Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00629
DEVELOPMENT SERVICES DATE ISSUED: 11/3/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S105DA -17500
SITE ADDRESS: 14560 SW CATALINA DR ZONING: R -7
SUBDIVISION: PACIFIC CREST LOT : 063 JURISDICTION: TIG
Project Description: 1 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: 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:
RAYMOND BUNKOFSKE OWNER
14560 W CATALINA DR.
TIGARD, OR 97223
Phone: 503 - 590 -2649 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 11/3/2006 $46.85
[TAX] 8% State Surcharge 11/3/2006 $3.75
Total $50.60 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. I/1
Issued By: ,q/� Permittee Signature: �% I /L /
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 � a ®� FOR OFFICE USE ONLY
.=-Y C of Tigard E�{� �0 Date/
a (� j 0 � Permit No. 4 6 _ 00 642.8 _ u 13125 SW Hall Blvd., Tigard, OR 972 Plan Revie
11 4 Phone: 503.639.4171 Fax: 503.598.196OV 2006 Date/B mm
Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready /By: 65 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF W( i1/ILD ING DI VISION., PLAN REVIEW
❑ New construction ® Addition /alteration /replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF 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 ", "1 -2 ", "I -3 ",
Job no.: Job site address: 14560 SW Catalina Drive 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: Tigard, OR 97223 ❑ Health - care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
.FEE SCHEDULE
Cross street/directions to job site: Fern St To Catalina Description I Qty. 1 Fee. I Total I
New residential single or multi - family dwelling unit.
up hill house is second from top on left. Includes attached garage.
Subdivision: Pacific Crest Lot no.: 1,000 sq. 11. or less 145.15 4
Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 l
Limited energy, residential 75.00 2
. DESCRIPTION OF WORK . . (with above sq. ft.)
Limited energy, multi - family 75.00 2
Prepare a circuit for a fan/light and a set of rope lights. Electrician to residential (with above sq. ft.)
separately connect circuit to panel Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
® PROPERTY OWNER El TENANT 201 amps to 400 amps 106.85 2
Name: Raymond and Mary Bunkofske 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 14560 SW Catalina Drive Over 1,000 amps or volts 454.65 2
City /State /ZIP: Tigard, Or 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (503)590 - 2649 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 ent, or - • •n • -, accorsin• 'o ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
/ / � Branch circuits — new, alteration, or extension, per panel
Owner signature: �1_� _ - \ ` ,., . - .,,/ - Date: // /3/ 0 G
A. Fee for branch circuits with
® APPL ANT ❑ 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, 1 46.85 46.85 2
first branch circuit
Address: Each add'l 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
Business name: ` n` Signal circuit(s) or limited -
M �' w Wl./ energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (I hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: (,. �j
Print name: Date:
Plan review (25% of permit fee):
(� State surcharge (8% of pennit fee): 3 , 75
_ 5101.......
Authorized signature: /� l� N UV �f.� . TOTAL PERMIT FEE: 50. /,,0 /,,0 This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I.\ Building \Permits \ELC- PermiiApp.doc 05/23/06 440- 4615T(I I /05 /COM /WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
n Burglar Alarm
❑ Garage Door Opener*
n Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 -260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
❑ Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
❑ Nurse Calls
n Outdoor Landscape Lighting*
El Protective Signaling
n Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1: \Building \Permits\ELC - PermitApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200& -00629
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/3/2006
Phone: (503) 639-4171 IM�uul9l�l�i
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/16/2007 TIME: 7:01AM PAGE: 77
SITE ADDRESS: 14660 SW CATALINA DR CLASS OF WORK:
SUBDIVISION: PACIFIC CREST LOT #: 063 TYPE OF USE:
PROJECT NAME: BUNKOFSKE
DESCRIPTION: 1 branch circuits,
OWNER: BUNKOFSKE, RAYMOND PHONE #: 503-690-2649
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 3116'2007 Pour Time:
Code # Inspection Description Confirm # C tact # Message
199 Electrical final 044911 -01 603 - 590.2649 N
Corrections/Comments/Instructions:
•
PASS PART! L APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL ❑ ( , ECT • ip ADDITII• AL FE ASSESSED
�i
Inspector: W)€10 L Date: Phone #: (503) 718-
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Bus - - ess Liri (503) 639 -4171 MST
_ Z D BUP
Received Date Resuested AtM PM BUP
Location 5 7; 0 4 ' • - ' e . MEC
Contact Person Ph ( j PLM
Contractor Ph ( ) SWR
•
BUILDING Tenant/Owner ELC 0
D
Footing
Foundation Access: EL
Crawl LR
Drain
Crl Drain
Slab Inspection Notes: SIT •
Post & Beam
Shear Anchors 3 C I o O
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall �_..
Fire Sprinkler
Fire Alarm /CtA,e_ed' -w-e,0
Susp'd Ceiling
Roof �
Other: __
Final J4 4`� _ C Q ') 36,
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole l
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post& Beam
Rough -In
Gas Line
Smoke Dampers
Final
T FAIL
ELECTRIC
Se
ough -I
lab
Low Voltage
Fire Alarm
Fin ❑ Reinspection fee of $ required before next inspection. Pay - • all, 13125 SW Hall Blvd.
PASS ART FAIL
SITE Please call f• reinspec . .4n RE: �, Unable to inspe -. access
Fire Supply Line
ADA 6 A
El/I
pproach/Sidewalk Date Inspector Ai/
Other:
Final DO OT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-00629
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11a/006
Phone: (503) 639-4171 rell
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2126/2007 TIME: 7:00AM PAGE: 41
SITE ADDRESS: 14560 SW CATALINA DR CLASS OF WORK:
SUBDIVISION: PACIFIC CREST LOT #: 06:3 TYPE OF USE:
PROJECT NAME: I3UNKOFSKE
DESCRIPTION: 1 branch circuits.
OWNER: BUNKOFSKE, RAYMOND PHONE #: 503-590-2649
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
195 Miss. inspection 043872-01 603-690-2649
Corrections/Comments/Instructions:
ofl- 1A@Ct
0 6A/
El PASS n PARTIAL APPROVAL • CEL El NO ACCESS
0 FAIL fl CALL FOR INSPECTION • ADDITIONAL FEES ASSESSED
Inspector: -4 ;; f4 Orga Date: 2 -P IA " Phone #: (503) 718- Ii4L-1k)