Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00563
COMMUNITY DEVELOPMENT DATE ISSUED: 8/13/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 1036 B -12700
SITE ADDRESS: 12305 SW ANN CT ZONING: R -4.5
SUBDIVISION: LAKE TERRACE NO. 2 LOT : 020 JURISDICTION: TIG
PROJECT: BECKMAN
Project Description: Wire hot tub.
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:
BECKMAN, KURT A + MELANIE M WILLAMETTE ELECTRIC INC
12305 SW ANN CT PO BOX 230547
•
TIGARD, OR 97223 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 8/13/2007 $46.85 LIC 75059
[TAX] 8% State Surcharge 8/13/2007 $3.75 SUP 4226S
Total $50.60 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 -00 -a I 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 gI / Permittee Signature: SiLe / C
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.
FIUG 1 0 2007 10:28AM WILLAMETTE ELECTRIC INC. 5555555555 p. 2
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1Et ica1 Permit C Applieptid4li`u rt- l : y ii t. :F OFF�IC;E TSE �NI i- s to ;
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3125 SWi tall l lvd.,'I'igard,OR 972_, v Plan Review Q t��'� — � (O�
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Phone: f 03 6 9 4 : 71 Fox: 503.598.1 960 � •t' , � J ,t, f
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inspection Line: 503.639 4175
AUG ® fi t. y � ' D ate Read }ffsy - !u,is 1 Qi See Vogel for
Internet: www.ci.tigard.or.us 20 7 Notified /Method: - 7/6-.- Supplemental info-mullion
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❑ New constr.tctiorl Addition /alterati s!t ement Please Lintel< all that apply:
❑Service over 225 amps, cornm'I ['Hazardous location
❑ Demolition ❑ Other:
., - ...__.... . - -- "W. - .... ❑Selvioa over 320 amps rating ❑ Buildng over I0,000 sq. it -,
c'AlitLr&$li't.. dJ1d JC` - A4 J":-• '. t • ." ' • of 1- and 2- family dwellings 4 or more new residential
65 - and 2 -family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Building over three stories ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder El Other: •
DOccupant load over 99 persons ❑Manufactured structures or
T hSt „ _nssrv� � = _'.:;'l.` =:r? .: Egress/ lighting play RV park
�::� ” -:- +_':��' ��.�•s: -: —�; _ - -• F i x s - .- ......_ - ❑Egre !,ghtt B P
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Job no.: 9 vt� Job site address: I Z 505 g t ,,� / 4 4 0 , G 1 ❑Health -care facility ['Other: -
Submit 2 sets of plans with any of the above.
City /State /ZIP: -- I f f5d J o� I .7.3 The above are not applicable to temporary construction service.
l�f __ _ - - -_
Suite bldg. /apt no.: Project name: ® µ ..,.. _ .r�,. .,._....; ,:,.. ..... �:. -..... �` .*
Qty, Fee. Toni
Cross Street /directions to job site: New residential single - or multi - family dwelling unit.
Includes attached garage.
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1,000 sq ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential . 75.00 2
Tax map/parcel no.: - Limited
test 7500 2
� �l?_`�:.,� „_ _. _. ; ... • . , . _ :.:, = .: >;: -: s: - ' ; 'i' i � Eachmanufa�ctured or modular
J 1 / G //e It' 71IA b dwelling, service and/or feeder 90.90 2
�1/ T Services or feeders installation, alteration, And /or relocation
i
200 amps or less 80.30 2
. - ...., ., .. _ .. •.- , . . _.._..�.. ��: -:.; . - - - :.,•, -_ €== = '=-:: - - mps taps Z
�: : ;:_. ,.•,.,, ,_ :_ .. _.... ..,..,. . . „
_. _ -1 . __ ?,n ._.M,,... 401 amps to600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 1 2
Address: Over 1,000 amps or volts 454.65 ' 2
Reconuect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
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
-•_ . • .` c =jam , - :rr `,
•' _ - \. °:_s t, _ _. lug-•; B•. � �fr :61'"r= �-�l� is oa,c' A. Fee for branch circuits with
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_ . 6
-_.. r__..• . r s irs. s •...._i a ::._._ _ ... =x service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 46.85 146'4 2
Address: Each add'i branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not Included)
Pump or irrigation circle 53.40 2
Phone: ( ) 1 Fax:: ( )
Sign or outline lighting 53,40 2
E -mail: Signal ctrcuit(s) or limited-
tgs ? _ � 4 _s1 - Vi: Panel, alteration, or
sr_ -= l
t`� X51;' >lrr' ,..
' .:il >: ... ? ,t am .' energy
extension. Describe: Pag e 2 2
Business name: Lt 1 f a,m etrt c C./ e,; h .. L
Each additional inspection over allowable In an of the above
Address: P C7 g c7/6 } -C41
Per inspection 62.50
City/State/ZIP: T, 5 0.r' t? ,9,._ "it ? Z I Investigation per hour (1 hr mir.) 62.50
( ) 4'. 6 Fax : ( ay ) 6 . ?' eJ 3 industrial plant per hour 73.75
.
Phone: �`' � - FaY at .._ - - -- _ -
CCB Lie ° jy t. `” Electrical Lic. `1 Suprv. Lt.c.: ' ? 6 5' Subtotaal
Suprv. Electrician signature, required . . - -•- «- r�-°'^ "'••" " - ' Plan review (25 %ofpermit fee)
State surcharge (3% of permit fee) 3 , 7 ..6
Print name: 0 0 a ; ; ,,/ a • I ` lute: /D .-t7 7
TOTAL PERMIT PEE 50 , 66
i Authorized signature: This permit applicattaa expires if a permit is not obtained within 180
__ days after it has been accepted as complete
Print name: Date: I " Fee methodology set by Tri- Ccunly Banding Industry Service Board
`• Number of inspections per permit allowed.
i•\i3uild log\t'r r:mtsiHL.C- PerrntApp cioc IV03 440 -45I 5 :RiwoJICOMIWIiI3