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Permit
CITY OF TIGARD ELECTRICAL PERMIT ° PERMIT # ELC2008 -00207 COMMUNITY DEVELOPMENT DATE ISSUED 4/9/2008 1 I'GARLf 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DC SITE ADDRESS: 13330 SW BRITTANY DR ZONING: R -12 SUBDIVISION: BRITTANY SQUARE NO. 1 LOT : 023 JURISDICTION: TIG PROJECT: MUNDON Project Description: Installing (4) branch circuits. 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: 3 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: CAROLYN & JERRY MUNDON STAR ELECTRICALSERVICE 13330 SW BRITTANY DR PO BOX 1784 TIGARD, OR 97223 BEAVERTON, OR 97075 Phone: 503 - 524 -3089 Contact #: PRI 503 - 579 -9201 FEES Description Date Amount Reg #: ELE 26 -963C [ELPRMT] ELC Permit 4/9/2008 $66.80 LIC 153627 [TAX] 12% State Surchar 4/9/2008 $8.02 SUP 4313S Total $74.82 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 rule re set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC a 503.246.6699 o / r800.332.2344. Issued By: / Permittee Signature: 444, 4")( „ova. l 72 /�/ 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 FOR OFFICE USE ONLY " cy4 City of Tigard Date/By: y/ Ce eJ/ Permit No.: �•/ G � g , "� ° 13125 SW Hall Blvd., Tigard, OR 9722 a y tit ��' � Plan Review '- - 2 - Phone: 503.639.4171 Fax: 503. •ARI 6_ t}',_, Date/By: Other Permit: T I G A It D Inspection Line: 503.639.4175 i "'t� 9 10 Date Ready /By: Juris• ® See Page 2 for Internet: www.tigard-or.gov k . Notified/Method: Supplemental Information OF WO 'ij'? U .. •, ";; t►s PLAN REVIEW II n t �� Addition /alter t�r Please check all that apply (submit 2 sets of plans w /items checked below): Ell New construction L11t me ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. • CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 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 ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "1 - ", Job site address: X 33 ) / / • 7 1 , p {) S ix or or more residential more. R occupancy. Recreational Job no.: l O 7 (^! r/ / i Vy V/ ❑ S ix or more residential units. ❑Recreational vehicle parks. City /State /ZIP: Q /I l -7-;T, ❑ Health -care facilities. ❑ Supply voltage for more than � 0 9 ❑Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: I Project name: r?2b14��'�t V ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: Description i Qty. I Fee. 1 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 Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) i/ ,� -•:."' ----- l Limited energy, multi - family I/ v /_ T 0 /1/ �� residential (with above sq. ft.) 75.00 2 Services v J or t installation, alteration, and/or : li 11 amps or 80.30 Name: ,•. ' ROPERTY% WNER � /�/ /} ❑ TENANT , 1 . • 600 . ■ 160.60 - ® / / `� 61 . • 111: 1 ME 240.60 _ Address: ■ / dr..t, ) / Over 1,000 amps 0 /' Temporary services or feeders t. alteration, and/or relocation • • d . / 11 amps or .. .. 201 amps to 400 amps - 100. — Owner installation: This insta lation is being made on property that I own which is not 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, ter panel Owner signature: Date: A. Fee for branch circuits with - ❑ APPLICANT I CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: ,2 /2.c (!' % B. Fee for branch circuits Contact name: L �i /�� without service or feeder fee, 46.85 , ,S-' 4 „, 2 first branch circuit Address: / 0 , AI ^ / Each add'I branch circuit 2 6.65 /q. ( 2 r j C Miscellaneous service or feeder not included City/State /ZIP: P Q VJ�7 O"--/ Each manufactured or modular ■ 90.90 - © dwellin', service and /or feeder Phone: ( O IP I. 0) Fax: : ( ) Reconnect only = 66.85 —© 1 or • 1 CONTRACTOR or outline lighting 53.40 Business name: 5' i % / f _ /Al/ ,p / / / // Signal energy Address: 0 e 1/ R ° V / ` extension. Describe: U' City/State /ZIP: a z r / �,nj 0)"\-_,/ :additional : r i : : above Per inspection 62.50 G V Phone: (, ) 5. 9 — 920/ Fax: ( ) Investigation 1 CCB Lie.: �` Electrical Lie.: J — L uprv. Lic.: plant I IF 'ELECTRICAL PERMIT FEES . ' Suprv. Electrician signature, required: i " 7/ 1 W -A .4 '' Millinaubtotal: •• • . • Print name: J� may/ Date: / / •1 Plan review '(25% of permit fee): l'/ ��rii / © State surcharge (12% of permit fee): V Authorized. signature: TOTAL PERMIT FEE: --- t � This permit application expires if a permit is not obtained w1 tin 180 Print name: Date: days after it has been accepted as complete. * Number of inspections allowed per permit. I.\ Building \Permits\ELC - PermitApp doc 05/23/06 440- 4615T(t I /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: a 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* n V • acuum Systems* n O • ther: 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 n Clock Systems ❑ Data Telecommunication Installation n Fire Alarm Installation ❑ HVAC n Instrumentation n Intercom and Paging Systems ❑ Landscape Irrigation Control* n Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n 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 #: EI.C200800207 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 419/2008 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 4/2212008 TIME: 7:00AM PAGE: 18 SITE ADDRESS: 13330 SW BRITTANY DR CLASS OF WORK: SUBDIVISION: BRITTANY SQUARE NO. 1 LOT #: 023 TYPE OF USE: PROJECT NAME: IViUNIX)N DESCRIPTION: Installing (4) branch circuits. OWNER: MUNDON, CAROLYN & JERRY PHONE #: 503-624-3089 CONTRACTOR: STAR ELE PHONE #: f:;03-5799201 Inspection Request Scheduled For: Date: 4122/2008 Pour Time: Code # n • • n Description Confirm # Contact # Message 199 Electrical final 0687204)1 503-6242704 • - • Comments/Insions: • . '2 & At tt e Olt_ - 3 I A (O • 1- ZE 9 ,s \ ra. PASS LII PARTIAL APPROVAL fl CANCEL NO ACCESS 0 CALL FOR INSPECTION ONAL FE ASSESSED Inspector: t Date: Ot Phone #: (503) 718-1A