Permit CITY OF T ELECTRICAL PERMIT
TIGARD PERMIT #: ELC2006 -00358
-,,'' 3'f ��� DEVELOPMENT SERVICES DATE ISSUED: 6/30/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S134DC-06400
SITE ADDRESS: 11480 SW DAWN'S CT ZONING: R -4.5
SUBDIVISION: DAWNS INLET LOT: 001 JURISDICTION: TIG
Project Description: Installation of (1) branch circuit for RV outlet. Job # 7948.
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: 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:
TERRY ROOT WILLAMETTE ELECTRIC INC
11480 SW DOWNS CT PO BOX 230547
TIGARD, OR 97281 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 6/30/2006 $46.85 LIC 75059
[TAX] 8% State Surcharge 6/30/2006 $3.75 SUP 19655
Total $50.60 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: . ere, P)4,>.(J
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 30 2006 7 07RM WILLFI TE ELECTRIC 5036242938 .2
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, '0 It „�:. c �� ��� i i ,-. /ft. � 66 � �d 3
"; sv,I 1_1,111 BI:i1, l ig.:,d, ;)r, )/27 % t t , �� � �.� � -, -
f•lique 503 .6.1;) 4171 i' i _ ' i ` I `i . `` i� > ,e ,l , , I t;:. i'; im ,
U J
inspectOn L.i7e 503.619 4 s "I ', J x • - ' � � Oat( R - ' {- 1 ,- � -- I
t .., rF yi . T /jar/ � See rage 7 f
la tcmet- w�Fnv CI tigard or us ■ O G T �G S\ O - i`!oirficd /lvlcatdd . -..— -- - A L!_ L.1J - - - -- -
ritnplrsnent: Ini n-�a
7 70;': ' `'Nfi x-'. t'a)t:`'.?, ':.:' _ _ 't :< < it ^ :, V -t $ � s : S'. , -- -•, -- . - - ---- - - - - - -- - -- -- -- - -- -- -
Yhu0:SY 1;tk, i t£..A. + r. •i;.h rs °, ` .,, - `r. ---
❑ New construction tia Addition/alteration/replacement Please check all that apply.
Demolition ❑ Other: ❑Service ovet 225 amps, comm'I ❑Hazardous locatiorn
'� ❑Service over 320 amps - rating ❑Butldng over 10,000 ft ,
' ° ,, - 41' 1 ` i"'Y - x 's"'i i,'irk ; ',,`. � � i. rr i .•:; � ;l :; . - ,..may n Sy
.; : .-ut:�, #°aw.,,,, ,,, - r. ,.-, 1. rgs§ a ,- .4 w , .. ,.. .• ..... ....... of 1 -and 2- fanaly dwellings 4 r
- ��rr,'�r �^ .,; ,r ('. = .��•�' '.:...,. o more new reside ntial
a 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories OFeeders, 400 amps or mot e
❑ Multi-family ❑Master builder ❑ Other
a + k > Ya p s .. ._ e' / e " E,, . ' " t "a r u . e - s4 e, - ❑Occupant load over 99 persons El Manufactured shuctures or
t4 > ~ ` A aF + u t t t rA t ie u t . _ s ' i w t i .a4 ae 4I 4 ) ' ? ' �. r 1s ❑Egress/l'ghting plan RV park
Job no.: 7 w g Job site address: ) J t( b, 4 Ss /1 , si <
,•-= ❑Health -care facility ❑Other.
V Submit 2 sets of plans with any of the above
Cit}r /State✓ZIP. }. S tl (3).--... The above are not applicable to temporary construction service
Suite/bldg. /apt. no.: J Projectname: ; na# In �? Y'J
I C K,n ►� Z) r i Qty F ., e ,
ri Fee. Total
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage. j
1,000 sq. ft. or less 145 15 4
Subdivision: Lot no.. Ea. add'1500 sq ft_ or portion 33 40 1
Limited energy, residential 75 00 2
Tax map /parcel no
_ Limited energy, non- residential 75 00 2
r s a
Iz ;: ' " y 11 K i r �" ' i . ?� s r'Si ;e7 :: e` c M : f t
��_> ,r���'- �„.. �' ' ,����.�� .:r:,r�a�I �Y. .,r r�a�a�sy� Each manufactured or modular
dwelling, service and /or feeder 9D 90 Z
L Ae� tl Services or feeders installation, alteration, and /or relocation
200 amps or less 80 30 1 2
i i ii „ v . - , n:1 a x'ffac ��°ii?� � ft'l' ,,, 't, 11 ,', , ', � ', 1i r ' ,fir„ t j ; - i<. lq, ,',1e,t; �; 201 amps to 400 amps 106 85 2 I
f ' ' a ° ' 401 amps to 600 amps 16060 2 '
+ Name: � I i - �.ri.A 601 amps to 1,000 amps 240 60 2
Address. ) / X V t S L,..J -' O 1, \h J G----- Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 I 2
City /State /ZIP. Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) , Fax: ( ) 200 amps __
200 amps or less 56.85 i
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
i s " L, •` i " c r c }>��r "`131MV,472 ° <� y ' , t6".,,,..' A. Fee for branch circuits with
+,f C 'l'ad .fr Y >l. S of �. ii , _ f b� Y' Pit �, ,. 1 , ,.� K
: 't.iS �l� w. �tq ' : Sr � •. ��n �t .t, r} C'�� r ir• , o-.m � �� p - - i5 �. .. .. . rl , � ::"{1.44 , +;
service or feeder fee, each
Business name: , branch circuit 6 - 65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
each branch circuit (l 46 -8 17l/ 2
Address. Each add'l branch circuit 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) ( ) Pump or irrigation circle 53 40 2
Fax:
Sign or outline lighting 53.40 2 -
E -mail: Signal circuits) or limited-
5 xGi �r 2 M.�e� i �aM li� ' Ci.7 , t Y ', N , •'':,t''' ' i •
r.,. Mir ^ �r, :44,,. , ' •' t n �., , j"` '~z' t, ... 1 1 3 a `:r i;.1 -,;1 J energy Panel, alteration or
.1 " .. ` n gk'aJFXi'•��r� ^l' ,�..., . x ... 'hixfiyt' .#t „�^SJ'�t. . . i - .. 'J �a�
F - , extensior. Describe. Page 2 2
Business name • �,_ � y
Address: �f� Each additional inspectio ove allowable in any at the above _
1�� e Per inspection 62 50
City /State /ZIP. . "i' _ T Investigation per hour (1 hr min) 62 50
Phone: ( Or. ) 4 ' ;,' ' N Fax � i ) a g t' Industrial plant per hour �� Yrjt7 73 75
Y Ft * tkatIt;� ll4i'V•"`If W v...'0r4�d.iPP'!0054}S,}`' '.a • - `M' '':'-
CCB Lie.- 7-i Electrical Lie : je. Su Tv. Lie . 4(4
Subtotal �‘
Suprv. Electrician signature, required: ��� Plan review (25% of permit fee)
Print name' - Date 4_ ra ,+ State surcharge (8% of permit fee) 3 ,? __
TOTAL PERMIT FEE .S0 LC)
Authorized signature This permit application expires ifs perms( is not ■btntned within ISO
- - - - -- - -' days after it has been nccep led as comprc (e
Print name: Date, .. Fee methodology set by Tel- County Building Industry Service Board
.. Number of inspections per permit allowed
, vnuild mgF'e muis.EL.C- rcrmivapr rice 12(03 440.46151 (7b/fiz /COLVWSa
CITY OF TIGARD
BUILDING DIVISION - PERMIT #: ELC2006- 0035I
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5!3012006
Phone: (503) 6 39 - 4 1 71 nNN���Wppl �����
Inspection Requests (24 Hrs.): (503) 639 -4175 ,JJJ'
INSPECTION WORKSHEET FOR DATE: 7 TIME: 7 PAGE: 44
iiA s , ir3
SITE ADDRESS: 11480 SW DAWN'S CT CLASS OF WORK:
SUBDIVISION: DAWNS INLET LOT #: 001 TYPE OF USE:
PROJECT NAME: ROOT
DESCRIPTION: Installation of (1) branch circuit for RV outlet. Job # 7948.
OWNER: ROOT, TERRY PHONE #:
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503-624-3631
Inspection Request Scheduled For: Date: 7/1412006 Pour Time:
Code # Inspection Description Confirm # Contact # ssag
199 Electrical final 033104 -01 503 - 624 -3631 , Y 'PM
Corrections/Comments/Instructions:
jP ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL I I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (7F Date: 9 l e 6 Phone #: (503) 718- Z‘W