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Permit CITY OF TIGARD `' ELECTRICAL PERMIT • CITY #: ELC2005 -00505 DEVELOPMENT 5 SW Hall BId.,iga Tigard, 97223 DATE ISSUED: 7/15/2005 503- 639 -4171 PARCEL: 2S115AD SITE ADDRESS: 10836 SW DOVER CT ZONING: R - SUBDIVISION: DOVER LANDING LOT : 017 JURISDICTION: TIG Project Description: (1) branch circuit for hot tub. 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: ETZEL, FRANK JOHN OWNER 10836 SW DOVER CT TIGARD, OR 97224 Phone: Phone: FEES Reg #: Description Date Amount [ELPRMT] ELC Permit 7/15/2005 $46.85 [TAX] 8% State Surcharge 7/15/2005 $3.75 REQUIRED ITEMS AND REPORTS Total $50.60 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 dir -ct t-stions or.• UNC at 503 - 246 -6699 or 1- 800 -33 -2344 Issued By: � /64 r/ 5 Permittee Sign • , '= ' t ✓ OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or r- 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 USE ONLd City of Tigard Date /By Permit No . 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 e'"Aryiirlt \ D ate /B Other Permit. Inspection Line: 503.639.4175 1 y '_�_I_ Date Ready/By' Juris ® See Page 2 for Internet: www.ci.tigard or.us Notified/Metho ..r/ (f 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 ❑ Service over 320 amps — rating ❑ Buildng over 10,000 sq ft., CATEGORY OF CONSTRUCTION ' - • of 1- and 2- family dwellings 4 or more new residential and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑S over 600 volts nominal units in one structure El Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more ❑Occupant load over 99 persons 0 Manufactured structures or - JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park Job no.: Job site address: 0, 3 b S CO P 0 uete. C 1--- ❑Health -care facility ❑Other Submit 2 sets of plans with any of the above. City /State /ZIP: '7 _ b 0a 77' 2 e../ The above are not applicable to temporary construction service Suite/bldg. /apt. no.: Project name: FEE *`SCHEDULE` Description I Qty. I Fee. I Total Cross street/directions to job site : V Z Ke b /O � New residential single- or multi - family dwelling unit. includes attached garage. U cl& C-77 I 1,000 sq. ft. or less 145 15 4 Subdivision: .O L 014-)6-- Lot no.: Ea. add'I 500 sq. ft. or portion 33 40 1 Tax map /parcel no.: Limited energy, residential 75 00 2 Limited energy, non - residential 75.00 2 DESCRIPTION OF .WORK - - Each manufactured or modular _ dwelling, service and/or feeder 90 90 2 i LGY / '1c I = i ® �''���`'rC S 7 / P '_ t 'V 2 c ODC Services or feeders installation, alteration, and /or relocation C.PAA -C Der C /GN7S R etoCT 0lal.ET5> AD z26 jior -net3 200 amps or less 80.30 2 201 amps to 400 amps 106.85 2 ja PROPERTY' OWNER . ❑. TENANT Cif C.Lt t r 401 amps to 600 amps 160.60 2 Name: Z 0 WA/ ET 'Z�� 601 amps to 1,000 amps 240.60 2 Address: J ©g3 c S (--C _J D,_.„, L e__:,-,-- Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State /ZIP: �, l c) ( 7 7 2.--2 Temporary services or feeders installation, alteration, and /or relocation Phone: (5z ) 6 3 Cj. A, 7 is Fax: ( ) 200 amps or less 66.85 1 Owner installation: This installation is /eing i ade o property that i own which is not 201 amps to 400 amps 100.30 2 intended for sale, l o han acco : n: ACORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2 Owner signatu: = yo.` 20, Date:LS C 6 r Branch circuits — new, alteration, or extension, per panel • . ` ❑ APPLICANT i , ❑ CONTACT PERSON A. Fee for branch circuits with service or feeder fee, each 6.65 2 Business name: branch circuit Contact name: B. Fee for branch circuits without service or feeder fee, Address: each branch circuit 46.85 2 Each add'i branch circuit ? 6.65 2 City/State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- 4 ' CONTRACTOR , energy panel, alteration, or s extension. Describe: Page 2 2 Business name: Address: Each additional inspection over allowable in any of the above Per inspection 62.50 City /State/ZIP: Investigation per hour (1 hr min) 62.50 industrial plant per hour 73.75 Phone: ( ) Fax: ( ) ELECTRiCAL PERMIT FEES* ' CCB Lic.: Electrical Lic.: - Suprv. Lic.: Subtotal Suprv. Electrician signature, required: Plan review (25% of permit fee) Print name: Date: State surcharge (8% of permit fee) TOTAL PERMIT FEE Authorized signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board •• Number of inspections per permit allowed. r\ Budding \Permits \ELC- PemiitApp doe 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: v - Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ 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 ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC ❑ Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations I \Bu0ding\Permits\ELC- PenniApp doc 04/03 CITY ���� ��U�� �� ���� ��m o m OF n n��»�unm�� BUILDING ��U��U��U��0� ~°~°"~~~~"""~° ~~"°.~,,~~"" PERMIT #: ELC2006-00505 13125 SW Hall Blvd., Tlgand, OR 97223 DATE ISSUED: 7/15i3(0;:.` Phone: (508) 639-4171 ArtvgatiiiP Inspection Requests (24 Hrs.): (503) 639-4175 „Alai-AL INSPECTION WORKSHEET FOR DATE: 10612008 TIME: 7:03AM PAGE: 27 SITE ADDRESS: 1UO36fI0 DOVER CJ CLASS OF WORK: SUBDIVISION: DOVER LANDING LOT #: 017 TYPE OF USE: PROJECT NAME:, ETZFL DESCRIPTION: (1) branch circuit for hot tub. 7Y25/O5: Added (3) branch ci/cuibzfur kitchen /emodm!. � OWNER: E]]�EL, FRANK JOHN, ' PHONE #: CONTRACTOR: DYVINFR, PHONE #: . Inspection Request ^ , Scheduled For: - Date: 1061200G Pour Time: . ! ' ' Code # |n ` ' ` bn Confirm od essage 199 Elechical final 02.5711-01 503-639-'1678 � Corrections/Comments/Instructions: ' - . / • . ^'. , / _~- / • • ' .'~ . ^ . `. • � \ ' [l �AN[}^ �' ' �� NO ACCESS �= ' ' '' — APPROVAL -- — -- ! � � ' / 1KPASS FAIL ^ LFnR INSPECTION �� -- ^� ^ . r Inspector: ^ Date: �� (503) 718- =~~ ' � � C OF TIGARD BUILDING DIVISION PERMIT #: ELC2005 -00505 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7f150005 Phone: (503) 639 -4171 / ' 4N ' q IpiipGf�f�l Inspection Requests (24 Hrs.): (503) 639 -4175 . INSPECTION WORKSHEET FOR DATE: 7!25/2005 - TIME: 7 :Q7AM PAGE: 59 SITE ADDRESS: 10935 SW DOVER CT CLASS OF WORK: SUBDIVISION: DOVER LANDING LOT #: 017 TYPE OF USE: PROJECT NAME: ETZEL DESCRIPTION: (1) branch circuit for hot tub. 7/25/05: Added (3) branch circuits for kitchen remodel. OWNER: ETZEL, FRANK JOHN, PHONE #: ' CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7!26120055 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 012119'01503.621 - 7434 Y Corrections /Comments /Instructions: 5 6] PASS Li PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6-- ktb 1 L Date: ti'( at-) Phone #: (503) 718- 1-IAA lari CITE OF TIGARD , - - t.r BUILDING DIVISION PERMIT #: ELC2005.00505 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/15/2005 Phone: (503) 639 -4171 � jj�uN���ii�fi��i i f\ Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 7/25/2005 TIME: 7 :12AIVI PAGE: 83 SITE ADDRESS: 10838 SW DOVER CT CLASS OF WORK: SUBDIVISION: DOVER LANDING LOT #: 017 TYPE OF USE: PROJECT NAME: ETZEL DESCRIPTION: (1) branch circuit for hot tub. Dv RA p OWNER: ETZEL, FRANK JOHN, I (V S0.55A PHONE #: CONTRACTOR: OWNER PHONE #: b31 Inspection Request Scheduled For: Date: 7/25/2005 Pour Time: Code # Inspection Description Con ' ii # Contact # Message 120 Electrical rough -in 01200 01 5503 -521 -7434 Y L —� 4 9 \'> tV Z.,zL Corrections /Comments /Instructions: ri PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n �A LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ,',47,"" / -%' Date Z Phone #: (503) 718-