Permit CITY OF TIGARD, P
COMMUNITY DEVELOPMENT ELECTRICAL PERMIT
I PERMIT #: ELC2007 -00693
D ATE ISSUED: 10/8/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110 BA -02900
SITE ADDRESS: 11580 SW CLOUD CT ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT : 035 JURISDICTION: TIC
PROJECT: DEMPSEY
Project Description: Replace existing panel and 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: X W /SERVICE OR FEEDER: 2 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
JOHN DEMPSEY THREE PHASE ELECTRIC
11580 SW CLOUD CT. 493 NE 3RD AVE SUITE B200
TIGARD, OR 97224 CANBY, OR 97013
Phone: Contact #: PRI 503- 263 -2558
FAX 503 - 651 -3540
FEES
Description Date Amount Reg #: ELE 24 -390C
[ELPRMT] ELC Permit 10/8/2007 $93.60 LIC 128282
[TAX] 8% State Surcharge 10/8/2007 $7.49 SUP 4498S
Total $101.09 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -01. . You may ob ain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
INI
Issued :. & . 1 Permittee Signature: / �r�,,' / , 4 14
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR' INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
0 6 /
2007 -10 -08 15:14 0 1 / 2 0 0 4 5 0 2 0 0 4 13:28 FAX 6035981980 CI T Y OF T I G A R D three phase e l e c t r i c � 2/2
1 ,
Electric er t o lication i 1►R t n`1 it ar t .1' f1
City of Tigard CEI'V r O 8 O7- S40 Perm"... ELL., I • ^ 00(0'
13125 SW llall$lvd, Tigard, OR 97223
Plume: 503,639.4171. Fax 50359E -1960 OCT p I '' � j' � E 1 � O r t e � oria +
Impaction ction line: 303.639 -4175 C 2 . , ` , - -- . E
"mast; www.ci tl o► ua
CI T a ram _
rq'�,, ,vyy b Liic -'� " i�' F + ,,gl t t ‘, Y � i a p'tv,. . Y r
L1�. ?}L 1.171,117.,4,-,";;f . . t 14 . 1 1, � +� t �l r •� r t 4 `... , , r �` � ,, ,, X r ry � ,_T`,, ,,J , . , ^i 1 '; r� ' ty 447ir ?; F y+, A, 7 /... - ..
1:1 N ew con> ruction ►r. Additian/111tcrIKOWeplacement Please check s11 that Apply:
DService ova 225 wipe. oonmi t ❑Harardous location
❑ Demolition 0 r , �, it t41 °Service over 320 amps-ruing °8uildng over 10,000 sq. ft_,
F . - r r 4"', . : L1 � r � r ...C {nr`f r, .O!'�•tor y a` )G4' '}exe j . J of1- wd2- fandlydwelling 4ormoee new residential
.r ��
►� 1 - 2 family dwelling ill Cammetvial ❑ Acoeasaory building ❑ 5 y ,r em over 600 volts nominal units in one Annatura fBulldln` ova than stories ❑Fead.ra, 400 mime or we
❑ Multi-fetal. ■ Master builder ❑ Other [Occupant load over 99 persona DMsnufactured sttvonlres Or
nl. ~, rte ' ' "7" 1 t r i • 7 ._ I , , : T L.c T.r'T' . �....: '"; ?. ., § i ,71r QEgress/lighting plan RV park
lab no,: Job Bite address: C • fHealth -alts fa;1l ty OOthel
4 • Submit .L sets of plans with any of the above.
C i t y / S t a t e / Z I P : ' t : k 4 . The above are not applicable to tempora y construction ecPIine.
Sulte�ldg./Cpe- no.: project name: , e its 4 r „ll t S X: a'.vh,t': ., ' ,S tar -� :�� -° 6 . ar
beaetples titre Yaw Total
Cross street/directions to Job site New rwWsntlel "Ingle- or mufti - fanny dwdlfag unit
Includes attacked prase.
1,000 aq. R or less 145.15 4
Subdivision; Lot no.: a add'l 500 sq, ft, or portion ., 33.40 1
Li t y. : anrrg y tbaidandal 75.00 .3
Tat mrp/psrcel no_: Limited energy, nna-reeidcntiat 75.00 2
I - .: z ' +. t l' 1 '�^ . t,_�� __ .1 6att rrt®itBachnr� ar modular
dwelling, service and/or feeder - 90,90 2
Services or feeders instellatloo. alteration. end/or relocation
-- 300 arms or s 3 { 60.30 4-+ OT 2
°'+ r - , r i r • . i .1 . 1 • r . ,6 ,4 .- i. r ^ 1I< - . , I 201 201 atnps to 400 an= 106.85 2
401 amps to 600 amps 160.60 2
Name: 'IA A , .e.. ■ , - 601 erne to 1,000 amps - 240.60 2
Over 1,000 lumps or volts 454.65 2
Addl ease Reconnect only 66.85 2
City/StsraJZIP: Temporary services or feeders Iearallsalob, stleretios, and/or
Pax ( ) r440041011 �: ( ) 200 amps ur less 66.85 1
Ownse installations This installation is being =do on property that 1 own which is not 201 amps to 400 Lima 10030 7
invaded /la role, lease, runt, or exchange, warding to ORS 447, 449, 670, and 701 401 mpg to 600 amps 13175 I 2
Owner eig e: ,,Date: . Branch drills- new alteration, or atsaslon, per panel
r ., r, -.; ?- = (ii •'•; •: ' islet forbranch circuitswith
.. .. — service or feeder fee, each
Rosiness Ontocc branch circuit /9• 6.65 f3,30 V 2
B. Fes forbrmch circuits
•1'r: witont service or feeder fee.
ant branch gin:wit 46.85 2
Addtess: J
Each eddl hunch circuit 6 .65 2
City/SonnrZO: Miscellaneous (service or feeder not lnotudedk _
pump or krigsrioe circle ' 53.40 2
pbnn& ( ) Fax:: ( ) Signor outline lighting 53.40 2
E- i1: y . '� .'�•n_.•�
Signal aiTOUit(s) or limited-
r1: -i •,!'^ j r l' yl , ', `• 7..•76,,1 r t+ r i � ! .r• �6C ` Y' * t ! a: .�n � panel, alteration. or Par 3
,•_ �F; � t�tc n Describe: Pe 2
� ' Each additional inspection over allowable in an of the above
_ '• -A r 1 � r � Pa inspection 62.50
City/State/ZIP: _ i , r a Investigation per hour (t hr min) II 6210
,� ax Industrial cant per hour 73.75 y , •
CcS I-it.: c t!� ti _ y ~ r. Subto ‘
Suprv. Uo tdcian *ninnies required; I , ID/i � 1 s Plan review (2394 of pen* tee) -
�,� r ►,. , i,', Stets *unhorse (8l4 of permit fee)
Print name: . �, �.� 1��` : l� ' /D : _ IC 7 TOTAL PERMIT /-011-4071? Atttholizad Bid nature: ' � ` This permit applicadon expires if a permit Is no obtained widths 110
gays After k aaa been asepted at cmnptta
Print nazi= r Date: • Fes motodnlogy set by Tri- County Building lding Industry Soro BM-Id
•• Number of Inspections per
c1a r7dieeen tPa"y'Aw 1=1 "4■146tsT(taA1/Cr1MNIU1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: RG2007•006,93
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/812007
Phone: (503) 639-4171 470/1401#
Inspection Requests (24 Hrs.): (503) 639-4175 AIL
INSPECTION WORKSHEET FOR DATE: 211/2008 TIME: 7:02Alvl PAGE: 45
SITE ADDRESS: 580 SW CLOUD CT CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 035 TYPE OF USE:
PROJECT NAME: DEMPSEY
DESCRIPTION: Replace existing panel and branch circuits. 10/11/2007 ADD 200amp SCrliCe.
OWNER: DEMPSEY, JOHN PHONE #:
CONTRACTOR: THREE PHASE ELECTRIC PHONE #: 503-263-2558
Inspection Request Scheduled For: Date: 2/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 064353-01 503-263-2558
Corrections/Comments/Instructions:
Cb -PROT L P14 a(L E LE - - AT
PAS 111 PARTIAL APPROVAL 111 CANCEL 111 NO ACCESS
fl FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: $5- Th 0 (Se) Le Date: #2 CS Phone #: (503) 718- 1)44110.
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELC2007•00693
- '
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11w8/2007
Phone: (503) 639-4171 Ap otiveilifil'
Inspection Requests (24 Hrs.): (503) 639-4175 '
INSPECTION WORKSHEET FOR DATE: 10/30/2007 TIME: 7:02AM PAGE: 55
SITE ADDRESS: 11580 SW CLOUD CT CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 035 TYPE OF USE:
PROJECT NAME: DEMPSEY
DESCRIPTION: Replace existing panel and branch circuits. 10/11/2007 ADD 200amp seivice.
OWNER: DEMPSEY, JOHN PHONE #:
CONTRACTOR: THREE PHASE ELECTRIC PHONE #: 503-263.7558
Inspection Request Scheduled For: Date: •0/3012007 Pour Time:
— -- ---_____
Code # Inspection Description Confirm # - N Contact # , Message
\ `,.
115 Electrical seivice , 058576-01 ; 503-263-2558 Y
\--= ____ ,,,./ 1_ 9 39
Corrections/Comments/Instructions: ____. , ( Z 0 ki
LP1 RIY
, .
ril . PASS • I I PARTIAL APPROVAL I I CANCEL 0 NO ACCESS
fl FAIL I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: -- , N oe) Lt 101 361 O Phone #: (503) 718-1-4
, -