." ' / J ! 's 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 amps 100.30
2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
_ . „,,_ .., u Nib;; >> zta ;q r ° `'i�t ;e A. Fee for branch circuits with
'I :s ,. :. ,��p ;;aa: iS x.?�: L; i'I K <•:t=t, W� ” 8 k+;„• � .;=,. e > : ".v acit
w : ;It:.. ,,. J >.. v.t; :. „ _. € a,7kit :...,, .,..,r. A service or feeder fee, e
..,r.,. '.d 6.65
branch circuit
Business name:
B. Fee for branch circuits
Contact name: without service or feeder fee, 16.85 /. 1 , ,,, ; ' , x',1 2
first branch circuit
Address: Each addi branch circuit `,ei'l__ 6.65 j f.::::. 22
City/StatelZlP:
Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2 j
Phone: ( ) I Fax: : ( ) Sign or outline lighting 53.40 2
E-mail; Signal circuit(s) or limited -
:, ; , t •• ; ,:vi 7t V ' � > 4” energ p anel, alteratio or
? -„.,-* 7 n e r aw.. F . �_ Page
��� :. < ;�'��= :`r�Y';�; =' ?.� � ,�,:� _ _ ... extension. D escr ib e:
Business name: Sunset Heating and Cooling
Each additional inspection over allowable in any of the above
Address: 0607 SE Idaho Per inspection 62.50
City/State /ZIP: Portland, OR 97239 Investigation per hour (I hr min) 62.50
Industrial plant per hour 73.75
Phone: (503) 234 -0611 I Fax (503) 234-0439 r s - ^^�-� 46,11v,'.: *'„
CCB Lie.; 161085 Electrical Lie.: C117 Suprv. Lie.: 4638S Subtotal i L I
Plan review (25% of permit fee)
Suprv. Electrician signature, required: e ,/ / , � y ,
State surcharge (8% of permit fee) `•i' ' j
Pri name: E ✓
Authorized signature: Date: ��
— TOTAL PERMIT FEE 1� (- ' :, 80
1 / This permit application expires if a permit is not obtained within I
days after it has been accepted as complete
Print name: L � 1 &i`.- D ate : ' j # • Fee methodology set by Tri-County Building Industry Service Board
,C�, r1 G.� t ' • Number of inspections per permit allowed.
i:\ nuitding \PmnirstELC- PermitApp.doe 12/03 440-4615T( I 0107JCOM/WEB
CITY 'OF TIGARD `~
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 f � l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1 TIME: PAGE:
SITE ADDRESS: / 51� N11400L/L- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
Ale GcleV
OWNER: PHONE #:
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
i C c�1 r
00%< t/I . qat PAA 5
itte 2.0Crk 00 Fia4 e
I PASS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL I I CAL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: Date: 5 / - q / Phone #: 503
p � ) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00555
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/712007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/22/2007 TIME: 7:01AM PAGE: 58
SITE ADDRESS: 15625 SW ALDERBROOK CIR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.8 LOT #: 477 TYPE OF USE:
PROJECT NAME: LYSTER
DESCRIPTION: Install (3) branch cricuits for furnace, a/c and OFI.
OWNER: LYSTER, MARJORIE J, PHONE #:
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503-234-0611
Inspection Request Scheduled For: Date: 8/22/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 054357 -02 503 - 620.9175 N
Corrections /Comments /Instructions:
V n)
❑ PASS ❑ PARTIAL APPROVAL n CANCEL MI NO ACCESS
62 FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718-