Permit CITY OF TIGARD ELECTRICAL PERMIT
u COMMUNITY DEVELOPMENT EERMIT# E
DATE ISSUED 12/18/20/18/20
07
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503 639.4171 PARCEL 2S103DC -00805
srrE ADDRESS 11415 SW FAIRHAVEN ST ZONING R -3 5
SUBDIVISION VIRGINIA ACRES LOT 003 JURISDICTION TIG
PROJECT JAMES
Project Description Panel change and (10) 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 1 W /SERVICE OR FEEDER 10 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 SVC /FDR >= 225 AMPS• CLASS AREA /SPEC OCC
Owner Contractor:
SUZANNE JAMES MICHAEL RAFFAELL CONSTRUCTION
11415 SW FAIRHAVEN ST 15170 S W KIRK RD
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone Contact #: PRI 503 - 632 -6720
1'AX 503 - 632 -6732
FEES
Description Date Amount Reg # ELF 3 - 299C
IELPRM I'j ELC Pei mgt 12/18/200" $146 80 LIC 58422
[FAX] 8% State Surcharge 12/18/200 $11 74 SUP 25625
Total $158.54 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Muniapal 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 than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center
Those ru s are set f In OAR 952- 001 -0010 through OAR 952 -001 -0100 You may obtain copies of these rules or direct questions to OUNC at
503 24 or 1 800 f 44
Issue By: lk Q. Permittee Signature sir 'eft
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. � - —® ! !f9 -- 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.
Dec, 16 07 1221p Michael Raffaell 503 - 632 -6732 p3
tie ctrical Permit E, li y FOR OFFICE USE ONLY
i City of Tigard u [ �UE g l f.:D Re - -
• 13125 SW H alt Blvd Tigard, R 9722}tt D a(aBV ,
Plan Re, /R /7 07 �/ Print Nc �.C.G �
Phone- 5036391171 Pax � -�9R -1960 /III / x. i
TIGARD Inspection Line, 503639417
la- TT r•t rr'1 Ip1] Date/By Other Permit
Internet inanetlgard -or gov i ii , g" i1t il lD Dare Ready/Fly m o-
NonneatMetho,i. I H See Page p for
C r w n.Ir '^ s, ^ ^r � —, to Supplemental luformation
1 PE OS WORK
❑ New construction I PLAN REVIEW
Add +tlon / alteration/ replacement Please check all drat apply (submi 2 sets of plans w /nems checked below)
I Demofitinn Other j
wh Seance or feeder 400 amps or dune ❑ Building over three storms
CATEGORY OF CONSTRUCTION ere de available fault current 0 Marinas and bcatyar its
exceeds 11,002 amps at 150 volts or 0 Floating budmngs
l and 2 d selling ❑ CommerctaLlndusinal ❑ Accessory building
less to ground, or encems 14,000 0 Commercial -use agricultural
❑ Multi amps for all other installations buildings
Y 0 Master builder ❑ Other ❑Fire pang 0 installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑imergency system larger sepaatcly dented system
JOl)no. O Addition of nevi motor 'aid of
C A ^ ,'g • "12 "'13"
Jon S.LC address- ` .ti 011? more
! 1 ! Sv./ 7 ltI }u4'.v or
occupancy ❑S rr -e e resrde tec onus ❑ Recreational ve forL Faris
! �i �'i�a nip L•-p :-i 0Healrh -care famines 0 Supply voltage for more than
Suite /bid /apt. ❑0 - I 0 Hazardous locations 6CD soils nominal
g p Project name. .J•3 0 Sevee or feeder 600 amps or more
Crass street/directions [Dinh site FEE SCHEDULE
Deictiptioa _
Qn I F r
attached
alai I
New residential esr cal single - or multi- family dwelling unit.
Suodivtsmn
Lot no
Ea_ Includes attached garage -
1,000 mq R or less 145 15 I 4
Tax map/paled no E add 500 s ft- or porton 33
DESCRIPTION OF WORK Limited energy, resident al
f s,ln shoves - ft) 7500 2
____::l CS �,,„ � Limited ed energy, multi -remit 75 00 I 2
f tial (with alw'.e q fi }
/0 >r'� — Services residen or feeders iasm alteration, and/or relocation
❑ PROPERTY OWNER [] TENANT 200 amps or less / 1 8030 fi -2
Name' L 11 201 amps to 400 amps I 10685 12 ,4, Zt'i t- — „Li_ L v, p 401 amps to 61x1 amps 1 160 60
Address: f :i 1 '5 5 L•/ ° f- 74� 1 601 amps to 1,000 amps I 240 60 2
s t ' b' "a j Over 1,000 a or volts CtlylS[aWr: !
45465 + f 2
ll�i p9l2 la 4 (-- temporary services or feeders installation. alteration, and/or
Phone. ( relocation
1 Fax ( ) 200 amps or less
Owner installation: This installation is being made on property that I - 66 85 1 t
Dun which is not 201 amps to 400 amps 100 30 I 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701- 401 amps to 599 amps
Owner srgnatmc 133 75 j 2
Date: Branch Circuits — new, alteration, or extension, per panel
0 APPLICANT - i A Fee For branch r fee s Iona
0 CONTACT PERSON above service or feeder tee,
Business name each branch circuit ) 6 h5 �( S = I ri
B Fee for branch circuits
Contact name a (shout service or feeder fee,
first branch circuit 46 85 2
Address: Each add'l branch circuit 6 6
5 2
Cl /State, NLSeellaueous(service or feeder not included)
Each manufactured or modular
Phone ( ) Fax- r ' dwelling, service and /or feeder 90 90 2
E -mail. 3 40 Reconnect only F 66 85 I 2
Pump or lmgation circle I 5 2
CONTRACTOR _
Business neme /, - Sign cr outline lighting 5340 2
f -- '"( -� 2 p '.� , _ Signalelreurt(s)orlimited-
a r , .j- t energy pane], alteration, or f
Address t / � � extension Describe I Page 2
/? i t•: c' G3 c g 2
1 5 /7
Cityi$tate2lP- n
Ut• N -Lr
! TY G ?EF_ ( -. _ �'7u it E' Each additional inspection over allowable to any of the above
tz
Phone' (t �., Fax (*A 3)
7 Per inspection F 6250
CCB Le f �` ' 7 Investigation per hoar p hr men) 62 50
ScS'2` E l ectrical Lie - - - ,^ c i Supra L[c •h 5 _ , Industrial plant per hour 7375
Suprv, Etectncian signature, require 7 // 0 . y J/ �•7re /0X1/440
ELECTRICAL PERMIT FEES I
���t- :./�•: / /c --f '.Cl+' Subtotal r-) •p (r S c'
Print name I L t' .._€, ( n Plan review (25°4 of permit fee)
pot/ �/'t•f P L Date /
Authorized signature �� I State surcharge (3 %afpermdfee) /( �� /�
TOTAL PERMIT FEE i
Print name- ` 7IIn permit application 1 es '� 150
Date: !x days expires if vcot mpleet dw OD
days after it hits been accep a s complete.
I'DatS.rglPormm4l C PLrniAppdr 092:'05 • Number nFmspmcnma allowed per permit
4 40- 16151[ 11 O LCOI W W r- b
CITY OF TIGARD
BUILDING DIVISION PERMIT #• ELC2007 -00650
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 12//8/2007
Phone (503) 639-4171 +1�Id����
Inspection Requests (24 Hrs )• (503) 639 -4175 s_h-
INSPECTION WORKSHEET FOR DATE &27 /2008 TIME: 7:01AM PAGE 15
SITE ADDRESS: 11415 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES LOT # 003 TYPE OF USE
PROJECT NAME JAMES
DESCRIPTION Panel change and (10) branch circuits.
OWNER JAMES, SUZANNE PHONE #
CONTRACTOR MICHAEL RAFFAELL CONSTRUCTION PHONE # 503-632 6720
Inspection Request Scheduled For: Date' 6/27/2008 Pour Time
Code # Inspection Description Confirm Contact # \(vlssage
199 Electrical final 071942 -01 503- 781 -9857 �� Y
Corrections /Comments /Instructions L iJ oi(v
(gym
N
\\_
\
/v
&As's) I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector G • 6 8 LC Date: b in 0 Phone #. (503) 718- )./. i-I I
CITY OF TIGARD ..
BUILDING DIVISION PERMIT # ELC2007 00850
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED 12/18/2007
Phone. (503) 639 -4171 ICI
Inspection Requests (24 Hrs) (503) 639 -4175 j �. '__..
INSPECTION WORKSHEET FOR DATE 4/17/2000 TIME 7.02AM PAGE 20
SITE ADDRESS 11415 SW FAIRHAVEN ST CLASS OF WORK.
SUBDIVISION VIRGINIA ACRES LOT #- 003 TYPE OF USE
PROJECT NAME. JAMES •
DESCRIPTION Panel change and (10) branch circuits
OWNER JAMES, SUZANNE PHONE #
CONTRACTOR MICHAEL RAFFAEU L CONSTRUCTION PHONE # 503 -632 -6720
Inspection Request Scheduled For Date. 4/1/12008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
14£ 2- F 5
Aft or heating unit circuit UG854.. 01 ,,0378 f- BS,.�7 Y
Corrections/Comments/Instructions:
tit UadL V\a't\T -
_il-e' 01 2 S i S : CA-S66 * 6 6tC \ pctm'$�.reQ �o tiN-
,
% Vey- '
e
- ■ tll.f±62).11 cdi,- ut���
PASS PARTIAL APPROVAL El CANCEL Ill NO ACCESS
1 I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED �p
Inspector. G-1 0 6e1LF, Date: .�'[
1 Phone #. (503) 718- �` %
CITY OF TIGARD i r
BUILDING DIVISION CIIS � PERMIT# ELC2007 -00850 A
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 12/18/2007
Phone. (503) 639- 4171 liif
Inspection Requests (24 Hrs) (503) 639 -4175 4.4- `__..
INSPECTION WORKSHEET FOR DATE 3/7/2000 TIME. 7:00AM PAGE: 48
SITE ADDRESS. 11415 SIN FAIRHAVEN ST CLASS OF WORK:
SUBDIVISION VIRGINIA ACRES LOT # 003 TYPE OF USE
PROJECT NAME. JAMES
DESCRIPTION Panel change and (10) branch circuits
OWNER JAMES, SUZANNE PHONE #
CONTRACTOR MICHAEL RAFFAELL CONSTRUCTION PHONE # 503-632-6720
Inspection Request Scheduled For. Date 3/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message d�,,,,""
120 Electrical rough-in 0662.58 -01 503 - 781.9657 Y L u .liuu 111 '1
Corrections /Comments/ Instructions
' laW 4 1 2 ' . Y
1 1 2 -R_ Cep 1 e - 7 1 , 0 ) (1°
ok / • . A. IL.- Yom'
ii-
(k4k- (11)5e Oleo --D - 1294) l eyk li
o k - q t1 & =c - .eo4 Il Hs 0 c 1,6 0-), 44 r) kvi I
1 IA1 - dtLA G , f l 4. r lefe
/
1 0 if- Q 11 64; }'�1 - A yin )Z()
❑ PASS PARTIAL APPROVAL CANCEL I I NO ACCESS
I FAIL CALL FO INSPECTION ADDITIONAL FEES ASSESSED I., Inspector: Date /Dt Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT # ELC20U7- 00860
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 121113/2007
Phone. (503) 639 -4171 ,1 1 � A
Inspection Requests (24 Hrs )• (503) 639 -4175 !i' I..
INSPECTION WORKSHEET FOR DATE. 3117/2008 TIME: 7:01AM PAGE 18
SITE ADDRESS. 11415 SW FAIRHAVEN ST CLASS OF WORK
SUBDIVISION VIRGINIA ACRES LOT # 003 TYPE OF USE
PROJECT NAME JAMES
DESCRIPTION Panel change and (10) branch circuits
OWNER JAMES, SUZANNE PHONE #
CONTRACTOR MICHAEL RAFFAELL CONSTRUCTION PHONE #• 503-632-6720
Inspection Request Scheduled For. Date: 3/17/2008 Pour Time.
Code # Inspection Description Confirm# Contact # Message
120 Elechical rough -in 066801-01 503.781 -9867 \ Y
Corrections /Comments /Instructions
N .. FLoocz v-1/4 QM rr s3T BE q09
iN6 e st P ` t ests2
a
PASS ❑ PARTIAL APPROVAL PI CANCEL H NO ACCESS
F AIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: C N 44 Date. 3 • 11 ' OA Phone #: (503) 718 - 446