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Permit CITY OF TIGARD ELECTRICAL PERMIT IL PERMIT #: ELC2008-00192 COMMUNITY DEVELOPMENT DATE ISSUED: 4/2/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S125DC-08200 SITE ADDRESS: 07070 SW ASH CREEK CT ZONING: R -4.5 SUBDIVISION: ASH CREEK ESTATES LOT : 015 JURISDICTION: TIG PROJECT: ASH CREEK ESTATES Project Description: Installing (1) branch circuit for hot tub. 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: WINDWOOD CONSTRUCTION INC JEROME ELECTRIC 12655 SW NORTH DAKOTA PO BOX 751 TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: 503 - 780 -4375 Contact #: FAX 503 - 648 -9723 PRI 503- 648 -5144 FEES Description Date Amount Reg #: ELE 34 -119C [ELPRMT] ELC Permit 4/2/2008 $46.85 LIC 158119 [TAX] 12% State Surchar 4/2/2008 $5.62 SUP 28775 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 ma o•, ain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: � ': /yam ,� Permittee Signature: , t' 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. Electrical Permit Application ti FOR OFFICE USE ONLY ., IN City of Tigard 4 Date/By: G( d Ar gigaj d t.' No.: j coo/g)... v 1 3125 SW Hall Blvd., Tigard, 09723` Plan Review Other Permit: C Phone: 5 Fax: 503.59 2 Date/By: T 1 G A RD �+ 1��t V Inspection Line: 503.639.4175 N t ` ry t ' j' � Date Ready/By: Juris El See Page 2 for 4 Internet: www.tigard or.gov i , N 1 � 5 Notified/Method: Supplemental Information TYPE ,OF� �alo�+ �. PLAN REVIEW ❑ New construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Mannas and boatyards. - CATEGORY OF CONS TRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings, less to ground, or exceeds 14,000 ❑ Commercial -use agricultural ❑ 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or JOB' SITE INFORMATION AND LOCATION . ofe ❑ Emergen n em. larger separately derived system. - 0 of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", • 7 CAC IOOHP or more. occupancy. Job no.: Job site address: —10-7D 0�D �W �S i f K t ❑ S ix or more residential units. 0 Recreational vehicle parks. City/State /ZIP: 7 D (-- 9 2 Z 2J ❑Health -care facilities. ❑Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more. FEE SCHEDULE . ' Cross street/directions to job site: 7 Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: I S 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add] 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 . DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 \oT TQ.6 kAL(2 G residential (with above sq. ft.) 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 Name: - 3 -- A1 7 ...1._ SuA, amT- 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: 07 5k Over 1,000 amps or volts 454.65 2 City/State /ZIP: T GRR9 Q 9'7 Z2-.3 Temporary services or feeders installation, alteration, and/or relocation Phone: (50 3 qgC) - 70 7 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 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 • each branch circuit Business name: 7 /i J B. Fee for branch circuits ) Contact name: 1 without service or feeder fee, 46.85 2 f branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular dwelling, service and /or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 E -mail: Pump or irrigation circle 53.40 2 CONTRACTOR ' ' Sign or outline lighting 53.40 2 Business name: ` Signal circuit(s) or limited - e �otAL T12- en pnDesct r or Page 2 2 Address: / JA S. �.�„, ,�... City/State /ZIP: fiS D e_ G -71D3 Each additional inspection over allowable in any of the above ` °��� l Per inspection 62.50 Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50 CCB Lic.: /e5 / I Electrical Lic.: gtt, /1 qG Suprv. Lic.: —77 Industrial plant per hour 73.75 E LE_ CTRICAL" PE RMIT FEES. Suprv. Electrician signature, required: Subtotal: •16 r Print name: Date: Plan review (25% of permit fee): State surcharge (12% of permit fee): 5 • C --- Authorized signature: TOTAL PERMIT FEE: s 7 Print name: Date: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. • Number of inspections allowed per pennit. L \Building\Permits\ELC - PermitApp doc 05/23/06 440- 4615T(11/05/COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: ;;RESIDENTIAL WORK'ONLY Fee for all residential systems combined $75.00 Check Type of Work Involved: n Audio and Stereo Systems* ❑ Burglar Alarm n Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY:' �� Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls PI Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* n Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD BUILDING DIVISION , . PERMIT #: ELC2008-00192 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 412/2008 Phone: (503) 639-4171 llypii7a Inspection Requests (24 Hrs.): (503) 639-4175 ......,..., I • .. .... INSPECTION WORKSHEET FOR DATE: 4/9/20 8 TIME: 7:00AM PAGE: 23 SITE ADDRESS: 07070 SW ASH CREEK CT CLASS OF WORK: SUBDIVISION: ASH CREEK ESTATES LOT #: 015 TYPE OF USE: PROJECT NAME: ASH CREEK ESTATES DESCRIPTION: Installing (1) branch circuit for hot tub. • OWNER: LED", JAMES & SALLY PHONE #: 503-989-7077 CONTRACTOR: JEROME ELECTRIC PHONE #: 603-648-5144 Inspection Request Scheduled For: Date: 4/9/2008 Pour Time: Code # Inspection Description Confirm # Contact # Messa ■ - 199 Electrical final 068092-01 503, 648-5144 d I160 Corrections/Comments/I str ctions: r REPO (ZIT L. / / (6 , JO. C.012_12 ec.....2. "LI co /A-t cLit.„-N • _ ARTIAL APPROVAL - EI CANCEL I I NO ACCESS 7 FAIL ij / ALL FOR INSPECTION III ADDITI NAL FEES ASSESSED L... Inspector: ...........c...........:2.. Date: tig Phone #: (503) 71 87Z9 CITY OF TIGARD F BUILDING DIVISION PERMIT #: ELC200B.00192 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/2i2008 Phone: (503) 639 -4171 emit ii�i��J1 Inspection Requests (24 Hrs.): (503) 639 -4175 _ INSPECTION WORKSHEET FOR DATE: 4/7/2008 TIME: 7 :01AM PAGE: 31 SITE ADDRESS: 07070 SW ASH CREEK CT CLASS OF WORK: SUBDIVISION: ASH CREEK ESTATES LOT #: 016 TYPE OF USE: PROJECT NAME: ASH CREEK. ESTATES DESCRIPTION: Installing (1) branch circuit for hot. tub. OWNER: LEC:°.T, JAMES & SALLY PHONE #: 5039897077 CONTRACTOR: JEROMF ELECTRIC PHONE #: 503- 64t35144 Inspection Request Scheduled For: Date: 4/7/2008 Pour Time: Code # Inspection Description o• Contact # sage 109 El ct.iical final 067958.01 503 - &113 -F ;144 `f Corrections /Comments /Instructions: C _Aa- 00 01 - `. ' S - 6Q I t 3 �np►A iMy 6f S� L 7i T ELEN\j, vB - 'VQ- (B0•42. A. 1 . ate. i.siN; W L, Pe- I , a • °-6 C63 IyC��'' Ste' �� © (8D c v cii-a-tastee w'l ► 6 ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS X FAIL tp FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: V •1\16 1 16 `- Date: P • V v Phone #: (503) 718- i 1b