Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00279
I I
DEVELOPMENT SERVICES DATE ISSUED: 5/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 102 CA -0 0216
SITE ADDRESS: 13175 SW ASH DR ZONING: R -4.5
SUBDIVISION: VIEWCREST TERRACE LOT : 014 JURISDICTION: TIG
Project Description: (1) branch circuit.
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: Z 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:
BARBARA TAYLOR FIVE STAR ELECTRIC, INC.
13175 SW ASH DR PO BOX 555
TIGARD, OR 97223 BANKS, OR 97106
Phone: Contact #: FAX 503 - 324 - 0973
PRI 503 - 324 -0948
FEES
Description Date Amount Reg #: ELE 34 -665C
[ELPRMT] ELC Permit 5/18/2006 $46.85 LIC 158231
[TAX] 8% State Surcharge 5/18/2006 $3.75 SUP 46225
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 - 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: L Permittee Signature: � A
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.
e \
. ; ect' Permit Application'4 FOR 01:11(•E USE ONLY
City Of Tigard ta q ` DateB� ■ 0 % Permit No.' L
� al w:
13125 SW Hall Blvd., Tigard, OR i • 6 Plan Review
Phone: 503.639.4171 Fax: 503.5 ",8.1960 f '� 1,00 �,ll titit i'". 1. <I Date/By Other Pemvt.
Inspection Line: 503.639.4175 - ! '' Date Ready/By: lads: 6J See Page 2 for
Internet: www.ci.tigard.or.us � L Notified/Method: .� 1 rl V Supplemental Information
s(1`IC " " PLAN REVIEW
❑ New construction ® Addit ► on/replacement Please check all that apply:
❑ Demolition ❑ Otifi'SWV ❑Service over 225 amps, comm'1 ['Hazardous location
❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of I- and 2- family dwellings 4 or more new residential
® 1- 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 ❑Other:
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: FS486 Job site address: 13175 SW Ash Drive
['Health-care facility ❑Other:
Submit 2 sets of plans with any of the above.
City/State /ZIP: Tigard, OR 97226 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: Taylor, Barbera FEE* SCHEDULE
DIJLE
Description Qty. I Fee. I Total I "
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea add'l 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Install Lighting dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: 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 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
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, ` �
Address: first branch circuit 46.85 4to�1)7 2
Each add'l branch circuit 6.65 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Five Star Electric
Address: PO Box 555 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Banks, OR 97106 Investigation per hour (1 hrmin) 62.50
Phone: (503) 324 -0948 Fax: (503) 324 -0973 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lic.: 158231 Electrical Lic.: 34 -665C Suprv. Lic.: 46225 Subtotal Li 6, ��
Suprv. Electrician signature, required: Plan review (25% of permit fee)
�, A UJ Date: 05/17/2006 State surcharge (8% of permit fee)
Print name: ZOM W I S y (i n� 75
TOTAL PERMIT FEE SO, a
Authorized signature: This permit application expires if a permit is not obtained within ISO
. days after it has been accepted as complete
Print name: Date: t Fee methodology set by 'N - County Buddin Industry Service Board
" N of inspecti ons p er p erm i t al lowed.
i:\Builcling\Permits\BLC-PermitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
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CITY OF TIGARD
BUILDING DIVISION .. .. PERMIT #: ELC2006-00279
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 615/2006
Phone: (503) 639 -4171 / i441 lt
Inspection Requests (24 Hrs.): (503) 639 -4175 °`:_..
INSPECTION WORKSHEET FOR DATE: 7/12/2006 TIME: 7 :05AM PAGE: 52
SITE ADDRESS: 13175 SW ASH DR CLASS OF WORK:
SUBDIVISION: VIEWCREST TERRACE LOT #: 014 TYPE OF USE:
PROJECT NAME: TAYLOR
DESCRIPTION: (1) branch circuit. 6/5/06: Added (2) branch circuits. `lob 1/FS486.
• OWNER: TAYLOR, BARBARA PHONE #:
CONTRACTOR: FIVE STAR ELECTRIC, INC. PHONE #: 503. 324- 0M
Inspection Request Scheduled For: Date: 7112/200€1 Pour Time:
Code # Inspection Description Confirm # Contact # ' essage
199 Electrical final 032935 -01 503-522 -5160 YNrf
Corrections /Comments /Instructions:
0 c. psii,: .
I�j ' . SS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/
Inspector: e.:J-I i I Date: t 7 i2_ 6 Phone #: (503) 718- 2-4 y4