Permit w CITY O F TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00347
COMMUNITY DEVELOPMENT DATE ISSUED: 5/21/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 102CA -00232
SITE ADDRESS: 09560 SW FREWING CT ZONING: R -4.5
SUBDIVISION: VIEWCREST TERRACE LOT : 013 JURISDICTION: TIG
PROJECT: SWANSON
Project Description: 2 branch circuits to furnace and AC.
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/ FOR: 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:
SWANSON, PRISCILLA PHIL'S ELECTRIC
9560 SW FREWING CT 6600 SE CHARLES ST
TIGARD, OR 97223 MILWAUKIE, OR 97222
Phone: Contact #: PRI 659 -0303
FEES
Description Date Amount Reg #: ELE 3 -217C
[ELPRMT] ELC Permit 5/21/2007 $53.50 LIC 46126
[TAX] 8% State Surcharge 5/21/2007 $4.28 SUP 3201S
Total $57.78 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.
• t r;
Elec rical Anplicatio> R ►�i , l o i`I ICE.U o L `
City of Tigard 13125 SW Hall Blvd., Tigard, OR 97223 2 Received r permit N o.� _�
7 ` 's MAY 6+ 1 200/
Date/B _ t t� • // d1
III Phone: 503.639.4171 Fax: 503.598.195,1'N Cr'.' BUILDING iGARD Date/ . Other Permit:
T IG A I ± Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: luns ,/ ® See Page 2 for
. Internet: www.tigard- or.gov Notified/Method: 7 Supplemental Information
TYPE OF WORK PLAN REVIEW .
❑ New construction 2 Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
• CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
®' 1 - an d 2 dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
y g ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
• JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 - ", "I - 3 ",
I OOHP or more. occupancy.
Job no.: Job site address:
6/6 0 . j £,tJ /i^(°CIJI %v C C'[- ❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State/ZIP: ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: (� Description I Qty. I Fee. Total
ki;‘ o l New residential single - or multi - family dwelling unit. •
•
Includes attached garage. °It Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
• DESCRIPTION OF WORK (with above sq. ft.)
J Limited energy, multi - family 75.00 2
1�(d.It?JifIYCF?. rg I G l°.-i ",!Z cei T S residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
. 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 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 599 amps 133.75 2
Owner signature: Date: Br anch circuits -new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT I ❑CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City / State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: /
■ Signal circuit(s) or limited -
R A./ ` L1 e t �r't "f' �S energy panel, alteration, or
• Address: extension. Describe: Page 2 2
City/State/ZIP: , aia ( 4 ) 4 , U+ e ` \di , T / i t I
G /'-.1 ( lf v Each additional inspection over allowable in any of the above
. Per inspection 62.50
Phone. ( r? t7 Fax: ( Investigation per hour (1 hr min) 62.50 CCB Lie.:.Z4 i z 6 Electrical Lie.:3_A ? c uprv. Lie.: ? ,TO /_, Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES _
. Suprv. Electrician signature, required: pi / Subtotal: 62 ,
v6 U G , 1t 110 Plan review (25% of permit fee): 2 ,
Print name: / re- i C l .: ' ti /1" a ru R A Date: J 1 / /? `i '
f � Sta surch arge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: 711 (j / ftiti /n 4 ou Date: 5/2 i i0 7 days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(t I /05 /COM/WEB 5-7 7
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
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
• ❑ Vacuum Systems*
❑ Other:
C COMMERCIAL WORK.ONLY:.
• Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260)
Check Type of Work Involved:
- ❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
. ❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical •
❑ Nurse Calls
•
❑ Outdoor Landscape Lighting*
p Protective Signaling
❑ Other
Total number of commercial systems: _
*No licenses are required. Licenses are required
. for all other installations
I:\ Building \Permits\ELC- PermitApp.doc 03/23/06
Case Activity Listing 6/7/2007
Case #: ELC2007 -00347 10:30:35AM
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ELC1010 Application received 5/21/2007 None RECD BB 5/21/2007
BB
ELC1020 Permit created 5/21/2007 None DONE BB 5/21/2007
BB
ELC1030 Check for parcel tags 5/21/2007 None DONE BB 5/21/2007
BB
ELC1250 ELC signature on 5/21/2007 None DONE BB 5/21/2007
application BB
ELC1270 Ready to issue permit 5/21/2007 None REDY BB 5/21/2007
BB
ELC1280 Issue permit 5/21/2007 None DONE BB 5/21/2007
BLD
ELC2199 Electrical final 5/21/2007 5/22/2007 5/22/2007 None PASS CB 5/22/2007 048775 - 01 — 503 803 - 7074 — VM -
STI N
ELC1740 Case finaled 6/5/2007 None DONE CB 6/5/2007
CB
Page 1 of 1 CaseActivity..rpt
CITY OF TIGARD
• BUILDING DIVISION PERMIT #: ELC2007-00347
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/21/2007
Phone: (503) 639 -4171 / d 4 �n ,
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 5/22/2007 TIME: 7:01AM PAGE: 45
l
SITE ADDRESS: 09560 SW FREWNG CT CLASS OF WORK:
SUBDIVISION: V)EWCREST TERRACE LOT #: 013 TYPE OF USE:
PROJECT NAME: SWANSON
DESCRIPTION: 2 branch circuits to furnace and AC.
OWNER: SWANSON, PRISCILLA, PHONE #: NA
CONTRACTOR: PHIL'S ELECTRIC PHONE #: 669 - 0303
Inspection Request Scheduled For: Date: 5/2712007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 0413776-01 503 -803 -7074 N
Corr s /Comments /Instructions:
c_ 1 2 -if= .
e - c_49 ...- =7---e____ 2_ e..) AThr-•.. ---- —
•
k -ASS i // PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
is FAIL / CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ -41111111111.6 Date: ..S"
, ZZ 07 Phone #: (503) 718-
`