Permit CITY OF TIGARD ELECTRICAL PERMIT
,..�' PERMIT #: ELC2007 - 00612
COMMUNITY DEVELOPMENT _ DATE ISSUED: 8/31/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104 B C - 02401
SITE ADDRESS: 13998 SW FERN ST ZONING: R -
SUBDIVISION: HANDY ACRES LOT : 023 JURISDICTION: TIG
PROJECT: TANNER EQUITIES
Project Description: Electrical reconnect.
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: SIGNAUPANEL:
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA /SPEC OCC:
Owner: Contractor:
TANNER EQUITIES LLC LIGHTHOUSE ELECTRIC LLC
36445 NW LONG RD 27750 SW 95TH AVE # 109
CORNELIUS, OR 97113 WILSONVILLE, OR 97070
Phone: • Contact #: PRI 503 - 582 - 9600
FAX 503 - 582 -8484
FEES
Description Date Amount Reg #: ELE 3 -562C
[ELPRMT] ELC Permit 8/31/2007 $66.85 LIC 154897
[TAX] 8% State Surcharge 8/31/2007 $5.35
SUP 3051 S
Total $72.20 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 -0 • hrough O • R 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 / ' !� I Permittee Signature .. i ' ja , e ilifirear
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:
C NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: �� DATE: •
LICENSE NO: &5
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.
A
8/31/2O7 @9:28 5035828484 PAGE 02/02
t..
• .
Electrical, P .
E-mit Application sli\i'a,
''' .
. • . FOR OFFICE USE ONL . Y .
City of Tigard C ' o/ eived I gi 6 7 4t Permit No. gt,e407--ez & 1 2--
I)nt
I q 13125 SW Hall Blvd., Tiga
15 rd, OR 97223 . i ni Plait Review
. ' Phone' 503.639.4171 Fax 503.598.1950IS' ,.. L u
II
A k3 S ‘ Date/By: Other Permit; — --
T1GAR113
Inspoctirm Line 503.639.4175 IA 0 Date ftentlyily: auris,...: 0 See Page 2 for
Internet: www.tigard-or,gov 41
( IlGik? • ,.% Notified/Method: Supplemental Information
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,i,..,' Til• , P P - '4..:Ii;„)..;',iie , ,`,::::! , ,,": , P,( , .
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y:, a ;;%, p;P:Fp'pl':.;,'p:P.O2:.k.;;JP , n; ,r,',?`.:1■1;(,,,,4 ),;• ..k,P ).. o 'po. • p ., V I 1 VA t „„4 r I.. k 12,i,, ... a • • L . ■ 4,,,,,A6d,,,,t14.4 ,,,14: .. P 4 ....Al...., \ ph. p, pV i
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Piggsc dictlIc n11 that apply (submit 2 sets of plane whienie checked holow)P
ID Ncw construction -1aAddition/alterationtreplacement
0 Service or feeder 400 amps or more 0 Building, over three stories.
III Demolition 0 Other whore Me available faith current 0 Marinas and boalyards.
,...
11 '':1'''";1 :!.:;.lt;;I:y4i:':;;,;:41;;;ii:i e :tom i'impt :11 150 vttitA or 0 1;'Inating hid Irtfrw,
less to ground, or exoceds 14,000 0 Commereinl-use agrieultm.1
. 1- and 2-family dwelling El Commercial/industrial Cl Accessory building amps far all other installations buildings.
D Multl-family ID Master builder 0 Other: 0 1 mrilip, 0 lnsiallaiion of 75 KVA or
,,,,,,,,, D Erncigcncy system larger separately derived system.
4i 4 4
,1446140"Kiti, Willilkirj4008#014:ti .i. , .0.-9 19 ( 1." El Addition of now tumor Inarl nf 0
1".,',,ii' V, 1 :•••• ': :Y. /P:VV:'1 1: . :P1:::t I: l'Al ;1(,,,,l,„44.,::: 0 ,: ,' ',,,,,, , • ,' ■r:fi . 0 . ''','-'■(,‘ ' ':
Job no,: \ ry) Job site address: \30 f\
0 SL() Eer 0 n St 100HP or morc.
Sec or more resident 0 ial unite (=lip:1m.y,
Recreational vehicle pnri.:F.,
0 ticalth.eare facilities. 0 Supply voltage for 1T1OTC than
City/SIOleiZIP: \ va (-) 0 C
0 Hazardous locations. 600 V011:4 n011110;0,
---......... 0 Servic0 or feeder 600 MIMS or mere
Suite/bldg./apt, no.: J Projcct name:
. • • • 1,1. 1 ,'
Cross street/directions to job site: merr■ptinti I Qty. i Wee. 1 Total 1 4
— — New residential single- or multi-family dwelling unit.
Includes attached garage.
. .
4
1,000 sq. ft or less 145,15
Subdivision: Lot no.:
Ea. add'] 500 sq. ft, or portion 33,40 I
Tax map/parcel no.: , , Limited energy, residential
1 ) 5.
: nt (with above grill) 7 00
,-,. • !, : ',.;iii,;,04.;,(1,:,,1:;......u.,,....,....,....1,. L imited 2
: ---
.. G energy, multi-family
Y■r-p1.(1.c.R.6,, \ -u■-. S\sl_t ___Oisp— residential (with above sq. 0.) 75.00 2
Seryices or feeders installation, alteration, and/or relocation
0 Me-,\' 200 amps or less 80.30 2
— —
7.' sbotatiti,:rowiiiitte;! rolti■tot.,:q. 201 amp' to 400 amps 106,85 2
Name; ,,,b,/,..iek tez / 77E6 4.1-e..... 401 amps to 600 amps 160 60 2
601 amps to 1,000 amps 240,60 2
Address: 31.0 gral AfiA 1 --0•-id -' Over 1,000 crops or volts
454.65 2
City/State/ZIP: CO 1?-1..) Cut L.& Oa- c h L13 Temporary itervieef; Or feeders 'nstalIntion, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66,85 -7
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, perpanel
Owner signature: Date: A Fee for branch circuits with
LI $14,1N1' eit'APt! k iL.r,''V g;''';'' . t',4' ..;' .ei ' 10;46 ‘i;;;: .;iWT above service Or feeder fce.
...,- ■..v:.::;`:.2. ',"i:).,.„ :.., ,..„ ‘., ;:;..:L.n. „..a W I i 11 , I i • \PI, , I' I. '1 \ ,' \ ht, 1 k 6,65
each branch circuit 2
Business mime: L.1_8 \N 6\ .Q, Fil e c__tr• LL_C.._ B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit '16,85 2
----
Address: Each add') branch circuit 6,65 2
Miscellaneous (service or feeder not included) ---
City/State/ZIP; l... manufactured or modular
9
90.
dwelling service and/or feeder 0 2
Phone: ( ) Fax; ; ( ) ROCOrtneol only t 66,85
E Pump or irrigation circle 53.40 2
--
.1t0NittfACTtili .... ..,... ' .. :: • /r..:' ,' :. •-•,.. ' , • i ,' '' ''; ,1 Sign or outline litOting 53 40 2
,
Business name: LIGHTHOUSE ELECTRIC LLC Signal circuit(s) or limited-
— energy panel, allerat ion. or
--
Address: 277.50 SW 95 AVE, SUITE 109 extension. Describe: Page 2 2
City/State/ZIP; WILSONVILLE, OREGON 97070 Each additional inspection over allowable in any of the above
--- Per inspection 62.50
Phone: (503) 582,9600 Fax: (503) 582.8484
Investigation per hour ( hr min) 62 50 —
- . _ — .--
COB tic.: 154897 Electrical Lie.; 3-562X Suprv, Lie.'. 3051A Industrial plant per hour 73,75
--- .---- ' . " - '.'"" ' tLgCTRT*Ceiii :PV,R1Vat ftt'S A
Supry. Electrician signature, required; Subtotal. I„ 6 . s <-
----- ....,_ ......), —
Prim name; - Date% „O ---t Plan review (25% of permit fee),
--
RAN DAIMil■LL Slate surcharge (8% of permit fee). S . -35
0 .-........ ._......
Aul horized signa WO . 4 i efOTAI., PERMIT 14.,F. - 7 , ). 0
This permit appliMian expires if a permit Is not ohLined within ISO -
Print name: Date. dap later it bus been accepted as complete.
------ ...,
" Number of inspecimm.,innwed per pcnnii
i u..i,,i,a t .permIlAp don 05/111/06 440-41
A
CITY OF TIGARD��
BUILDING • DIVISION L f24-.h PERMIT #: ELC2007 -00512
13125 SW Hall Blvd., Tigard, OR 97223 ' �- DATE ISSUED: 8/31/200/
1,
Phone: (503) 639 -4171 ` hi �ypi �ffl
Inspection Requests (24 Hrs.): (503) 639 -4175 -'�'+�
INSPECTION WORKSHEET FOR DATE: 9/412007 TIME: 7:01AMM1 PAGE: 47
SITE ADDRESS: 13998 SW FERN ST CLASS OF WORK:
SUBDIVISION: HANDY ACRES LOT #: 023 TYPE OF USE:
PROJECT NAME: TANNER EQUITIES
' DESCRIPTION: Electrical reconnect.
OWNER: TANNER EQUITIES LLC, PHONE #:
CONTRACTOR: LIGHTHOUSE ELECTRIC LLC PHONE #: 503- 582 -9600
' Inspection Request Scheduled For: Date: 9/4/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 195 Iviisc. inspection 055030 -01 503- 582 -9600 N
Corrections /Comments /Instructions:
Xi o *waif- l ) `I// < 5-e41/1i-e`
1 c'-� , 45 , - —
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y
„,---,s/-
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I) PASS I I PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL I I CALL F R INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: r Date: 7 0 Phone #: (503) 718-