Permit CITY OF TI3ARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00329
COMMUNITY DEVELOPMENT DATE ISSUED: 6/12/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 10AB -04800
SITE ADDRESS: 11488 SW COLE LN ZONING: R -4.5
SUBDIVISION: HAWK MEADOWS LOT : 001 JURISDICTION: TIG
PROJECT: DEAVER
Project Description: Installing (3) branch circuits for ceiling fans.
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: SIGNAUPANEL:
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: 2 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:
PHIL DEAVER PERFORMANCE ELECTRIC
11488 SW COLE LN 14674 SE SUNNYSIDE RD #170
TIGARD, OR 97224 CLACKAMAS, OR 97015
Phone: 503 - 352 -9756 Contact #: FAX 503 - 656 -0693
PRI 503 - 656 -0496
FEES
Description Date Amount Reg #: ELE 3 -582C
[ELPRMT] ELC Permit 6/12/2008 $60.15 LIC 161535
[TAX] 12% State Surchar 6/12/2008 $7.22 SUP 4499S
Total $67.37 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: 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.
Jun' 19 08 03:59p Performance Electric LLC 503- 656 -0693 p.1
Electrical Permit Application • FOR OF F1(r I :S „O NLY .+.._.[,,,,
City of Tigard izec Received
DateB : sffi
it Permit No.: E 7 " .,�
I e • 13125 SW Hall Blvd., Tigard/ R 2 7,.22 ED Plan Review • Phone: 503.639.4171 Fax: 598.1.96 Other Permit:
•� Date, :
T I G,C R O Inspection Line: 503,639.417 nn Date Ready/By: r r s El See Page 2 far
Internet: www tigard or.gov TUN 1 0 200 Notified/Method: Supplementa1 Info rroanon
TYPE OF WORK PLAN REVIEW
ps,,%l[e� pl'e ( 1 j pj Please check all that apply (submit 2 sets of plans w,riterns checked below):
ID New construction qiddition teratio
El Demolition El Other: Milt l i'� ,? ` ' 1ON ❑ Service or feeder 400 amps or more ❑Building over three stories.
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or 0 Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
a1- and 2- family dwelling ❑ Commercial /industrial El Accessory building mps for all otherinstnflations. buildings.
❑ Multi - family ❑ Master builder El Other: ❑ Fire pump. ❑ Installation of75 KVA or
JOB SITE INFORMATION AND LOCATION ❑EmerbRncy system. larger separately derived system.
` � I ❑ Addition of new motor load of ❑ "A" "E" "] -2" "I -3'
Job no.: Job site address: 100HPornrore. occupancy.
'"�q / / ❑ Si x or more residential units ❑ Recreational vebicte parks.
City /State /ZIP: ' 1 1 , i n I '- 7 ', ' ) 12 Health -care facilities. ❑ Supply voltage for more than
l V� I r ! ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: l Project name: D ea 11 er,, 0 Service or feeder 600 amps or more.
I\ FEE SCHEDULE
Cross street/directions to job site: oesrripean l Qt { r «. I Total {
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. 1L or less 145.15 4
Tax maplparce] no.: ' Ea. add'I 500 sq. ft or portion 33.40 1
Limited energy, residential
75.00 2
DESCRIPTION OF WORK Swithabovesq.f.)
{ Limited energy, multi - family
. s�j tt _ A ,5 residential (with above sq. fl.) 75.00 2
Services or feeders installation, alteration, and/or relocation
�� Q �/ 1 r3 w' 200 amps or less f 80.30 2
❑ PROPERTY OWNER l
❑ TENANT 201 amps to 400 amps 106.85 2
Name: R h`1 \ 11 r 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps I 240.60 2
Address: Q „- L • , e. Ck h e Over 1,000 amps or volts 454.5 2
City/State /ZIP : —}-1 t, 12� r� ` 9 7 , / Temporary services or feeders installation, alteration, and /or
_ ll t� 9 '�/ relocation
Phone: (503) 3 -� — f 7 , 3 6 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 599 amps 133.75 . 2
Owner signature: Date: Branch circuits -- new, alteration, or extension, per panel
❑ APPLICANT A. Fee for branch circuits with
0 CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: ` B. Fee for branch circuits
Contact name: without service or feeder fee, Y
first branch circuit I 46.85 IttoiS 2
Address: Each add`I branch circuit c;:, 6.65 ( 3, 3) 2
Miscellaneous (service or feeder not included)
City /Slate/ZIP: Each manufactured or modular
L Phone ( ) I dwelling, service and/or feeder 90.90 2
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: r(' ` Signal circuit(s) or limited -
eii } ` cr t2 11� GL 1 - 1 c. c.., F 4 e (` I; 1- energy panel, alteration, or
I (oil./ a C�LL._v\v'\L S{ ) j _ tI r ,_ extension. Describe: page2 n
Address: !
City /StaterZIP: , - py I a I i ,, (1 z i ' 0? ,G) Each additional inspection over allowable in any of the above
U 1 v 7 ' Per inspection
Phone: �1 / 4 - -- p 62.50
(y7 3) 5 �' ( � Fax: (�� "� lL.4 i�r' 9 Investigation per hour (l hrmin) • 62.50
CCB Lie.: /6/_- 35 Electrical Lie Suprv. Lie.: T i " 9 f c7S Industrial plant per hour 73.75
ELECTRICAL PERMIT FE
Suprv. Electrician signature, required: _
Subtotal:
Print name: �2 l ,��, 4 , ,{ } Vl 5 - Date: ,��jr, /Q plan review (25 %ofpermit fee):
Authorized si y
V V State surcharge (12% of permit fee): — 71
bn. , f /, 721--7�r i C I TOTAL PERMIT FEE: 1 3 7
Print name: � Date: a permit is nor obtained within 150
� ./:„ , , t - R - O - Kilt i'r e. aC //fQ /� --" days after it has been accepted as complete.
r: Building 'rPetmialELC- PetmitApp.doc G5127 /06 ' Number of inspections allowed per permit.
440- 4615T(1 I /05,COM/wEa
CITY OF TIGARD
BUILDING DIVISION , PERMIT #: EL.C200&•00329
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: C/12/200l
/
Phone: (503) 639 -4171 u,t���yiu, en-
INSPECTION Ins Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/16/2008 TIME: 7 :00AM PAGE: 56
SITE ADDRESS: 11488 SW COLE LN CLASS OF WORK:
SUBDIVISION: HAWK MEADOWS LOT #: 001 TYPE OF USE:
PROJECT NAME: DEAVER
DESCRIPTION: Insiailing (3) branch - circuits for ceiling fans.
OWNER: DEAVER, PHIL PHONE #: 503 -352 -9756
CONTRACTOR: PERFORMANCE ELECTRIC PHONE #: 503 - 6560496
Inspection Request Scheduled For: Date: 6/16/2008 Pour Time:
Code # Inspection Description ,• 'cm # Contact # M
199 Electrical final - 071357 -01 503 - 666.0496 V /0'
G 30
Corrections /Comments /Instructions: 3S Z llEt
PRII- , re
PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
Li FAIL ( ] CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: •" 9 V 661—& Date: bit 41 Phone #: (503) 718 -
z