Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00402
COMMUNITY DEVELOPMENT DATE ISSUED: 6/14/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102 D B -02000
SITE ADDRESS: 13255 SW BURNHAM CT ZONING: R -4.5
SUBDIVISION: BURNHAM PARK LOT : 014 JURISDICTION: TIG
PROJECT: GARDNER
Project Description: Install (3) branch circuits for furnace, a/c and GFI.
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: 2 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:
GLORIA GARDNER SUNSET HEATING & COOLING
13255 SW BURNHAM CT 0607 SE IDAHO
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: Contact #: PRl 503 - 234 -0611
FAX 503 - 234 -0439
FEES
Description Date Amount Reg #: ELE Cl I7
[ELPRMT] ELC Permit 6/14/2007 $60.15 LIC 161085
[TAX] 8% State Surcharge 6/14/2007 $4.81 SUP 46385
Total $64.96 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 w J/ ' (7 / y �/,
= Permittee Signature: C7 "" 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.
Jun, 43 07 02:04p p.4
Electrical Permit A lie .f c , „n f received 1 . om, l,: ( SI: 0\11.
City of Tigard � ► DateB : , 1 a- Permit No.: EL 6 6 -40 d _
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639A171 Fax: 503.598.1960 • JUN 1 �!"t'1 " "•.. i t ' Date/B : Other Permit:
Inspection Line: 503.639.4175 'd V 1 ' ,, - . a1.j • '_1 . Date ReadyBy: BS See Page 2 for
Internet: www.ci.tigard.or.us 7 - Notifted/Method: IIM Supplemental Information
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❑ New construction _.,. ® Ad. 1 li '0 , ���i. t: ,fli , -:'. , 1 Please check all that apply:
❑ Demolition 111 Other: ❑Service over 225 amps, comm'l ❑ Hazardous location
,� } , , gat k , r fa £ ,, � „ , , ❑Service over 320 amps - rating ❑ Buiidng over 10,000 sq. ft.,
i r i ,t v; r r 3 a y ? F � a '` f *` : 11' N W tx N a of 1- and 2- family dwellings 4 or more new residential
[.�^, 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building [(System over 600 volts nominal units in one structure
❑ Multi family ❑ Master builder 111 Other: ❑Building over three stories' El Feeders, 400 amps or more
��##'' ,� „•, .� ,� a��sx ❑Occupant over 99 persons ❑Manufactured structures or
tt?'C. t r n^ '3' i .3 i vs to .,. .. e3�" ., t s � ..» :.aa ..a.'�� tja b'r gh g P
5K wrz- h ( t� v �, s s ' " : ' i 'rZSV'P 'Nvp . N' , s ❑E ess/li n Ian RV park
e' .- , - t ❑Health-care facility ❑Other. - Job no.: (
i 6,- Job site address: i :.7 r-,.
'' a r- 1 = - . ' ,, - Submit 2 sets of plans with any of the above.
C ity/State /ZIP: 7` - "' r ", " - ) - 2 ;_ '2 The above are not applicable to temporary construction service.
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Suite/bldg. /apt.no.: Project name: �ri �'�'••'�-�' ° �• � � " ,
er �'L'(-i •(,.:' r Description Qty. Fee. Total
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 14.5.15 4
Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 I
Tax map /parcel no.: Limited energy, residential 75.00 2
�
::;<.; t r'ga ht ?a t'ra,' �' w- 1 • :3,: xM yr:.r.= ; s' z apt Limited energy, non- residential 75.00 2
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01M -,s s.:,,,_ w:a,.; ,4,, a Each manufachrred or modular
dwelling, service and/or feeder 90.90 2
+ Services or feeders installation, alteration, and/or relocation
'--) 200 amps or less 80.30 1 2
w;�ik ; :.�V -,� a; w.,. .,,, .. <:.;i0 vi ; 041t.='.-i�";,. " , V - : ',414: 201 amps to 400 amps 106.85 2
i•' a�, � "�` al sA.`t �eq� .:- ,�.:� x o �' v.xj4.;.r S�, saki, �4
.:`'L;.-.... � &,4.41 s.:. w...- a ., , .:: ; t ,s ."i' , s ':': : 401 amps to 600 amps 160.60 2
Name: � 1 -'•i 9 t)€` t 6 1 - ( . ... 1(3, i ; J t 1, -, 601 amps to 1,000 amps 240.60
2
Address: ') : ' ( ,, 454.65 2
) \ i „/ ,,1, - Over 1,000 amps or volt
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Reconnect only 66.85 2
City/State /Z1P: r) 0 6 :17,.,,3:) Temporary services or feeders installation, alteration, and/or
relocation
Phone: (tit 5) (i./ 0` 0 )' I' j Fax: ( ) 200 amps or less 66.85 l
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
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,, ,, , ,",, ` . -* J ; .0 w ;; %*tr ".I w , i . .v v ' >.n A. Fee for branch circuits ee, with
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.:. . ... , =F,..:,.;'.;� .., �� :,.,::. .,. , =' : r. .....,..:.,.;..�4 service or each
fee, e 6.65 2 r
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee, 1 i ti
46.85 -.ti,p .y ,, 2
Address: first branch circuit
Each add'I branch circuit c:) 6.65 ) t 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( )
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
ti w-. , ..;, -t `. . , :x: a ener panel, ; rx:;� '�.: , ; �.�,:o,•�:....�.s ��. �, - '"v or
aM >: :4.,.,,.
extension. Describe: Page 2 2
Business name: Sunset Heating and Cooling
Address: 0607 SE Idaho Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97239 Investigation per hour (I hr min) 62.50
Phone: (503) 234 -0611 I Fax: (503) 234-0439
Industrial plant per hour 73.75
CCB Lie.: 161085 I Electrical Lie.: C117 ( Suprv. Lie.: 4638S Subtotal f r:r C
lt ) / 5
Suprv. Electrician signature, required: ` Plan review (25% of permit fee)
Print name: I Date: '' l i ' State surcharge (8% of permit fee) £ {
ESS Li
TOTAL PERMIT FEE tf
Authorized si ature.
b'n Thu permit application expiiYS i a permit is not obtained within ISO
days after it has been accepted as complete
Print name: , ' 1G�,� e . i G: , Ay l �l.QS I Gam- Date: E`•) �� • F e e m ethodology set by Tri- County Building Industry Service Board
• • Number of inspections per permit allowed.
i:\ Buiidina \Permiu\ELC- PerntitApp.doc 12/03 440-4613T( 10/02/COM/wEa
` CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00402
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2007
Phone: (503) 639 -4171 s�4p�'Ii�VT� It
Inspection Requests (24 Hrs.): (503) 639 -4175 �..' . .
INSPECTION WORKSHEET FOR DATE: 6/27/2007 TIME: 7:00AM PAGE: 66
SITE ADDRESS: 13255 SW BURNHAM CT CLASS OF WORK:
SUBDIVISION: BURNHAM PARK LOT #: 014 TYPE OF USE:
PROJECT NAME: GARDNER
DESCRIPTION: Install (3) branch circuits for furnace, a/c and GFI.
OWNER: GARDNER, GLORIA PHONE #:
CONTRACTOR: SUNSET" HEATING 8 COOLING PHONE #: 503 -2M -0611
Inspection Request Scheduled For: Date: 6/27 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 050987-01 50 234 0611 Y
Corrections /Comments /Instructions:
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PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
( Inspector: � , S . Date: /07 Phone #: (503) 718 -