Permit II
CITY OF TIGARD ELECTRICAL PERMIT
IIII
'° PERMIT #: ELC2008 -00633
COMMUNITY DEVELOPMENT DATE ISSUED: 11/14/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112BC -14100
SITE ADDRESS: 14596 SW DEKORTE TER ZONING: R -4.5
SUBDIVISION: LEISER PARK LOT : 010 JURISDICTION: TIG
PROJECT: LEISER PARK
Project Description: Reconnect only for service to private street light
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor: dm ,...
OWNERS OF LOTS 9 & 10
14596 SW DEKORTE TERR
TIGARD, OR 97224
Phone: Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 11/14/200! $66.85
[TAX] 12% State Surchar 11/14/200/ $8.02
Total $74.87 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- rough O • e •52- 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: -- , 4 / 101l i Permittee Signature (--, . c . „ *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.
Electrical Permit Application FOR OFFICE LiS'E ONLY
City of Tigard Date/By // /5l 08"t�!8 0
Perms No
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
. _ ° = Phone. 503.639.4171 Fax' 503.598.1960 Date/By Other Permit
T I G A R D Inspection Line' 503.639.4175 Date Ready/By. hi: El See Page 2 for
Notified/Method fa Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction f Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below)'
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION
13 Emergency system larger separately denved system.
❑ Addition of new motor load of ❑ "A ", "E ", "l -2 ", "1 -3 ",
II �+,,.i / 100HP or more. occupancy.
Job no.: Job site address:/// > e fz I C� 1! ✓ ❑ Six or more residential units ❑ Recreational vehicle parks.
Cl T G �(� / ❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP: 1 ` J K r e `� q 7 Z 2'1 ❑ Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job s f Description I Qty. I Fee. I Total
{� New residential single- or multi - family dwelling unit.
cit.) L p l s e v 4.. cc.... t� ' Includes attached garage.
Subdivision: Z-C1 Se ✓ (mi k, Lot no.: /0 1,000 sq. ft. or less 145.15 4
C/ Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: _
Limited energy, residential
75.00 2
DESCRIPTION OF WORK ( with above sq R )
o / \ ,�/' Limited energy, multi - family
\�— f n yec `f i 9N , / dvl e'Ie v - S� (" A r (Z- residential (with above sq ft.) 75.00 2
/ / Services or feeders installation, alteration, and /or relocation
( +.' "1 Y'. /4 S� r e `I 1 ('q �" flC G N - 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 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, ren e ch co ng to OR 447, 449, 670, . -; 701 401 amps to 599 amps 133.75 2
Owner signature: _ c Date: ‘7, A. circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
El APPLIC T 21 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, 46.85 2
first branch circuit
Address: t `{ 5q 7 Su' -D L- (( it 1—E- ( tf tr Each add'1 branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP: " --- ( -7 \ 4 ( CQ Q '\ 7 2-2-q Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: (G 3) ( Z o ,_ 9 t f b Fax:: ( ) Reconnect only / 66.85 (t 6. b-5 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: energy panel, alteration, or
Address: extension Describe Page 2 2
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: ( ) Fax: ( ) Investigation per hour (1 hr min) 62.50
CCB Lie.: Electrical Lie.: 1Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal 6i, i 5
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): i o Z
Authorized signature: TOTAL PERMIT FEE: 7 ti,, 7
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
Number of inspections allowed per permit
I \ Budding \ Permits \ELC- PermitApp doe 05/23 /06 440- 4615T(11/05/COM /WEB
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CITY OF ��mn m *.pn Un��m=uwm�� ,
BUILDING DIVISION '
PERMIT ~~"°"~°^~~"~ : ELC200a-0O633
13125 SW Hall Blvd., Tigard, OR 97223 . DATE ISSUED: 11/140.00B Phono:(G08)639'4171
ifr Inspection Requests (24Hsj:(5U3)83Q'4175 ^ ��m , O 12.
INSPECTION WORKSHEET FOR DATE: 11/17/2008 TIME: 7:00Ak4 PAGE: 12
SITE ADDRESS: 14596 SW DEKORTE TER CLASS OF WORK:
SUBDIVISION: LE|BERpARK LOT #: 010 TYPE OF USE:
PROJECT NAME: LOSER PARK
DESCRIPTION: Rocwnnmui only or service i private dnmet light. /
OWNER: OWNERS OF LOTS 9 & 10, PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 11/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 078140'01 5O3-620'9487 N
Corrections/Comments/Instructions:
.
6, . . - .
. /
, ��
� -~
PASS `
ri PARTIAL APPROVAL. pi CANCEL Ll NO ACCESS
U'FA|L fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED .
��
� � K� � ����
Inspector: wr�0��� m��' Date: � �� Y� Phone #: (503) 718- �~U n ~~
- ' 8 �~ ` '
INSPECTOR'S SIGNATURES ARE NOTP.. • _. .
Inspections Required for: t , g- eC 53 REQUIRED ON GREEN INSPECTION CARD.
Code Inspection Description PASS Date B 1 Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing dram 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection•
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 ' Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection•
315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm dram
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation • 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply Imes SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I \Building \ Forms \InspCard _AOP -Blank doc 02/02/07
K ELECTRICAL PERMIT
• t 4 : ., CITY OF TIGARD ,
PERMIT #: ELC2008 00633
COMMUNITY DEVELOPMENT
DATE ISSUED: 11/14/2008
'TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112BC -14100
SITE ADDRESS: 14596 SW DEKORTE TER ZONING: R -4.5
SUBDIVISION: LEISER PARK LOT : 010 JURISDICTION: TIG
PROJECT: LEISER PARK
Project Description: Reconnect only for service to private street light
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor: , `�/�'
„ /
OWNERS OF LOTS 9 & 10 i�J
14596 SW DEKORTE TERR
TIGARD, OR 97224
Tri
Phone: Contact #: ,�
FEES 0
Description Date Amount Reg #:
[ELPRMT] ELC Permit 11/14/200! $66 85
[TAX] 12% State Surchar 1 1/14/200! $8 02
O
Total $74.87 REQUIRED ITEMS AND REPORTS 0
e
ua
W
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- -0- through O' r: 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: ( p,� 4 " - � t Permittee Signature: ,. ' ' r , , _ , _ „ , - ,./
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.