Permit C ITY OF TIGARD ELECTRICAL PERMIT
iiiii
711 PERMIT #: ELC2007-00014
COMMUNITY DEVELOPMENT
D ATE ISSUED: 1/4/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112BB -05600
SITE ADDRESS: 08285 SW FANNO CREEK DR ZONING: R -
SUBDIVISION: COLONY CREEK ESTATES NO.2 LOT : 039 JURISDICTION: TIG
Project Description: 2 branch circuits AC and GFI
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: 1 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:
ROBIN & JANET REVEL HILLSBORO ELECTRIC
8285 SW FANNO CREEK DR 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: 971 275 - 4080 Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -4399C
[ELPRMT] ELC Permit 1/4/2007 $53.50 LIC 134481
[TAX] 8% State Surcharge 1/4/2007 $4.08 SUP 4941S
Total $57.58 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: )CG A „44 4 z _ t Permittee Signature: 4 - is 7 d p,' �! �fA
/` 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.
01 04 -'07 10:42 FROM- Hillsboro Electric 503 - 601 -3680 T -479 P002/002 F -085
jrltectrYcai rermit Application E " ,/E -
City of Tigard Received ^�
Date/BV: A0 J • 14 Permit No, 1 ' poc H
13125 SW Hall Blvd., Tigard, OR 97223 A 7 X17 Plan Revie
. Phone: 503.639.4171 Fax: 503.598.1960 [:r ' 4 l' ^ Date/13y: Other Permit:
Inspection Line: 503.639.4175 , ' 1 171P9r'1 Date Ready/By: lurix El See Page 2 for
Internet wwW.ci.ti ard.or.us
�`�
S C� 1„13" l 1 Notified/Method: Supplemental Information
.. ..-,. .. ewe• -�
:�fE �Q1tt :� Ui(11 tVlt l�f�q. t +• ��,„�.r1tlTS91:1! :..: . ..: :. ... .
❑ New construction Is Addition /alteration/replacement Please check all that apply: .
['service over 225 amps, ['Hazardous
❑Demolition ❑Other:
• :::: .,...: :; ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft..
.. .: .. .. . . . - : • ..... C ..T Q ,'Y :Oi iCO1! CrIOJN..; r ; :.: i of 1
• -and 2- family dwellings 4 or more new 1- and 2-family residential
E dwellin nt
Y S ❑ 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 .
•." '' ;:. r:r :i::,;; •:: .:..... t load over persons ❑Manufactured structures
.; ... .....
:.. ,... :::d . ':SLTE' i1VP or
:::,:,_::.:::� :�:;:,::_:�::.....AIE~ .. o��f'��'ii:OlK °�:�QDQ iQ�
... � , � � L'��� ❑Egess/ljghtins plan c RV park
Job no.: $ LH Job site address t ( DI-care facility ❑ Other:
�o X�� v r ' Submit 2 sets of plans with any of the above.
Thb li cable to temporary construction service.
City/State/21P �� 1 j Y � 1 � � AK The above are not applicable
Suite/bldg. /apt. no.: Project name: / v ,, ?lw °t?
erne / `: . IJ;`°;! ,::: °';;.: :ii:!,:. ';:.::.
ti Dmcriptiml I QV 1 Nee. I Tout ' r ;r
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
includes attached garage.
1.000 sq. ft, or less 145.15 4
Subdivision: Lot no.: Ba, add'l 500 sq. ft. or portion 33.40 1
TaX map /parcel no.:
Limited energy, residential 75.00 2
e 75.00
.. , . ,.- ..�:. ;:,',; .::..:. - ....,::�..•�- - �� -,— , non-residential
:. to energy, ,.:...:::. �. ��5' T, i�l! 1�" i. �? �!''`' P1 't.�ItTCi;;: "::: ;:.:
. .
� , :.: ".' Each manufactured or modular
1 . Al dwelling, service and/or feeder 90.40 2
Services or feeders installation, alteration, and/or relocation
200 amps _ _
s or less
80,30 2
P
2
O] amps to 400 amps 1 Ob.8S
';LJf`.1E? tE�T'X . )E p
„� 401 amps to 600 amps 160.60 2
Name: ,A f a • 4 �, ilF V 601 amps to 1,000 amps 240.60 2
Address: / 1 a Grvp Over 1,000 amps or volts 454.65 2
C] V Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone; li I 01/1S - W 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, Iease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature:
_,:.�: � ?,;. . , ::..x:. : ._� : .. . , .,. . .�..� :, :�.. °, , .,.... , , circuits
:- � •.%� : :..... ,.::• ,:: ` A. Fee er ie tc - hc
... .c ........................_,.., ..,,,......., .. .. ;:;;• A F for 'trcuits extension, per panel
service or feeder fee, each
Business name; t �n '
branch circuit 6.65 2
*-�� B. Fee for branch circuits
Contact name: without service or feeder fee,
Address;
40 5 gG
first branch circuit 46.85 2
Bach add'l branch circuit ' 6,65 (P 1 -PS 2
City/State/ZIP: Miscellaneous (service or feeder not included) .
Phone; Pump or irrigation circle 53.40 2
E-mail.
( ) Fa�C. ( ) Sign or outline lighting 53,40 2
Signal circuit(s)
.... .•:.; ,.... :., .. ,..: .. , 41*k! .: ... ..
,, orgy panel, aleration, or
extension. Describe: Page 2 2
p
Business name: 1, j i+ f_. a
- Each additional inspection over allowable in any of the above
Address. a 1 IL tra ` A_llI r Per inspection 62.50
City / State/ZIP; 1 ,
si . 4 L r �. Investigation per hour (1 hr thin) 62,50
Phone: , Fes Indu strial plant per hour 73.75
K idd i t o 1p : ( )Pp • _,, :.
:..... ..:.. subtotal ..:
:: •::.:.�: :::�L#��'�Li[ CAL,; �>' >�Ii,M1i�':»>tLs :..:.:..:::
CCB Lic.; 131 , t t - E t�r Suprv. Lic.: W to
Suprv. Electrician signature, required: o
9 ., _,0- Plan review (2 /o of permit fee)
Print name: \1 r Vi X4/1 ! r� 0 � Date: 1 _ -_ 4. Vic- l State surcharge (8% of permit fee) �'
1I��v1 ww l 1 V l TOTAL. PERMIT FEE �l .1° , •
Authorized si a This permit application expires it a permit is not obtained withinn 80
days after it ban been accepted as complete
Print name: bate: = Fee methodology set by Tri -County Building Industry Service hoard
se Number of inspections per permit allowed.
i:\ Building \Perm$s\ZLC- PecmitApp.doc 12!03 4404613T(10/02/COb1/w'6B
CITY OF TIGARD
BUILDING DIVISION " . A PERMIT #: ELC2007-00014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/4/2007
Phone: (503) 639-4171 keol i 1\
Inspection Requests (24 Hrs.): (503) 639-4175 _A- 41-
INSPECTION WORKSHEET FOR DATE: 1/9/2007 TIME: 7:03AM PAGE: 34
SITE ADDRESS: 08285 SW FAWN° CREEK DR CLASS OF WORK:
SUBDIVISION: COLONY CREEK ESTATES NO.2 , LOT #: 039 TYPE OF USE:
PROJECT NAME: REVEL
DESCRIPTION: 7 Nandi circuits AC and GFI
OWNER: REVEL, ROBIN & JANET . PHONE #: 971-275-4080
CONTRACTOR: FilLLSBORO ELECTRIC PHONE #: 503-435-9666
•
Inspection Request Scheduled For: Date: 1/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 041913-02 971-276-4080 V
Corrections/Comments/Instructions:
C
10 , PASS PARTIAL APPROVAL n CANCEL I ' ■ ' CCESS
• FAIL 0 CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: C--/ Date: /A / Phone #: (503) 718-