Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00254
COMMUNITY DEVELOPMENT DATE ISSUED: 5/5/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S110DD -01500
SITE ADDRESS: 10405 SW CENTURY OAK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT : 022 JURISDICTION: TIG
PROJECT: FISH
Project Description: Installing (2) 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: 1 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:
JOSEPH & ANNIE FISH GRF ELECTRIC
10405 SW CENTURY OAK DR 15460 S PARADISE LN
TIGARD, OR 97224 MULINO, OR 97042
Phone: 503 - 684 -4878 Contact #: PRI 503 - 829 - 4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 5/5/2008 $53.50 LIC 76751
[TAX] 12% State Surchar 5/5/2008 $6.42 SUP 1655S
Total $59.92 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 By Permittee Signature: Sec 7y % .�7/`�
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.
May 05 08 09:130 / , GRFELECTRIC 5038295747 p.1
, . )1,.. ce.Ljk."
•i R oil I Jl k' 1 `tl ("lit .. . .
Electrical Permit Appll 'i ' ` ion y % . , ,,,,,co �
City of Tigard �P `r\ _ , O p `lv S l% pwih o.: F G� �rIC1)-
lit - ' ' 13125 SW Hall Blvd., Tigard, OR 97221. O Mat &cview Othn PamIt:
Phone: 303,639.4171 Fax: 503.59 0, 0�, Dateav:
Cram R Lori,:
l l!'v. I:'1.t Inspection Line; 503.639.4175 Ui3 See Pere t for
Supplementallarora■ neo
Internee www.tigard- ar.gov et . t+otifindlt4ahod:
TYPE OF WORK ' PLAN REVIEW
Flan,: desk all ohm apply (submit 1 acts of plans whlaas checked below}
ONOW COn91Itiction elditio11/alteratlon/rtplaeematt 054Ni:et or reader 400 amps vrmore 0 Sullding owe three ucries.
❑ Demolition ❑ Other:
where the available fault tomes CI Marinas and boatyards.
CATEGORY Of CONSTRUCTION exceeds I 0.o0) amps it ISO volts or ❑ Floating bmtdtnga.
1019 so ground, or caccedt 14,000 ❑ Cammem•LO agricultural
' ildi
l -and 2-family dwelling ❑ Commercial/industrial 0 Accessory b ung snips for au otherintollauonr, building".
El Pirp pum p. ❑ !Damp anon of 75 ICVw sr
❑ Multi-family ❑Master builds ❑ Other: ❑ Emergency noun. larger accurately daixd atom.
JOB SITE INFORMATION AND LOCATION ❑ A,tdltion dam:noon loa4 or ❑ "ft".'4• . t.r. "l.3 .
� V I001SP a more. occupancy.
lob no.: 1 lob sits address: Jo 11 5 S I .., C� e_ I /('�1 d Y r ❑ Six err more residential manta Q ❑ (tao,na6.nd vchicla parka.
J ktealthwre faoititioS. ❑ Supply voltam re more that
Cit, /State/ZB': T I fl r 11 tZ L f u 0 h 1/} 1 ,- , ❑ Naandous locations. 000 volro nominal.
Gorier 000 Imps or mom.
5uite/bldglapt no. Project name: ❑ service el FEE SCHEDULE
CraSS strcet/directions to job site:
DotNpie■ 1 Qry. S re' r 7a1++ I •
New raidenti ■I single- or multi-Grady dwelling unit.
Includes attached garage.
1. sq. R of less 145.!5 h 4
Subdivision: Lot no.:
- Ea add'I 500 s4. ft. or po rtion 33.40 1
Tax map/pa(cel no.: • Limited energy, Rsident(al 75,00 2
DESCRIPTION OF WORK Swish above eq. n.) •
Limited energy, multi family 75.00 2
2-- . 4 . , ' residential (with above Kill-) i
Services or feeders (robins tion Ieratiun, and/or relocation
200 amps or lea 10.30 1 2
ikraorfR"lY OWNER 1 ❑ TETMNr 211 amps to 400 amps 106.65 ( 1
401 amps to 600 amps 160.60 2
Nuns Aviv) ! e F .S L1 601 amps to 1,000 amps 240.60 2
Address; ) / • ? 1 Over 1.000 amps or volu 454.65 2
Temporary services or feeders installation, alteration. and/or
City/State /ZIP: - T i '' r ei �( -1 z- Z Lt-- relocation
Phone: ( ) {` O Jc ! f.. �j -7 gi S Fax: ( ) 200 amps or less 1 66.85 1
,
Owner installation: This installation is being made on property that I own which iS not 201 amps to 400 amps 201 amps to 599 amps 133.75
100,10 2 2
intended for sale, leases rent, or exchange, according to ORS 447, 449, 670. and 70 i • gnash cheat& - Inv, alteration, or extension, ecr panel
• Owner signature: Date: A. Fee 0sr branch circuits with
❑ APPLICANT ] [I CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fec for branch circuits
1 - wirhour service or feeder fee. 4 46.8$ 4 (,, . k5 2
Contact name: Frye branch circuit
Each sdd'lblanch circuit 1 6.65 C, (, 5 .
Address: — MIsceltaneow (service or (ceder not included)
C l /Statc/ P: Each manufactured or modular 90.90 2
dwelling. service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 , 2 '
E-mail: pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 1 _ 2_
• Signal circuits) or limited -
Business name: (7 E_ e. c. [' energy panel, alteration. or
19fbo o S • . I A �� of Le l . . �,im,. oeserise: Pace 2 2
Address: �7
City /State/ZIP' /1/7 � 0 (,__ � ' C_ a Li: Each additional impaction aver allowable in any of the above
1 . i I /1 Q ' [ Per inspection 62.50
Phone: (4)) b Z� L f P>ix l } ) �2-' — 57 4' Investigation per hour (t hrmin) _ 62.50
CCB Lic.: -7 6 Electrical Lie.: 3 - Suprv. Lie.: , - Industrial plant per hour 73.75
ELECTRICAL FER IT FEES
Suprv. Electrician signature, required' v � � 5ubtotaL 1 y Q
v' Plan review (25' /. of petrnit fee):
Point ttJtme: v v 1 1 1 1 GI rot -C / s_l ` I Date: 1 (1 g
Autltotized si wc: ` - ' l
Stets surcharge (l2% of permit tceY
T OTAL PERMIT FEE: ----7-- (� i
Z
- This prront application aspire.I I a penult V am &laniard mini Ise
Print name: Dale: days after it has Sera acceptoA al cortspiesa
• Number of (napcctlons allnwod pot permit.
1:l avildiaaGp ,nlunaLGPaonittros.doe e711106 4411,461ST(11/037COMAVES
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 00264
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5I6it2008
Phone: (503) 639 -4171 A-'
I
Inspection Requests (24 Hrs.): (503) 639 -4175 - 'IL
INSPECTION WORKSHEET FOR DATE: 5/1` _008 TIME: 7:01AM PAGE: 5
SITE ADDRESS: 10405 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 022 TYPE OF USE:
PROJECT NAME: FISH
DESCRIPTION: Installing (2) branch circuits.
OWNER: FISH. JOSEPH & ANNIE PHONE #: 5 503- 684 -4878
CONTRACTOR: GRF ELECTRIC PHONE #: 50:1 - 829.4146
Inspection Request Scheduled For: Date: 5112/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 069740-01 503-82941146 Y
Corrections /Comments /Instructions: '�
__- b / Sze 7►,A 7�C 7_1 A-v✓L F' �5 S
lq(d_ /4 tIV 2-- A-frtf 1
'ASS fl PARTIAL APPROVAL ❑ CANCEL 7 NO ACCESS
MI FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
/ .
Inspector: Date: < f d Phone #: (503) 718- ZZ'