Permit .. CITY OF TIGARD ELECTRICAL PERMIT
Er, PERMIT #: ELC2007 -00017
COMMUNITY DEVELOPMENT DATE ISSUED: 1/9/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 DD - 07600
SITE ADDRESS: 08527 SW AVON ST ZONING: R -
SUBDIVISION: CHESSMAN DOWNS LOT : 002 JURISDICTION: TIG
Project Description: 1 branch circuit to micro hood.
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:
LOVE, RICK DUANE /PAMELA ANN VAST ELECTRIC
8527 SW AVON ST 1525 SEATTLE SLEW DR. SE
TIGARD, OR 97224 SALEM, OR 97301
Phone: Contact #: PRI 503 - 780 -8597
FEES
Description Date Amount Reg #: ELE 24 -521C
[ELPRMT] ELC Permit 1/9/2007 $46.85 LIC 160065
[TAX] 8% State Surcharge 1/9/2007 $3.75 SUP 4360S
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 503.7699 or 1.800.332.2344.
Issued By: 1:5 Permittee Signature: 7
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.
•. .
ri CUCI VT: 1 - )
Electrical Permit Application i'dit';8Y446,'E'll'
. ' jAN ci 2007 ,.,..,,,,t:,:,,f..i':.gi,....s:zo?a6.,t,:',.z,iioo,..a.p,,,.:,„,,::,..,--.::,-;„?,,A.,ctu:,,.,.,,,:.:;::,'":-,v„-,:,I,,:_,i:::::,,,L-J,.,.of:-,.
Recei ved
City of Tigard
.., 13125 SW Hall Blvd., Tigard, O 47121 . i I, 4_, k' -
..ii..- Phone: 503.6394171 Fax: 50k jid.;1910 I
IIP4 191KO
1.tki . DatefB . Ma= Pennit No.4t . 106.1_ 0 ,,, 0
DaillanerBRevi Other Permit:
Inspection Line: 503.639.41aror wrikTr. rillTirqlin '• Date Ready/By: EMI 65 See Page 2 for
A RP,
' '-'!.-' Internet: www.tigard T, I WI , Notified/Method: Supplemental Information
, ':'' . ..:5','■e,: . ?" ';'!"'- 4' .. 'i.'""..''' . e.' 00Avijia 71 '2:',AV:4.1..;,":,:iM:.-4-`4:".,:',..'4 ' W
12 New construction Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stones.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
1 v'okii6tilti iii'eoi .-#4 ''',:rzi" IN exceeds 10,000 amps at 150 volts or 0 floating buildings .
less to ground, or exceeds 14,060 0 Commercial-use agricultural
1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
0 Emergency system. larr separately derived system.
''':-'4O-11"iii:114°61M'iii;ii
.1 '' '.4i.''L.'4-"' ge 0 Addition of new motor load of
100HP or more. occupancy.
Job no.: Job site address: gf 5C77 A ih SY El Six or more residential units. 0 Recreational vehicle parks.
City/State/Z1P: li 0 Health-care facilities.
EI Hazardous locations. 0 Supply voltage for more than
1 at (0
600 volts nominal.
Suite/bldg./apt. no.: Project name: 0 Service or feeder 600 amps or more.
iiii tD1f,LE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: . 1,000 sq. ft. or less 145.15 4
Ea. addl 500 sq. ft. or portion 33.40 1
Tax map/parcel no.:
Limited energy, residential
75.00 2
l i r ' ,. ' 41 ;;; , ';' ,-4 3;":- 1.5 '''' ,1 . .. V (with above sq. ft.)
Limited energy, multi-family
Add 1-- c. re c-11 it - g.s Is wi i c (19 - tte0o 1 .-1. residential (with above sq. ft.) 75.00 2
1 < * i 4 - C, 1/e /1 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
Aill :',iF4:0 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address:
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) . 200 amps or less 66.85 1
2 400 to amps 100.30 *
Owner installation: This installation is being made on property that I own which is not 201 amps .
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
131 :! f tP: ' ..0- 1 - 4r 4: 1 Sfi':'; ' ''',.. Y 3 4, 4 , , ,, • 04 Co* 0 , 'E*Si):1414-':: :; ,,P . above service or feeder fee,
6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: . 46.85 2
first branch circuit I
Address: Each addl branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
0jSitiftAtTcift:` ',4: Sign or outline lighting 5340 2
Signal circuit(s) or limited-
Business name: AS E lecit IC energy panel, alteration, or
Address: 1 1 2 - ci ilk ' ie-t4i Or. ffr - extension. Describe: Page 2 2
City/State/ZIP: _51, 62 k - (473 I 7 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (503) 'NV- F - lo 7 Fax: (10 3) ,5-53 gg R.ff Investigation per hour (I hr min) 62.50
CCB Lic.: I ( ( 5 Electrical Lic.: it- 3 c.._ Suprv. Lic.: 5-, y ‘, i Industrial plant per hour 73.75
■Ply.40 - E1.3ECTRICXU. PERM IVFEES."..!;:f•-::,?°,?
Suprv. Electrician signature, required: 7 7.4.0 „ 2 4;04 - •- - .0 -1 „ -- prooe" Subtotal:
- . Plan review (25% of permit fee):
Print name: . " -- 1 4.4.i !L S- Date: i - i,-04
State surcharge (8% of permit fee): ;3..1 C
Authorized signature: TOTAL PERMIT FEE: 5 , de
This permit application expires if a permit is not obtained within 180
Print name: Date: .
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I: \ Building \ Permits NELC-PermitApp doe 05/23/06 440-4615T( I I/05/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
NESTDENI 4 WOKS ONI I , , . -#
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAI WORB4ONLY"'zO x
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape T ighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PermiWpp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00017
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/9/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1/10/2007 TIME: 7:03AM PAGE: 4
SITE ADDRESS: 08527 SW AVON ST CLASS OF WORK:
SUBDIVISION: CHESSMAN DOWNS LOT #: 002. TYPE OF USE:
PROJECT NAME: LOVE
DESCRIPTION: 1 branch circuit to micro hood.
OWNER: LOVE, RICK DUANE/PAMELA ANN, PHONE #:
CONTRACTOR: VAST ELECTRIC \\N\ PHONE #: 503 - 78¢8597
Inspection Request Scheduled For: Date: 1/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 041992 -01 503-780.8597
Corrections /Comments /Instructions:
^PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: 5 N €e L Date: I I 6 1 1 Y] Phone #: (503) 718- 2-4441).