Permit CITY OF TIGARD ELECTRICAL PERMIT
IN T _' PERMIT #: ELC2006 -00677
= COMMUNITY DEVELOPMENT DATE ISSUED: 11/29/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 103 B B - 01400
SITE ADDRESS: 12476 SW BROOK CT ZONING: R - 4.5
SUBDIVISION: BROOKWAY LOT : 014 JURISDICTION: TIG
Project Description: Change panel, add circuit for hot tub. Job No. 8161
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: 1 W /SERVICE OR FEEDER: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
RODNEY ZAGO WILLAMETTE ELECTRIC INC
12476 SW BROOK CT PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 - 3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 11/29/2001 $86.95 LIC 75059
[TAX] 8% State Surcharge 11/29/200( $6.96 SUP 1965S
Total $93.91 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 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
slaspended for more tharN 0 s. TTENTION: Oregon law requires you to follow rules adopted b�_the..Oregon Utility Notification Center.
jhose rules are set forth in R 952 - 2 0010 through OAR 952 -001 -0100. You may obtain co . �s of these rules or direct questions to OUNC at
5 or 1 .800. 332 344. 4 / ck:. ,��J i / I �
Is ued B y' k _ �7�I Permittee Signature: II� /l _
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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 INS ; ALLATION ONLY
SIGNATURE OF SUPR. ELEC'N:( j ' i l l i 7r 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.
NOV 28 2006 1:38PM WILLAMETTE ELECTRIC 5036242938 p.2
•
:: a } I f r f1 � • 7 -? i X f.. $ :d S"\t :.
ti' e: �ai-a�l Permit Application �, E F orr d E tVsE4QrL \ , E t . t' • Received l 'etniil Nn. i
CP.1.y ell iigatra R e c e iv e it o� � � ����'�� /lo acs 7 7
1 3125 SW Hatt B vd ,1lgard, (1R 97223 r:! Plan Review
Phone 503.639 41 71 Fax: 503.598.196 r+ �,,, t'it + f'3t Date/By: Other Permit
inspection Line: 503.639.4175 � ,,. _ �': ` Date Ready/Ely: J°rl RI Sec Page 2 for
Internet: \vww.ci.tigard - onus NOV 2 8 20 t Notifred:Method: ilea- Supplemental Information
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❑ New construction Iii - ddiduitem @i fii i i O$r 4nt Please check all that apply:
['Service over 225 amps comm'l []Hazardous location
D emolition ] Other: ❑ h ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. It..
of ] -and 2-family dwellings 4 or more new residential
IN '- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑Syste over 6 U0 vo lts nominal units in one structure
['Building over three stories ❑Feeders, 400 amps or more
❑ Multi-family ❑ Master builder ❑ Other: red structures or .
)' ❑Occupant load over 99 persons ['Manufactured
�, .; :. - a s,: ,' "• ,:c. ;:,l,ri;: ;,=:,:',:.::::''' :.i'' O. RV ark
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4 = r -. 1 . i , . , E = .. � >* r.. . ., : et,a — Q Egress/lighting pl p
,. ._...- �r. -,. ... «:.. ,,,,,et,„ ,. ✓.. ....yam..:. , .r .�.. ,. . � ^. ... , , : �:. �.......a, ;.:
"' - . OHealth- care facility ❑Other:
Job no.: j f Job site address: Zy r . 6 . " L / Submit 2 sets of plans with any of the above.
City /State/ZIP: 7 l `/,, 1, 9 994z 3 The above are not applicable to temporary construction service.
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Suite/bldg. /apt. no.: Project name: �i® U/J ..
Descr Qty. , Fee. I Tatal
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. 11. or less 145.15 4
Subdivision: Lot no.: Ea. add'1500 sq. ft or portion 33.40 I
Limited energy, residential 75.00 2
Tax map /parcel no.: _ Limited energy, non - residential 75.00 2
- . - •+�' ' r,,t +i a'r', �i '.� ,,y�e.'2. 1' .yyt g ;sii i; :;�'y.�'•
•�� �- 1 �_�•- '_ '' %} _.- - Each manufactured or modular
z:horI7G pen I t {/ ' *�1 M
/ /� dwelling, service and /or feeder 90.90 2
/� /' 7 Services or feeders installation, alteration, and/or relocation
200 amps or lets 1 80.30 ga. 30 2
', -� -�; - _:T, == - -= ;2.i��iir= ;rsi - _ �.`- _ '�i 201 amps to 400 amps 106.85
its- trtr?: • _ i, __ "FEE ;-_� �_.W .. ='e'o. • :: -.: _ -,,!, : c" ' _:>::;y ' '' 2
:...:.,. =;.'- _...: - _. "- w:._. . ". -� ,. -.:. ., r; :'<,....., 401 amps to 600 amps 160.60
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 _ 2
Reconnect only 66.85 1 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
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
r tt ^ <i Nir =:'I Y`, ' l ; # a . . ' F .. l •
... 4 1 1,w = � v ': d1 �,y ; Z , ; f A. Fee for branch circuits with
_ -_ - - .....- t l• - ' ._' ' r ' "'"' 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 2
first branch circuit /
Address: Each add'l branch circuit j 6.65 G , ps 2
City/State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) rFax:: ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
::.;. ,,_ ._..., - - :.:0:1.1. - :- - alteration,
.e "'" � •N,- -_ ,� ._� atr:t.: =;c,S.PrH< ' "C:,1. --';_': ". t ,'r; energy panel, or
o
:r �- :`.�; .n:. ;:.1::' ;E: i9 � ��e �;:t1 z.0 ?:., :Yi:�ei� � ..: +'i1 m��?L;�
"� extension. Describe: Page 2 2
Business name: , H ?,., of F e 67 tit tr,- . 2
Each additional inspection over allowable in any of the above
Address: p t } ' c }r` 2 3 8 � V "1 -
Per inspection .
City/State/ZIP: T t 9 0" C 0 v 9 "I Z c°) Investigation per horn (1 hr min) 62.50
F i Industr plant per hour 73.75
Phone: �y + - Gid Fax:(3� ) Lam!t -- .,
(,S�) 6 ate ��..;;, ^��°:�a`;__� -�"" ' s= i � ,�. , .: '.1'.--::";:i'-' .
�'= rd ",.:..tt�== ;.;�_:,.. ` '� ��:'�.e.�• �`: � @n.�iz'. -.::. . -
CCB Lie.: 75 `.i or Electrical Lic.: .3* -a3 C. Suprv. Lie.: V Z e d • -..S" Subtotal , c 95
Plan review (25% of permit fee)
Suprv. Electrician signature, requlred� ' ° .... . - ...= •- •' --�- -- -- " " " `
State surcharge (8% of permit fee) (j , 9�7
Print name. 0 y ; ,_d :, 1 -e Date:
TOTAL PERMIT FEE 3,6 I ,
Authorized signature: _ This permit application expires ira permit Is not obtained within ISO
days after it has been accepted as complete
Print name: Date: j ' Foe metledology set by Tri- County Building, Industry Service Board
•• Number of inspections per pesnit allowed.
r\ault ding \Permlt9\ELC- PeimitApp.doc 12103 440 -46 I i'r(1CIO2;COM /WISB
4 • ' .
CITY OF TIGARD
BUILDING DIVISION ., - . PERMIT #: ELM006-00677
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2006
Phone: (503) 639-4171 hosivit
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/13/2006 TIME: 7:04AM PAGE: 61
SITE ADDRESS: 12476 SW BROOK CT CLASS OF WORK:
SUBDIVISION: BROOKWAY LOT #: 014 TYPE OF USE:
PROJECT NAME: ZAGO
,..
DESCRIPTION: Change panel, add circuit for hot tub. Job No. 8161 .-
. •
OWNER: ZAGO, RODNEY PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-6243631
Inspection Request Scheduled For: Date: 12/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 040966-01 ' 603-624-3631 N
Corrections /Comments/ Instructions:
)7
74.,(6_,t crIc
Ili
C) .
PASS pi i i. RTIAL • PPRO AL
svrAf Vrillr fl CANCEL n NO ACCESS
I FL rff CA • r ' ir" E C T I 0 N el, ADDITIONA FEES SESSED
Date: 2.-
Inspector: l ' 49- P'hone #: (503) 71