Permit CITY OFTICARD ELECTRICAL PERMIT
44 PERMIT #: ELC2008 -00632
COMMUNITY DEVELOPMENT DATE ISSUED: 11/12/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S109AC -02101
SITE ADDRESS: 13030 SW BULL MOUNTAIN RD LOG CABIN ZONING: R -7
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: RYDER
Project Description: (1) service for trailer.
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: 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:
ALBERTA RYDER OK BROTHERS ELECTRICAL
13030 SW BULL MOUNTAIN RD CONSTRUCTION
LOG CABIN PO BOX 231133
TIGARD, OR 97224 TIGARD, OR 97281
Phone: Contact #: PRI 697 -4873
FEES
Description Date Amount Reg #: ELE 34 -45IC
[ELPRMT] ELC Permit l 1/12/2001 $80.30 LIC 49562
[TAX] 12% State Surchar 11/12/2001 $9.64 SUP 4334S
Total $89.94 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 issu- ce, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cen er. 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 JUNG at 5c '6.6699 or 1.800.332.2344.
Issued B� . te Permittee Signature: I�
--
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
City of Tigard � ' ! iew ived J/ ® l ,� ,yam Permit No.: -� a J = ?1
° 13125 SW Tigard O' Phone: 503639.4171 Fax: 503 i N' ! ���/// DateBy: Other Permit:
14
TI G A RD Inspection Line: 503.639.4175 1 '1 r Date Ready /By: Juris: ® See Page 2 for
' Internet: www.tigard - or.gov Nov 1 l\91) Notified/Method: CP Supplemental Information
TYPEr ..WO 4 0 � ° k `
P lease check all that apply (submit 2 s ets of plans w /items checked below
CO - " _ ' .- , - . ', r :PLAN. ' REVIEW ' ..
El New construction ❑Addition /alterae g
"v°" ❑ Service or feeder 400 amps of more ❑ Building over three stories.
❑ Demolition ❑ Other: Sk0- where the available fault current ❑ Marinas and boatyards.
' CATEGORY OF CONSTRUCTION' ' ' 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 ❑Emergency system. larger separately derived system.
. ❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: / 3 f' 3 0 .S j 2 JL` A 1001IP or more ❑ R c r eation.
❑ Six or more residential units. Recreational vehicle parks.
City /State /ZIP: T (6 �� Q ❑ Health -care facilities. ❑ Supply voltage for more than
,�y� f ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: t(4 L, , i /J j� ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: � Qty. � Fee. i Total FEE :SCHEDULE' , ,., _ 4, - n *
J Description
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
,. DESCRIPTION`OF WORK' - . (with above sq. ft.)
Limited energy, multi - family
/i5 0 � y, - r 5z � .S•'jrCE t)'�— 5�, residential (with above sq. ft.) 75.00 2
K Q Services or feeders installation, alteration, and/or relocation
�/ V 200 amps or less / 80.30 (1 2
PROPERTY OWNER'., ;n , . " -- ° ❑ '- TENANT 201 amps to 400 amps 106.85 2
Name: az...Eft R Yt T I� 401 amps to 600 amps 160.60 2
t1 ( / 601 amps to 1,000 amps 240.60 2
Address: / 30 3D � U1 / J4,,. Over 1,000 amps or volts 454.65 2
City/State /ZIP: 4 ,-- ,�-7� Temporary services or feeders installation, alteration, and/or
C/ relocation
Phone: ( ) 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
,, -:,: H. U 'APPLICANT ..... ,A• : '' - 0' CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 2
first 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
�� �o --& ll,(a)rmi
Business name: energy pane
y panel, alteerattion, , or or
Address: po ,, a / 1 3 -5 extension. Describe: Page 2 2
'
City/State /ZIP: 6 � [ d 4-- C 1 Z / Each additional inspection over allowable in any of the above
51 ZI F � 6, 2 � .�/ Per inspection 62.50
Phone: (
J`� 2 d 55 ( � Y— Investigation per hour (1 hr min) 62.50
CCB Lic.:S 0 Z Electrical Li� <1 u prv. Lic.: . Industrial plant per hour 73.75
�r f �, ._ELECTRICAL- PERMIT- ° FEES - - "
Suprv. Electrician signature, required , J Subtotal: 30 O
''� Plan review (25% of permit fee):
Print name: (�
�� t� xi .' Date: (' l L - o q` l
State surcharge (12% of permit fee): ( �p
Authorized signature: TOTAL PERMIT FEE:
aF
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 permit.
I. \Building\Permits\ELC PermitApp doc 05/23/06 440- 4615T(I1 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information ,.._
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
`COMMERCIA AORK ONLY ° I
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n C lock Systems
n Data Telecommunication Installation
❑ Fire Alarm Installation
n HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
n P • rotective Signaling
n O ther
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 #: - EL C2008-00632
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ' 111/2/2008
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503)' 639 -4175 . I..
INSPECTION WORKSHEET FOR DATE: 11/17/2008 TIME: 7:00Am PAGE: 4
SITE ADDRESS: 13030 SW BULL MOUNTAIN RD LOG CABIN CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: RYDER
DESCRIPTION: (1) service for trailer.
OWNER: RYDER, ALBERTA PHONE #:
CONTRACTOR: OK BROTHERS ELECTRICAL PHONE #: 697 -4873
Inspection Request Scheduled For: Date: 11/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 0713153 -01 503-780-5524 N
Corrections/Comments/Instructions:
04 , q ( 14 ,../_d_ 1.
0.
PASS [1 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPE TION ❑ ADDITIONAL FEES ASSESSED
Inspector:-- r••- -- Date: `I e 1 Phone #: (503) 718- '.4q
.
CITY OF TIGARD t.
BUILDING DIVISION PERMIT #: ELC200t3 00632
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/12/2008
Phone: (503) 639 -4171 a ���i�a,ilil
Inspection Requests (24 Hrs.): (503) 639 -4175 �' � `:_..
INSPECTION WORKSHEET FOR DATE: 11/14/2008 TIME: 7:00AM PAGE: 14
SITE ADDRESS: 13030 SW BULL MOUNTAIN RD LOG CABIN CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: RYDER
•
DESCRIPTION: (1) service for trailer.
OWNER: RYDER, ALBERTA PHONE #:
CONTRACTOR: OK BROTHERS ELECTRICAL PHONE #: 697 -1873 •
Inspection Request Scheduled For: Date 14 7008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
110 Temporary electrical servi .e 078088 -01 03-780-5524 Y
Corrections /Comments /Instructions: K(.
tMP
J - PR o v i D4 Abb t ivic. o snlo Rot 6a-
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1iii(e Re `< craA4NtIN cL 'RA*
una0? (L or) 6 >
vii G Re 14 b it
■
❑ PASS El PARTIAL APPROVAL n CANCEL El NO ACCESS
X i s FAIL \CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G'' 1 tv Date: N I I q al Phone #: (503) 718-