Permit CITY OF TIGARD ELECTRICAL PERMIT
- PERMIT #: ELC2005 -00028
�1�4
, DEVELOPMENT SERVICES DATE ISSUED: 1/18/2005
13125 SW Hall Blvd.. Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S103DB -11200
SITE ADDRESS: 11240 SW ARBRE CT
SUBDIVISION: GENESIS NO. 3 ZONING: R
BLOCK: LOT : 065 JURISDICTION: TIG
Project Description: New stove circuit, plug for fireplace fan.
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: 1 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:
CLU KEY, GLENN C AND GENIE ELECTRIC CONSTRUCTION
DEBORAH A 8701 SE 156TH AVENUE
11240 SWARBRE COURT PORTLAND, OR 97236
TIGARD, OR 97223
Phone: Phone: 503 - 762 - 9296
Reg #: LIC 56639
SUP 4536S
FEES ELE 34 -488C
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/18/2005 $53.50
[TAX] 8% State Surcharge 1/18/2005 $4.28 Rough -in
Elect'I Final
Total $57.78
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Spedalty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1 -800- 332 -2344. --
Issued By: ) tC�t� Permit Signature: D -
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 - 4175 by 7:00pm for an inspection the next business day
Electrical Permit Applicatio FOR OFl Ic E l SF: 0\1.1
City of Tigard _ � � Received / 0) .T Permit No.: COSH r C/0�z
13125 SW Hall Blvd., Tigard, OR . { Plan Review
Phone: 503.639.4171 Fax: 503.5'8.1' .0 4 ? tio �"'a- �' iiit;ra� I Date/By. abet Per
Inspection Line: 503.639.4175 ^ ,; .. Date Ready/By: kris: 0 See Page 2 for
Internet: www.ci.tigard.or.us \,h'X a I' Notified/Method: II Supplemental Information
`£fir` ,u :` O 5 r^ . xr a c ,- y . i - a :,, a t. ' '9 r It:Z.
❑ New construction G ••• 1 i.r'tl/al - / ite m ent Please check all that apply:
❑ Demolition ['Service m
Service over 225 amps, com'I ['Hazardous location
r_ N Ef „ z ,_. �S7$Ri1tN1`7O1V �a , Service over 320 amps — Buildng over 10,000 sq. ft.,
A?1'a0 ,Y flF E.VD , i'O rati
❑ rating ❑ - f of l- and 2- family dwellings 4 or more new residential
1 l —and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi-family ❑Master builder Other: ❑Building over three stories 0 Feeders, 400 amps or more
e a _ ❑Occupant load over 99 persons El Manufactured structures or
4• 't v, = ' 7 s RV park
.tom ". (4 ' Sl1wE ciSi, *, : ,, ;; �. ,0. , ;, ❑Egress/lightingplan
Job no.: -3 5 b Job site address: t t 211 0 5 k-- A-v P,,,-.. C / ❑Health - care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: • f-- ( r ( d r The above are not applicable to temporary construction service.
Suite/bldglapt. no.: Project name: s '' t _ +' SGl7EI) 'r `^.
Description I Qty. I Fee I Twat I
Cross street/directions to job site: ' t New residential single- or multi family dwelling unit.
Includes attached garage.
1,000 sq. it or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
. ; 3 ' -' a - s & b 77RWt�,,0131f/Y?, ; �? NI7AC � �` -` '_, ' Each manufactured or modular
,+ t t dwelling, service and/or feeder 90.90 2
/N4 .4?. t v S AUf �-L (.� -C r� P (G( t i'i � / /�, ,,,,,..e
Services or feeders installation, alteration, and/or relocation
--- 200 amps or less 80.30 2
f amps to 400 amps 1 06.85 2
401 amps to 600 amps 160.60 2
Name: C \ L\6, _I`
` I 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( )
200 amps or less 66.85 t
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
.,,- VA1 C - ' l • z(: �.,x N(1 .lE _ 1.1 _ A Fee for branch circuits with S^
tCG7
service or feeder fee, each 6.65 � 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 y(D L
Address: each branch circuit /
Each add'I branch circuit 6.65 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Pax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
v A energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Genie Electric Construction, Inc.
Address: 8701 SE 156th Ave . Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Po rt land , OR 97236 Investigation per hour (1 hr min) 62.50
Phone: ( 503) 762 -9296 Fax: (503 ) 762 -9188 Industrial plant per hour 73.75
CCB Lie.: 56639 Electrical Lie.: 34 -488C Suprv. Lie.: 45365
S ubtotal S) .,
Suprv. Electrician signature, required: L Plan review (25% of permit fee)
/ L ( G � State surcharge (8% of permit fee) I Zj
Print name: ■ Date: f Lego white 4�
�' TOTAL PERMIT FEE c7/7 (3
Authorized signature: o-'-Z 1 - -- This permit application expires if a permit is not obtained within 180
/ days after it has been accepted as complete
Pant. name: LeRoy White Date: 1 l ` G 5 • Fee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed-
CITY OF TIGARD 24 -Hour
BUILDING Inspection -.: (503) 639 -4175
INSPECTION DIVISION Business L (503) 639 -4171 MST
BUP
Received Date Requested 'a AM PM BUP
Location a t' A _' Suite ` / MEC
Contact Person P ( ) 3/ 3 7 733 PLM
Contractor (_ ) SWR
BUILDING Tenant/Owner ELC dSC�U S COO
Footing
ELC
Foundation
Access: ,6.67s
Ftg Drain i ELR
Crawl Drain /
Slab Inspect .N te / err SIT
Post & Beam ='� '/
Shear Anchors • . f . " . -
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: ‘1".4\11
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab •
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
• Storm Drain •
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In •
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL .
Service
Rough -In
UG/Slab •
Low Voltage
Fire Alarm
PART FAIL Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
S " ❑ Please call for reinspection RE: fl Unable to inspect — no access
Fire Supply Line
Date / / r `� Ins actor Ext
Approach/Sidewalk P yew-
Other:
Final DO NOT REMOVE this inspection record fr e job site.
PASS PART FAIL