Permit •
CITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 00361
COMMUNITY DEVELOPMENT DATE ISSUED 6/23/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BC-04000
SITE ADDRESS: 10414 SW BONANZA WAY ZONING: R - 7
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT : 077 JURISDICTION: TIG
PROJECT: FISHER
Project Description: Installing (2) branch circuits for replacement of furnace and NC.
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:
MARK FISHER T & T ELECTRIC
10414 SW BONANZA WAY 4287 SE INTERNATIONAL WAY #F
TIGARD, OR 97224 MILWAUKIE, OR 97222
Phone: 503 - 880 - 8738 Contact #: PRI 503 - 652 -7610
FAX 503- 652 -7612
FEES
Description Date Amount Reg #: ELE 3 -605C
[ELPRMT] ELC Permit 6/24/2008 $53.50 LIC 161187
[TAX] 12% State Surchar 6/24/2008 $6.42 SUP 5176S
Total $59.92 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: '` Permittee Signature: P ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7 :00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
'El ctrical Permit Application � � ' ° r`(iR orFI(t '' ' O - '.; , . �,; � '.' / , :
,- ! °;
-, "�; City of Tigard v, Et � �.,.y - Pe n u t No. 13125 SW Hall BlvdTigard OR 9 4 /�✓ 0 — �. IIII
Phone: 503.6394171 Fax: 503.598.196 �+� �1Q� � Dew albs- Permit:
Wj i� -
Tt G'ti L Inspection Line: 503.639.4175 J K c2ker D Date Ready/By: S Page 2 for r
Internet: www ltgard -or gov c 1 ' `� Notified/Method: ( .P Su mental Information
1 .,, .� .pra. � "
{9 {..> .. - .: S ., :._ ..$:.`�w. , Se 3l` BEEI : I a ; i"YU, s� wuxi¢icvcsxt air f. [i`€ii N! g fiff3d .. grar ' .. i� .wx l w .R Y •. '.. .
❑ New construction ® Addition/alteratio't8�:accment Please check all that apply (submiti sets of plans w/ileins checked below):
❑ Demolition El ❑ Service or feeder 400 amps or more ❑ Bailding over throe stories.
yz cS , €r t ��,. k:.G.. .+k. .ta.a t where the available fault current - ❑ Marinas and boatyards.
i'i ErET r t Ynu al S=F ,. ,. csees:s 10,000 amps at 150 volts or ❑ Floating buildings.
'�`.. k. � - a w;r �du less to
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory ildin Boun exceeds Commercial -use agr icultural
ry' 1 ? amps fet all othee r installatioons, ns. ❑ buildings.
❑ Multi family ❑ Master builder El Other: ❑ Fire pump. ❑ Installation of 75 KVA or
'�A . a ,�H-t;n� c� , t4 �'�srls3 s � ce" , �; °r t ❑ Emergency system. larger separately derived system.
ti'' is +" is6ra, h,,r a ❑ Addition ofnew motor load of ❑ "A" "E" "1 -2" "1 -3 ",
Job no.: 4 0 4. q Job site address: /Ca 4/1 1001 or more. occupancy,
all ii h 2 k' 4 y ❑ six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: p e r / l A , er g T a 2 Y. CI Health-care facilities, ❑ Supply voltage for more than
Y7 ❑Hazardous locations. 600 volts nominal
Suite/bldg. /apt.no.: Project name: P X E/5,4 14 ❑ Service or feeder 600 amps ormore,
Cross street/directions to job site:
Description Qty. Fee. Total •
New residential single -or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. ft. or less 145.15 1 4
Tax map/parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
y r fi , _ Limited ener re
l, t k s t ,,, . 75.00 2
t tt ck tk _ lA .:. o 1 . t `pima -f etus a.' . , y (with above s4 ft -)
G �Qn J 4 �u F Limited energy multi - family -
F� 75.00 2
QJl ..� �t residential (with above sq. ft.}
!
Services or feeders installation,alteration, and/or relocation
`� 200 amps or less • 80.30 2
; y, - r• t � d 9 l ' t ` 1 x ,i Ss, . `
��• c.���u'(ai•.�e�.u��rla. ma'''r: r ;.,, I�,.�� 201 turps to 400 amps 106.85 2
Name: /' l/�irIc F,'S, r 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: /Oq /[r S /-s' I3or/a/2 7c t., J. - Over 1,000 amps or volts 454.65 2
City/State/ZIP: Ref f�a� ,t' a it Temporary services or feeders installation, alteration, and/or
71 2 ` r1 relocation
Phone: (54 ) ,c1 Y_ C9',78 1 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
Owner signature: Date: Branch circuits- new, alteration, or extension, er panel
a = st �, �� r a Ger,:7 turntb. ta:� A. Fee for branch circuits with
P tai: - 1 ' a e' i.' �, - ' k above service or feeder fee, 6.65 2
+. .rts::ai,.,,.
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, / 46.85 X6. 2
first blanch circuit
Address: Each add'I branch circuit t 6.65 6 4 .5' 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and /or feeder 40.90 2
Phone: ( ) 1 Fax: : ( ) Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
s`?ssw. :.,§r.. lMI . iE _a ,''. Sign or outline lighting 53.40 2
Business name: / j T _ wiz 4 - c -RIG .,..K4 f I
energ panel, alteration, circuits) er or limited-
eeration, or
Address: 4 5 7 54 21 2 /i r - ,'msr.s / tra Su,' ,4 f extension. Describe: Page 2 2
City/State /ZIP: . ,444 t ., ,,e. rc... r e a ' l Z Z 2 _ Each additional inspection over allowable in any of the above
• Per inspection 62.50
Phone: ()'o i ) G s - 76/c Fax:(.? ) S2 - 7 L / 2
Investigation per hour (t hr min) 62.50
CCB Lie.: //‘ // g ? Electrical Lie. :l --5 - Suprv. Lic.: , Industrial plant per hour 73.75
� t - r " ffi 1 )` UM a yam `
Su s
rv. Electrician signature, a. �p � a«1^e�< „s� . , s�i� ,.
p gnattue, required:
Subtotal: 5 3 . S0
Print name: , Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): C , y L
Authorized signature: /7 7 TOTAL PERMIT FEE: 5 7, ?Z
Print name: T� , , �� s j G O a This permit application expires if a permit is not obtained within 180
J `/ / Date: / 3 ! . d ays after it has been accepted as complete
• Number of inspections allowed per permit.
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to
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00361
13125 SW Hall Blvd., Tigard, OR 97223 ,- -A DATE ISSUED: 6/23/2008
Phone: (503) 639-4171 a r PIIII ;
Inspection Requests (24 Hrs.): (503) 639-4175 .744*. -"... : V
INSPECTION WORKSHEET FOR DATE: 7/10/2008 • TIME: 7:00AM PAGE: 37
16
SITE ADDRESS: 10114 SW BONANZA WAY CLASS OF WORK:
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT #: 077 TYPE OF USE:
PROJECT NAME: FISHER
DESCRIPTION: Installing (2) branch circuits for replacement of furnace and NC.
OWNER: FISHER, MARK PHONE #: 503-880-8738
CONTRACTOR: T & T ELECTRIC .PHONE #: 503-652-7610
Inspection Request Scheduled For: Date: 7/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Elechical final 072357-01 503-579-2250 46‘16*
Corrections/Comments/Instructions:
A---- ye-, A-i-ti
rikle, q ki IN\
1%.:. • Ae
• .p..:L.„:. PARTIAL APPROVAL 0 CANCEL El NO ACCESS
pi FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
/ .
Inspector:
, Date: 7 /a pg Phone #: (503) 718- _00,