Permit CITY OF TIGARD • ELECTRICAL PERMIT
PERMIT #: ELC2008 -00391
COMMUNITY DEVELOPMENT • DATE ISSUED: 7/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 103 D B -06700
SITE ADDRESS: 11310 SW AMBIANCE PL ZONING: R -4.5
SUBDIVISION: GENESIS NO. 2 LOT : 019 JURISDICTION: TIG
PROJECT: CARR
Project Description: Installing (1) branch circuit for A/C.
RESIDENTIAL UNIT TEMP SRVCIFEEDERS 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: 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:
PAUL CARR FARWELL PERRY ELECTRIC
11310 SW AMBIANCE CT 2536 NE 10TH AVE
TIGARD, OR 97223 PORTLAND, OR 97212
Phone: Contact #: PRI 503 - 890 - 2352
FAX 503 - 760 -8498
FEES
Description Date Amount Reg #: ELE 26 - 855C
[ELPRMT] ELC Permit 7/9/2008 $46.85 LIC 91733
[TAX] 12% State Surchar 7/9/2008 $5.62 SUP 4067S
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 By: / ��� Permittee 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: 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.
•
07/09/2008 1 0: 06 5037608498 JOHN H GEORGES PAGE 02
- - Electrical Permit Application E cEIV■ r �) ' I i t i rw
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IIN
1 of Tigard n C 4,1=
/ / ► f�� Pam* No, � Z.� �1
l:1t25 SW !tall fllvd,. Tigard, ()R 97223
U Plan, Review -
Phone: 50.3639417) Fax: 503.598.1960 JUL 0 9 2� g other Permit: ► ,. v�
el W
Inspection Line: 503.639.4175 ' e Ready/Fly: . ® See Page 2for
Internet: wtvw.riltard- or.gnv CITY OF T i ed/Method: ental infbranatIon
t
TYFF. OF WO* PLAN REVIEW
New constniction ❑ Addition /alteration /replacement Please check all that apply (submit A sets of plans w /items c tcked below);
Ej ❑ Service or feeder 400 amps or more ❑ Building over three stories.
Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards,
CATEGORY OF CONSTRUCTION exceeds 10,000 amps as 130 volts or ❑ Floating building
1. and 2 dwelling, El Commercial/industrial less Si, gn other a exceeds 14,000 10 buildings.
cint -use agricultural
❑ Accessory building amps for all other installoions, buildings.
[I Multi - family ❑ Master builder ❑ other: ❑ Fire pump O Installation of 75 KVA or
.. -- .. - - -_ - . ....... _... ❑ Emergency system. larger separately derived Syltanl,
.108 SIZE INFORMATION AND IAC.4TION et ❑ Addition of new motor 10ed of ❑ A" ' r 1 - 2" 1 -3°
Jab no loh site address: j / 3 J 0 5 W I00HP or more. °economy.
�Ol . ( 1 C tL ❑ Six or more residential units. ❑Recreational vehicle perks.
('ity /State / %IP: i oc.. q` ❑ Healthcare thc,lttic . ❑ Suppl voltage for more than
- - -- - ►1 ,_ ! . . ❑Hazardous locations. 600 volts nominal.
tiu+te / bldg. /apt. nt >..
Project name: 1 Service or f e e d e r boo amps or mo FEE SCHEDULE
street/directions, ss street/directions, tt >job site: _ � Q neaerlptM■ I (NY. i wrw i Tatal I"
-,_ ..
New residential single or multi- family dwelling unit.
includes attached garage.
Suhdivicion' Lot no.: 1,000 sq. R. or less 145.15 4
-
- -._ . ........... .: ...........,,_..__ - -_ Ea sq. ft. orportion 33.40 1
Tax map /panel no.: Limited energy, residential 75.00 2
PESCRU'I iON OF WORK (with above sq. ft.)
A 1 /�
Limited energy, multi-family 75.00 2
t ll , iv residential (with above sq, ft.)
— - Services or feeders installation. alteration, and/or rdoartion
200 amps or less 80.30 2
❑ PROPERTY (1WNER f ❑ TENANT 201 amps to 400 amps 106,85 2
Name: 401 amps to 600 amp 160.60 2
_ .._...--
____ 60) amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 .. 2
tote /71 1>: Temporary services or feeders installation, alteration, and /o r
_ - - ._ reiocation _
Phone I ) Fax: ( ) 200 amps or less 66.85 1
- — ... -.. _..._.. -- ,..... -- 201 amps to 400 amps 100,30 2
Owner installation: This installation is being made on property that I own which is not
intended for stile, 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 extension. per panel
Owner signature: Date for r�rch circuits circ uits with
- A. Fee
❑ APPi,I('ANT El CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: '
/ l+ D. Fee for branch circuits
without service or feeder fee,
t ) tt first branch circuit 46.85 t c,...5-2 Addrtcc ....
name: . .... .. ...._ - - -- - ._. •, _ .g.
h I Each add') branch circuit 6.65
r 2 -. t
Miscellaneous (service or feeder nit inelnded) •
City/State/7.1P; p� � � Each manufactured or modular 90.90 2
•"
- - - — •-^ - - �� dwellr service n� se ice feeder
Phone; 1 Fax ( ) 5 "- ( V Reconnect only 66.8 2
1'. -mail: Pump or irrigat circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Rosiness name: ? t o le9 energy panel, c li or
rA �`~W��~ -- ....,,__.,., _ - - - - L��-f at C_. energy panel, alteration, or
Address: ' �, 45 ? ( Ai E . 1 Q 1- L" A� extension. Desc Page 2 2
p
City/Stare/7.W r n� \ r t D ( � (7 Z t Z Each additional inspection over allowable in any of the above
— -- ' erg. Per inspectimt 62.50
Phone: ( n 6 `] ;; I 0 .. c > '7.. Fax (` ?(c 449 ,' investigation per hour (1 hr min) 62.50
er hour plant industrial .n p per
rv, 1.Icclncian si . , r r t. -- -- -- - - - .V-
('(" 1'3 Lie.: 1 f '4 j 3 :le�ctr I,ic -' �� ;,, y „�C, Suprv- l.iC_A - i � { ,� �e � ..-. 7375
.... -
7 ! • _ . / ELECTRICAL PERMIT FEES
py7AV r- Faired:: � f r I ` h Subtotal: E
1CAi• S
_ r
Print ntltne: r ' Plan review (25% of permit fee)
Y APP l }. . � . 1e Da te: 9 �. r
_ " "' ° —_ State surcharge (I2% of permit flee): s ( (.s--
Authorized signature TOTAL, PERMIT FEE: � 9 7
This permit application rxri rn If a permit is not obtalaed within ISO
Print name: Date
dar3 after it has been accepted as compkte.
CITY OF TIGARD /f � °S
BUILDING DIVISION Z PERMIT #: ELC2008 -01391
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/11/2008
Phone: (503) 639 -4171 " 1M�ur°
Inspection Requests (24 Hrs.): (503) 639 - 4175!!+4 �'f I..
INSPECTION WORKSHEET FOR DATE: 7/17/2008 TIME: 7:00AM PAGE: 67
SITE ADDRESS: 11310 SW AMBIANCE PL. CLASS OF WORK:
SUBDIVISION: GENESIS NO. 2 LOT #: 019 TYPE OF USE:
PROJECT NAME: CARR
DESCRIPTION: Installing (1) branch circuit for NC.
OWNER: CARR, PAUL PHONE #:
CONTRACTOR: FARWELL PERRY ELECTRIC PHONE #: 503 - 890-2352
Inspection Request Scheduled For: Date: 7/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 07271502 503.655 -0556 V 1+10- IV&
Corrections/Comments/Instructions:
e l:-
Y __,,
KPASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ` CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: War Date: 7 h .) Phone #: (503) 718 -
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: .r acx1 - _ c / . REQUIRED ON GREEN INSPECTION CARD,
e
i ✓ • Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
•
410 Fill • 110 Temporary electrical service
415 Urading 115 Electrical service
205 Footing k 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover `
215 Footing drain 135 Low voltage
220 Slab _ 140 Sign installation
310 Crawl drain • 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation v 195 Misc. inspection:
235 Shear walls /anchors K
Electrical final •
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar) _
- • : 275 Framing
. , , 810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 .. Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
"' 295 Misc. inspection: 620 Hydronic piping
. 899 MPG- Structure final 625 Duct work
• 498 Grading final 630 Fire damper
_ 299 Final inspection 635 Smoke detector shutdown ,
640 Exhaust hood
. 695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit _ •
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough in 310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
-
998 Alarm final 320 Plumbing rough -in
•
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
• 340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill .. 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing _ 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection - 599 Final inspection
S
I:\ Building\ Forms \InspCard- AOP- Blank.doc 02 /02/07
71 CIT OF TIGARD ELECTRICAL PERMI
a CITY r[
PERMIT #: ELC2008-00391 _.
COMMUNITY DEVELOPMENT DATE ISSUED: 7/11/2008
`TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 •)
I PARCEL: 2S 103DB -06700
SITE ADDRESS: 11310 SW AMBIANCE PL ZONING: R -4.5
SUBDIVISION: GENESIS NO. 2 LOT : 019 JURISDICTION: TIG
PROJECT: CARR
Project Description: Installing (1) branch circuit for A/C.
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: 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:
PAUL CARR FARWELL PERRY ELECTRIC
11310 SW AMBIANCE CT 2536 NE 10TH AVE
TIGARD, OR 97223 PORTLAND, OR 97212
ITI
Phone: Contact #: PRI 503 - 890 - 2352 1°
FAX 503 - 760 -8498 C,
FEES P
Description Date Amount Reg #: ELE 26 -855C
[ELPRMT] ELC Permit 7/9/2008 $46.85 LIC 91733
[TAX] 12% State Surchar 7/9/2008 $5.62 SUP 4067S
0
Total $52.47 REQUIRED ITEMS AND REPORTS
W
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: /, ,- j ,.- ..-7.--- Permittee Signature: 4;.‘
. 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 per % it card shall •e kept in a conspicuous place on the job site until completion of the project.
. \ Approve•'plans are equired on the job site at the time of each inspection.