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Permit
CITY OF TIGARD ELECTRICAL PERMIT • PERMIT #: ELC2006 -10084 ra DEVELOPMENT SERVICES DATE ISSUED: 3/28/2006 "I� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S1 14 BA - 02000 SITE ADDRESS: 16100 SW GRIMSON CT ZONING: R - 4.5 SUBDIVISION: PICKS LANDING NO.2 LOT : i i g JURISDICTION: TIG Project Description: (6) 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: 5 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: JON BALLIN OWNER 16100 SW GRIMSON CT TIGARD, OR 972234 Phone: 503 - 307 - 1435 Contact #: FEES Description Date Amount Reg #: [ELPRMT] ELC Permit 4/6/2006 $80.10 [TAX] 8% State Surcharge 4/6/2006 $6.40 Total $86.50 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 OA - -0010 throu OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or 1 -800 -3 -2344. Issued y: A LAzif, 47114 Permittee Signature: 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. • F't ECEWED Electrical Permit Application MAR rc)IZ of l lCI lJSI ()Nl City cif Tigard 2 8 1006 �e/B — ?� - 0 613 Permit _ e�6 o 4 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Other Permit: r ��! Phone: 503.639.4171 Fax: 503.598.1960 CITY 1 � ' I Date/B Inspection Line: 503.639.4175 gUlL�ll�l OF �_ �i ' Date Re ady/By . fa See Page 2 for Internet: www.ci.tigard.or.us G �IV TIGAR ISI• r Notified/Method Supplemental Information TYPE OF WORK PLAN REVIEW • ❑ New construction ,l Addition/alteration/replacement Please check all that apply: ❑Demolition ❑Other: ❑Service over 225 amps, comm'I 0 Hazardous location ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., CATEGORY OF CONSTRUCTION of I and 2 family dwellings 4 or more new residential ® 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑ 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 RV park no.: Job site address: /, I )o SW ❑Health -care facility ❑der: Job no . 6J'. MSon G �. Submit 2 sets of plans with any of the above. City / State/ZIP: J t,o.rdt t O 2 Z 17 Z Li The above are not applicable to temporary construction service. V FEE* SCHEDULE Suite/bldg. /apt. no.: Project name: Description I Qty. I Fee. Tad Cross street/directions to job site: New residential single- or multi- family dwelling unit. Includes attached garage. D r I/�•n. --) e,t,vv.a.. cJ, (Left) — 3 tree -t -- r+r✓S f 1,000 sq. ft. or less 145.15 4 Subdivision: Lot no.: Ea. add'I 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 k l ' f tii 2e4.4,e / , ( Services or feeders installation, alteration, and/or relocation 200 amps or less 80.30 2 gi PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 401 amps to 600 amps 160.60 2 — ‘ 17 . , 9 " 1 Name: Q I I r ') NU -1 601 amps to 1,000 amps 240.60 2 Address: 6 t 6 S W G /' ‘ 0^ c.-1 , Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City /State/ZIP: 1 -, ce,r c ji / 02_ q L I Temporary services or feeders installation, alteration, and/or Phone: (x7 ) 30 ? —! -i 3S I Fax: ( ) relocation 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: 1/" .- !+o.it 'L Date: 3/211/4 6 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 B. Fee for branch circuits Contact name: without service or feeder fee, / 46.85 41 2 Address: first branch circuit Each add'l branch circuit - 4. - 6.65 33, 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 - CONTRACTOR energy panel, alteration, or extension. Describe: Page 2 2 Business name: ©w r.G/ 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 Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES* CCB Lie.: Electrical Lie.: Suprv. Lie.: Subtotal Df), () Suprv. Electrician signature, required: Plan review (25% of permit fec) Print name: Date: State surcharge (8% of permit fee) 6, LID TOTAL PERMIT FEE 'Q!„ 60 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. i :\ Building \Pemtits\ELC- PermitApp.doc 12/03 410- 4615T(I0/07JCOM/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: ❑ Audio and Stereo Systems* ❑ Burglar Alarm El Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* El Vacuum Systems* El 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 El Data Telecommunication Installation ❑ Fire Alarm Installation El HVAC El Instrumentation ❑ Intercom and Paging Systems El Landscape Irrigation Control* El Medical ❑ Nurse Calls El Outdoor Landscape Lighting* ❑ Protective Signaling El Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations is\ Building \Penniu\ELC- PamitApp.doc 04/03 CITY OF TIGARD - :--_L 0_,C___ BUILDING DIVISION �® PERMIT #:2066, — Ape) g ii 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: 503 44 Phone: ( 503) 639 -4 171 �y��l Inspection Requests (24 Hrs.): (503) 639 -4175 .- - INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS Jsz, I COS W C,V,A I,+hSa/N C"Y . CLASS OF WORK: 0 7 ION: N / LOT #: TYPE OF USE: PROJECT NAME: G- IM 5 0 1v DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message - L 0 071,1_____ 30 7 - l L- 3s Corrections /Comments /I uctions: Rsim.es F.-it.mL INseEclioto . tom hfptovaL. . Pd d ale a- o i-c�r ►^cam„ A, The electrical installation defects noted on this report shall be corrected and an inspection request made within 20 / calendar days per OAR 918- 271 -0030 1 1 15( Q 1 3 il P 14 ok - • '' U... • L�, ; , e 7 20 0 J P6S Cr M3 1 1 26 pt • • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • K Inspector: Date: 1 1 ' S — 0 (' Phone #: (503) 718- • c c� 9 cr■ • CITY OF TIGARD • ELECTRICAL PERMIT ° r PERMIT #: ELC2006 -10084 COMMUNITY DEVELOPMENT DATE ISSUED: 3/28/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S114BA-02000 SITE ADDRESS: 16100 SW GRIMSON CT ZONING: R -4.5 SUBDIVISION: PICKS LANDING NO.2 LOT : 119 JURISDICTION: TIG PROJECT: BALLIN Project Description: (6) 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: 5 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: JON BALLIN OWNER 16100 SW CRIMSON CT TIGARD, OR 972234 Phone: 503 - 307 -1435 Contact #: FEES Description Date Amount Reg #: IELPRMTI ELC Permit 4/6/2006 $80.10 [TAXI 8% State Surcharge 4/6/2006 $6.40 Total $86.50 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: 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. CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 474 Inspection Requests (24 Hrs.): (503) 639 -4175 ' INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS 1.6 O C AZ A lov ` s CLASS OF WORK: SION: � LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: Code # Inspection Description Confirm # Contact # Message I - Lo 51,C,, 3o7- I t -+- orrections /Comme /Instr • ions: . �.v R.E S FINAL i N 5 c1' i o n Aga (45 p kov AL. Pckl, dam, ; o it■ The electrical installation defects noted • on this report shall be corrected and an inspection request made within 20 calendar days per OAR 918 - 271 -0030 C) Nits 'ttuta ASS PARTIAL APPROVAL n CANCEL n NO ACCESS U FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date: -,S __ Q Phone #: (503) 718- °� 1 1 1 1 1 1 I I I I . I —�_a _ J � _. KABLE ST w , 1111 o a "a .' ii F 1 0 I I I I I -1 1 1 j 111 — 0 0 T dIllIV iiiii°01114amii „AN IN e sA .. 1. i D EiratiAdis o ` � ` „� �p \ *% USAF TER RF�E/ Allig. m GREEN � R \� \S‘tk• S � ti g � R � SUM T c • i m > 44 ■lin k , is V .' • u CENILI # .. ,� 6� 00,1'll'� • _ � J iii N (�} 1 DURHAM m AM l I RD - -- --- _ z - f SW-SW - RB ilOr& ■III „ � 041— A. w KE C S W ELI E , ■. I C- RENA WA_ I ! o � MINI gE o 1111111111 III IIII SW P_lCIC ■� ARTH • COOK CT _ ■ S '�k F D SW PJCK'S �T , ! Q II mcAPP ., 1 4 SWJ I Pa o= SERENA II II D Vmm 1 w � �'/ 1 TITAN LN _ = TUA CT,� 67. \., i - a I == \ a,__A ■ o c , ■ L F >— �/c, — KENT ST KEN C T # KE - �� • � � a I /—' �6� - < — a c : _ v co& II ni— - --i—• RIVERWO %� II I _� RIVF 0° ! i rv -' WAY • "1111 '---