Permit CITY TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00303
DEVELOPMENT SERVICES DATE ISSUED: 5/5/2005
� �h 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 114 BA -13700
SITE ADDRESS: 16280 SW COPPER CREEK DR ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 4 LOT : 102 JURISDICTION: TIG
Project Description: (3) 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: 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:
LARKINS, JANIS L + SHARON A SPARK ELECTRICAL CONSTRUCTION
16280 SW COPPER CREEK DR 4508 NE 123RD
TIGARD, OR 97224 VANCOUVER, WA 98682
Phone: Phone: 503 - 701 - 7822
FEES Reg #: LIC 143886
SUP 4394S
Description Date Amount ELE 26 - 9970
[ELPRMT] ELC Permit 5/5/2005 $60.15
[TAX] 8% State Surcharge 5/5/2005 $4.80 REQUIRED ITEMS AND REPORTS
Total $64.95
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 • • - 63.e in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is
susp- ded for more t 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility N5ift'ation Cen -r Those
rule are set forth in OA 95 0: II through OAR 952 - 001 -0100 You may obtain copies of these rules or direct quesfie s t• e r'y at
503 246 -6699 o 1 -800 -3 344
Issu:d By: I. • PermitteeSignatur
OWNER INSTALLATION ONLY WA
The installation is being made on property I own which is not intended for sale, lease, or rent
OWNER'S SIGNATURE: DATE:
CONTRACT,OrINS .1.,y + SON ONLY
i - - ,♦.ice �/�
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO: 1
Call 503 - 639-41 5 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 . tT� = iii - t FoR OFFicEtUSEroNLYd �.� a '" : ' '
r '* , r Kt ■ , , 6 r ,
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City of Tigard Received r J
Permit No: LI 00S
13125 SW Hall Blvd , Tigard, OR 97223 Plan Review /
Phone 503 639.4171 Fax 503 598 1960 y/�,> hill ' Date/By• Other Permit.
Inspection Line 503 639.4175 ...( 41 , 1*. eAL• : ,, Date Ready /By Suns El See Page 2 for
Internet www.ci tigard or us Notified/Method a Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction Addition / alteration /replacement Please check all that apply:
❑ Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location
EService over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
E( and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi family ❑ Master builder El Other ❑Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION C ❑Egress /li plan RV park
❑Health -care facility ['Other
Job no.: Job site address: Z D S�� ��� w �e G �, Submit 2 sets of plans with any of the above
City /State /ZIP: `,rq .,q r — '7 2 2 >.' The above are not applicable to temporary construction service.
Suite/bldg. /apt. no: f Project name: i 1 t,.. C) FEE* SCHEDULE
Description Qty. Fee Total
Cross street/directions to job site: / 2 cite C2 e .,, Ey ' .. rle 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
Limited energy, residential 75.00 2
Tax map /parcel no.:
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
dwelling, service and /or feeder 90.90 2
r.e--.2 e'- t 1 � Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160 60 2
Name: k.A 1) �/ 1 601 amps to 1,000 amps 240 60 2
Address: �`� f ` 1 F , Over 1,000 amps or volts 454.65 2
Reconnect only 66 85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each
Business name: branch circuit 6.65 2
Contact name. B. Fee for branch circuits
without service or feeder fee, r 46.85 44,g‘ 2
Address: each branch circuit
Each add'l branch circuit 2- 6.65 , 3. 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or imgation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53 40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
..��" extension Describe Page 2 2
Business name. � C ` �
� f`� ,yam £ ?
^/ Each additional inspection over allowable in any of the above
Address: . S Dy ,r./� /2 zfr, cie,C
44-?..z, Per inspection 62 50
City /State /ZIP: C..a... y (.L ,/ � Investigation per hour (1 hr min) 62.50
Phone: (cog) 7 of „ 7,-IT Z Fax: (34 .-P — V 7 '' Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: / Y_�,4'e Electrical Lic.. 2G - 9; ( Suprv. Lic - ? 9 xi`l Subtotal 6 ! S
Suprv. Electrician signature, required. 4.1r Z.. ' , Plan review (25% of permit fee)
•
Print name: U �. D ate: �J / ! State surcharge (8% of permit fee) y w
v! , , L•74 /o,( ,�
TOTAL PERMIT FEE ,, q
Authorized signature. ,,,,- �� . This permit application expires if a permit is not obtained 5vithin 180
� � l days after it has been accepted as complete
Print name: L /r' X 4 4 %_ r ,././4/.1., Date: Z2 17,3* - * Fee methodology set by Tri County Building Industry Service Board
** Number of inspections per permit allowed
i .\Building\Permits\ELC- PermitApp doc 12/03 440- 4615T(10/02 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information - '-
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
I Audio and Stereo Systems*
Burglar Alai_iii
Garage Door Opener*
I I Heating, Ventilation and Air Conditioning
System*
Vacuum Systems*
Other:
COMMERCIAL WORK ONLY:
Fee for each commercial system $75.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
Audio and Stereo Systems
n Boiler Controls
I I Clock Systems
Data Telecommunication Installation
Fire Alarm Installation
HVAC
y I Instrumentation
I Intercom and Paging Systems
I Landscape Irrigation Control*
Medical
Nurse Calls
Outdoor Landscape Lighting*
I I Protective Signaling
I I Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
\Bmldmg\Permits\ELC- PermitApp doc 04/03
II
IA-
CITY OF TIGARD Lkti, 41-4 '
BUILDING DIVISION PERMIT #: ELG200"rO1303
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/6/2005
Phone: (503) 639 -4171 / / iv�di�n��lh ili
Inspection Requests (24 Hrs.): (503) 639 -4175 „_'
INSPECTION WORKSHEET FOR DATE: 5/12/2006 TIME: 7 :08AM PAGE: 71
SITE ADDRESS: 162130 SW COPPER CREEK DR CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 102 TYPE OF USE:
PROJECT NAME: LARKINS
DESCRIPTION: (3) branch circuits.
OWNER: LARKINS, JANIS L + SHARON A, PHONE #:
1 CONTRACTOR: SPARK ELECTRICAL CONSTRUCTION PHONE #: 503- 701 - 7822.
Inspection Request Scheduled For: Date: 5/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message ll 00
199 Electrical final 006692 -01 503- 701 -71322 Y
Corrections /Comments /Instructions:
((,..-
PASS ❑ PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
n \\ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
4,2 Inspector: Date: Phone #: (503) 718-