Permit O� 1 1+ OF TIGARD ELECTRICAL PERMIT
V PERMIT #: ELC2007 -00272
COMMUNITY DEVELOPMENT DATE ISSUED: 4/26/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102 D B -03600
SITE ADDRESS: 13411 SW CHELSEA LP ZONING: R -12
SUBDIVISION: CHELSEA HILL LOT: 013 JURISDICTION: TIG
PROJECT: SETTELMEYER
Project Description: Furnace and A/C 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:
KEVIN SETTELMEYER CROWN VOLTAGE
13411 SW CHELSEA LOOP DANIEL TUCKER
TIGARD, OR 97223 12607 NE 199TH ST
BATTLE GROUND, WA 98604
Phone: 503 - 786 -9522 Contact #: PRI 360- 666 -0995
FAX 360- 666 -4673
FEES
Description Date Amount Reg #: ELE 37 -984C
[ELPRMT] ELC Permit 4/26/2007 $53.50 LIC 153934
[TAX] 8% State Surcharge 4/26/2007 $4.28 SUP 4116S
Total $57.78 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:
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.
P,pm � 4 07 G' 4 :53p CROWN VOLTAGE, INC. 1 360 666 4673 p.3
;K � , i •
• Electrical Pe: sni A ppl u o A l-,,-. . , . eoR OFFICE USE ONLY
City of Tigard Received
n��/d 4111 4,4_,4 PcmaiINo, , 00- - ) a
13125 SW1 fall 111vd,Tigard. OR 97223 APR F
J+ Pisa Review %
Phone: 503 - 639.4171 Nam 503398.1960 'r� DYrJB - Other Pemrit( 6 w - , 0Daa�p
Inspection Line 503.6394175 (1 a �/ r ' 4 � 1 t7 are Readyflly: fu, See Page 2 for
Internel:.9.ww- ci.tivrcl.or,ua - I I I �3 1 +L5 AloriI NVMctla,�1 Somdemental lwrormation
l 1 P.Lr OI+ r veO T PLAN REVIEW
❑ New construction _Addition /hllciatlon/rep1ae ment Phase check all that apply:
171 Demolition Q Other • ❑Savice over225 amps, coin'► ❑Haaanfous location
❑Serviu ova' 320 amps- timing 0nuildngover 10.000 sq. ft.,
CATEGORY OE CONSTRUCTION of 1 - and 2 family dwellings 4 or more new residential
✓?51 -- and 2- family dwelling ❑ Commcrciabrndcstrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Q Multi- family 0 Master builder ❑ Other:
over Mum stories ['feeders, 400 acnps or more
❑ Occupant load over 99 pee soon ['Manufactured structures or
.100 sat: INFORMATION AND LOCATION' ❑t:gres's/lighting plan RV park
Job no_: Job site addre : i t Loci() 5ld t: h €1 S❑heal//[ -care facility ❑above.
��/ Submit X gds of plans with any of the above.
City /Statc/ZIP: I cLrA V 7 7 2- The above are trot applicable to temporary construction service.
Suite/bldU/apt.no.: Project name: FEE' SCHEDULE
neie ipr I Qt,' I Et* T 1. °" 1 1. °" 1 .. °
Cross street/directions to job site: New re tideadal single- or rnalti- family dwelling emit,
- - V Includes attached garage. _
! PDOO sq, t[, or le 145.15 4
Subdivision: - ^� - 1 Lot no.: Fa add'I 500 sq. SL or portion 33.44 1
Tax mup/pArcet nil -: Limited energy, residential 75.00 2
Limi itedaragy, race+ rcsideati&1 75.00 2
DESCRIPTION Oft WORK Each manufteturodor'nodular
7_..- da,�cllia service and/or feeler 90.90 2
C.- � r Services or feeders Matadatina, alteration, aadlor relocation
IA. r Y`GI MN. C• �' C.- 1 VVL 200 amps or less - ....,.- _ - ^ . 8030 2
6..z .ROPERT OWNER 0 TI?N.11.1T 201 amps to 400 amps 1 06.85 2
401 amps to 600 amps 160.60 2
Name: __ '-e,1 mex , Y- 601 art to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /SlrrtdZ.,IP: • Temporary services or Etcetera imatatlat:oa, ■Iler*K. n, and/or
relocation
Phone: ( ) Fax:( ) 1
200 amps or less 66.85
[/wiser installation: This installation is being made on property that I own which is rm l 201 amps tom 100.30 2
intended for sale, lease. rent, or exchange, according to ORS 447, 449, 670, and 701 _ 401 amps to 600 a 133.75 - 2
Owner signature: ,.......r.- _ 1.)Atc: ._. Branch circuits- new, ar1teratiaa, or extension. per panel
❑ APPLICANT _ ❑ CONTACT PFJLSON A Fee for branch circuits with
setvicc or focder fee, cock f,,6S 1
Business name: branch circuit .
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit 46.85 1 1 .S 2
Address:
—. - -- _ - ..- Each add ( breach tarcaii[ 6,b5 . � 2
City /State /ZIP: Miscellaneous (service or feeder cat included)
Pomp or irrigation circle 53.40 2
Phone: ( ) j Fox: : ( ) -
.. _ Sign or outline lighting 53.40 2
E- mail: Signal cirwi1s) or lilnitcd-
COA177L►CTOit energy panel, alteration. or
j ` extension. Describe: Pape 2 2
Addre -\ 7 te �i , g' 9 �C Cacti additioaxl last over atbsnrb r is Awy of $be above
cis --._, Pcr ins-pcctioe 6250
city/Slide/ZIP: 0)6, U ���� Iavatigation per hour (1 hrmia) . 6250 -
I'horde: ( �( --0 q.,15- Fax: (1(pe!)) CGt'o(o II 61-3 industrial plant per /Pour 73.75
—
.. -_. — ELECTRICAL Yr_RAIrr PEES"
CCB Lie.: J S3 q 3t Electrical Lie.: 3 • Li su Lie.: L-! f/45 Subtotal 5' 2 ,
.l- l e
uprv. Electrician signature, rlxiuired: ■ i 0i (' b1 plan review (25% of permit fcc)
State surcharge (8•,4 of permit Pee) 4 1 • 2 •
Print nanrc: �{` t G� Tlm�Je� Date: 1./ 1'0_ - l 1
TOTAL PERMIT FEE {
A uthorized signature; 1.4 rk4 permit applkioe wires if ii atPermit it not obtained within 180
' / days alter it tae bear accepted ss complete. complete. Pri tn[ n�mC: \A�,C • - ( —k $ 0 v t � Sa f / ' F ee method set ty Tri -Coomy na:tdi ■g badu Service Board
— •• Number of iazpcdfima per permit allowed.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2007
Phone: (503) 639- 4171,�Imi" +�
Inspection Requests (24 Hrs.): (503) 639 -4175 . =I �..
INSPECTION WORKSHEET FOR DATE: 6/21/2007 TIME: 7:03AM PAGE: 103
lAkleae
SITE ADDRESS: 13411 SW CHELSEA LP CLASS OF WORK:
SUBDIVISION: CHELSEA HILL LOT #: 013 TYPE OF USE:
PROJECT NAME: S! TTELMEYER
DESCRIPTION: Furnace and A/C circuits
OWNER: KEVIN SETTELMEYER, PHONE #: 503 - 766.3522
CONTRACTOR: CROWN VOLTAGE PHONE #: 360 - 666.0895
Inspection Request Scheduled For: Date: 6/21 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # M- - • -
139 Electrical final 050539 -01 150-399-7986 /
Corrections/Comments/Instructions:
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ice
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►1 r ! PASS n 'ARTIAL APPROVAL ❑ CANCEL 19-AGG SS
= .._ e., • - INSP b I ADDITIONAL FEES ASSESSED
r 1 0
Inspector: Date: / r Phone #: (503) 718
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00272
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/260007
Phone: (503) 639 -4171 �o �(I
:tot
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.....,..„. -..
INSPECTION WORKSHEET FOR DATE: 5/17/2007 TIME: 7:00AM PAGE: 60
SITE ADDRESS: 13411 SW CHELSEA LP CLASS OF WORK:
SUBDIVISION: CHELSEA HILL LOT #: 013 TYPE OF USE:
PROJECT NAME: SE. ` •
DESCRIPTION. +' NC circuits
OWNER: IN SE.TELM3 PHONE #: 503 °785-9522
CONTRACTOR: CROWN VOLTAGE PHONE #: 350-555-0995
Inspection Request Scheduled For: Date: 5/17/2007 Pour Time:
Code # Inspection Description / Confirm # Contact # Message
1 9 9 Electrical final 048489.01 360- 666.0995 N
Corrections/Comments/Instructions:
Y
i 1 1.. ■ J
fit) ditkl 4/ 1/L(/)
(
e-)9- . g \ 1 16/1/ (*)--"•- (7#
.2 0
61/ 1°1 V .
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I PASS n PARTIAL APPROVAL n CANCEL NO ACCESS
IL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: 12 � / . 721 I t //
_Iir Phone #: (503) 718- / / WT.-1