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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00554 J 1 DEVELOPMENT SERVICES DATE ISSUED: 9/29/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 CC - 01600 SITE ADDRESS: 10275 SW CENTURY OAK DR ZONING: R - 7 SUBDIVISION: SUMMERFIELD LOT : 013 JURISDICTION: TIG Project Description: 5 branch circuits for kitchen remodel. 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: 4 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: DAN /MARY COUGHLIN BRIDGETOWN ELECTRIC 10275 SW CENTURY OAK DR 22732 NW GILLIHAN ROAD PORTLAND, OR 97224 PORTLAND, OR 97231 Phone: 503 - 620 -2629 Contact #: PRI 503 - 621 -7122 FAX 621 -7123 FEES Description Date Amount Reg #: ELE 26 -887C [ELPRMT] ELC Permit 9/29/2006 $73.45 L[C 103824 [TAX] 8% State Surcharge 9/29/2006 $5.87 SUP 41775 Total $79.32 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 .03- 6 -6699 or 1- 800 - 332 -2344. / Issued By: /_ ` a/ Permittee Signature: _ 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 OFFI USE ONLY ` . - - r ; City of Tigard ! ~ i E C E D V E f t Received ✓ i p No . Tigard, OR 97223 Date /B : ��g /� � / ' t�d� • 13125 SW Hall Blvd., Ti g Plan Revie Phone: 503.639.4171 Fax: 503. 1'9 Inspection Line: 503.639.4175 l 6 9 2 00 6 / 'if I Date/By: Other Permit: Ins P ,,,� W Date Ready /By: Juris: 0 See Page 2 for Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information ' " =; � �:; "� REVIEW ".... .cN � i �1��. ��'..� e3�.: -1i�y ` - Wes., 9..�5-3,3� .,pN ,.c= �- ,N..u*nu,•.w:R:.. ,- v-- c,a,no, , ^'°. rt.ait".hg -_ _c- ia, ❑ New construction Addition /alteration/replacelnent Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location ;_,: _H 3 _ z _" .., �, , „ ;,," -" ,, _,, ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., `� "�"�vCATEG(QR3'�'O GONS it6ON' �= -• :'';�,. ofl- an -famil dwellings 4 X > ,_ ....., • .:,.�� ,.,., ��.,, -- F _ , .... �.: ,. r� . �� :,:. ,, :E -._, -, s, Y e or more new resident" _ ,_�v- �., >,;�,- ., <., ._ >�� � <, - , ,_t _ ° °:,. 1 -and 2- family dwelling ❑Commercial /industrial ❑Accessory building ❑System over 600 volts nominal units in one structure U Multi -famil ❑ Building over three stories ❑Feeders, 400 amps or more y ❑ Master builder ❑ Other: ❑Occupant load over 99 . ; T .:_: q5 „,� ,..., ; ; ,:y ,,:• °'s: ,a., -. ,. ;. >»,- � ;�, ; , persons Manufactured structures or e Manufactu = .% ; 'i:„ J B SITEv>IN R r ev L ` `" ' P' ` g RV park �,__;;Y ` =�w f) FO NATIO °AND LIGA TION` = ' , x w,., .�:� _ w��. � ..., .A�« -� . �.,�� . _ >.,...,.,.,,, b,��, . ,. ,., m:;. -_ ._ „_ .�_ _ . .. :�,;� ❑E plan P � ❑Health -care facility ❑Other: Job no.:o 0 I Job site address: ( 75 sz ee'✓ /,.en� 6, QR Submit 2 sets of plans with any of the above. City/State/ZIP: dl a . /7 ,D n t s q7 2 a i / The above are not applicable to temporary construction service. l /.r �w <€ ,,,'�`��'i :'FEE SCHEDULE� -: -I Project name: Calf kW - ,. ::;:: , :.,; Suite/bldg. /apt. no.: J Description I Qty. I Fee I Total I ** Cross street/directions to job site: New residential single- or multi - family dwelling unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential 75.00 2 ,,,• " •. q , ". Limited energy, non - residential 75.00 2 =� .Ii�scRrr�rroiv `aF�woiuc���.:, �' °s'<F <. �, ;E.v , � � ., . ,,,,�. " >..:. , s , , >,�..�.:� > -_ _.a;a,E >a„� `tea• ,.. ........ M. >,,. Each manufactured or modular R (� T dwelling, service and/or feeder 90.90 2 e - 6 - c -fe. , � �re fft7e,� a f t �' U (i?> Services or feeders installation, alteration, and/or relocation t � ,J ea) at L/7 r?ovv . s7 � , . 4_ itoil - .., a o a amps or less 80 30 2 R �?«,�?; r. �y ^��� >- ' "���' "� 201 amps t 400 amps 106.85 2 :. > . _ 'P OPER "CI a; ;s ;TENANT " °` P P 401 amps to 600 amps 160.60 2 Name: Ojw e' )JY COvs, o 601 amps to 1,000 amps 240.60 2 Address: I 0 D.7 5 3 W . ce.„ i y alK5 AR Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City/State /ZIP: - 77;1 ,J 0 iS Temporary services or feeders installation, alteration, and/or 1 relocation Phone: ( ) j I 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 600 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel - .. ate,.., _ ._... - �; : ;:= `; AP <l `�a _: A Fee for branch circuits with A. ❑ P I CANT •, 2' ` - -' --- ' _., -. �::�:� =' >, ..,.. _.- ���.._�. -,_,� :: ,_em ;w s >•xed.�rt = ° , >-r_- � - _ - N, •,,.�.� � "..:.o, - • _ ..: __ _�,... � 6.65 .. / service or feeder fee, each �F 3, 2 Business name: � __, 65, 5 &l.� l O..J branch circuit B. Fee for branch circuits Contact name: ' G1Jia j without service or feeder fee, / 46.85 9� * s 2 Address: ,) 5 ©OD $ /00A, ` ! O first addst branch circuit cit _ Each '1 branch circuit 6.65 9�, (� 2 City/State /ZIP: ..,a HAD ® r Q co ?& (.0 (service or feeder n t included) �` Pump or irrigation circle 53.40 2 Phone: (5,)3) ° ( - j i _ 6hn a I 1' Fax: : (563 )-77/ - fey Sign or outline lighting 53.40 2 E -mail: ` Signal circuit(s) or limited - q,�•, ,;;;, ��� ..r, panel, alteration �.�_ ,x,Cl71V'I` : : ..� �. ° ":: , ,._ >. ..�� t energy P , or .---- extension. Describe: Page 2 2 Business name: b�1 j . _ /OvvIJ ELecrel -t Address: 0:7 3 f 61,c,/QA,//� Each additional inspection over allowable in any of the above Per inspection 62.50 City/State /ZIP: I t E D O) 97)-3I Investigation per hour (1 hr min) 62.50 Phone: (503 )C - 7I Fax: (503 ) 6,2 /` 7I,23 Industrial plant per hour 73.75 • � �;',, � ;;; ��;" ..EtiECTRIG;AL' PERMIT;`: FEES <.,, -,,<� . ".:,�M :,.'.,'`�� CCB Lie.: 'dye -f - ctrical Lii & g7 �„ Suprv. Lig L// 72 T Subtotal 3 . 5" Suprv. Electrician signature, required: -7 t Plan review (25% of permit fee) Print name: Date: /°7 State surcharge (8% of permit fee) 6.97 TOTAL PERMIT FEE '7 32- X Authorized signa '. Thi permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: _ , ,_---- - Date: 9 5'- 00 * Fee methodology set by Tri- County Budding Industry Service Board ** Number of inspections per permit allowed. is \Building\Permits\ELC -P it� pp.do 2 /03 440- 46!5T(I0 /02 /COM/WEB /5/0-7 CITY OF TIGARD 13125 S.W. HALL BLVD. TIGARD, OR 97223 IMPORTANT PERMIT NOTICE BRIDGETOWN ELECTRIC 22732 NW GILLIHAN ROAD PORTLAND, OR 97231 Electrical Signature Form Permit #: ELC2006 -00554 Date issued: Parcel: 2S111 CC -01600 Site Address: 10275 SW CENTURY OAK DR Subdivision: SUMMERFIELD Block: Lot: 013 Jurisdiction: TIG Zoning: R -7 Remarks: 5 branch circuits for kitchen remodel. Your company has been indicated as the electrical contractor for the permit indicated above. In order for the electrical permit to be valid, the signature of the supervising electrician is required. Please have the appropriate individual from your company sign below and return this Electrical Signature Form prior to the start of the work to the address above, ATTN: Building Division. No electrical inspections will be authorized until this completed form is received OWNER: ELECTRICAL CONTRACTOR: DAN /MARY COUGHLIN BRIDGETOWN ELECTRIC 10275 SW CENTURY OAK DR 22732 NW GILLIHAN ROAD PORTLAND, OR 97224 PORTLAND, OR 97231 Phone #: 503 - 620 -2629 Phone #: 503 - 621 -7122 Reg #: ELE 26-887C LIC 103824 SUP 4177S AN INK SIGNATURE IS REQUIRED ON THIS FORM XI , Signatu - • upervising Electrician If you have any questions, please call 503.718.2433. CITY OF TIGARD BUILDING DIVISION A PERMIT #: ELC200 41 6-0055 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/29/2006 Phone: (503) 639-4171 1 o4d/o0i,t; Inspection Requests (24 Hrs.): (503) 639-4175 ,..-151191. - 111. • INSPECTION WORKSHEET FOR DATE: 2f2a12067 TIME: 7:02AM PAGE: 35 SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: gi3 TYPE OF USE: • PROJECT NAME: COUGHLIN DESCRIPTION: 5 branch circuits for kitchen remodel. OWNER: COUGHLIN, DAN/MARY PHONE #: 503-620-2529 CONTRACTOR: BRIDGETOWN ELECTRIC PHONE #: 503-521-7122 Inspection Request Scheduled For: Date: 2/78/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 04484-01 50a-771-9606 N Corrections/Comments/Instructions: a -r:?--VL ir - - - - - • 0 0 prA PASS • al, - A r T I A L APPROVAL fl CANCEL 0 NO ACCESS 0 Fa L . A F4R INSPECTION I I ADDITION L FEES ASSESSED Inspector: ■-...0116.■ Date: Z( e Phone #: (503) 718-Z .. . _ CITY OF TIGARD BUILDING DIVISION • PERMIT #: ELC200 &.0651 13125 SW Hall Blvd., Tigard, OR 97223 ,. DATE ISSUED: 9/29/2006 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 10/1W/2006 TIME: 7 :06AM PAGE: 17 SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 013 TYPE OF USE: PROJECT NAME: COUGHLIN DESCRIPTION: 5 branch circuits for kitchen remodel. OWNER: COUGHLIN, DAN /MARY PHONE #: 503-620-2629 CONTRACTOR: BRIDGETOWN ELECTRIC PHONE #: 503- 621.7122 Inspection Request Scheduled For: Date: 10110/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 037948-01 503-771-9606 Y Corrections /Comments /Instructions: rY1) 47 kle y-A N L Z ir�,�yZ (C)( I I PASS I I PARTIAL APPROVAL CANCEL n NO ACCESS X FAIL 'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: /0 Phone #: (503) 718 - 00 ., _ _. ...,. CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC200 .44 6-00554 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/2912006 Phone: (503) 639-4171 . irr i Tit\ Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 10/12/2006 TIME: 7:01AM PAGE: 66 SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 013 TYPE OF USE: , PROJECT NAME: COUGHLIN DESCRIPTION: 5 branch circuits for kitchen remodel. , , OWNER: COUGHLIN, DAN/MARY PHONE #: 503-620-2629 CONTRACTOR: BRIDGETOWN ELECTRIC PHONE #: 503 Inspection Request Scheduled For: Date: 10/12/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough-in 03B062-02 503-771-9606 N Corrections /Comments/ Instructions: ga'CAT— iv . le • 04 . Otrif ) Gor-ket--Tabpu es.. /t-I P C - A PASS I I PARTIAL APPROVAL CANCEL I I NO ACCESS k . n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ell- Date: /�'/Z 'C Phone #: (503) 718- ... . " '