Permit /% e fi UGC
CITY , O 11GARD ELECTRICAL PERMIT
" PERMIT #: ELC2008 -00552
COMMUNITY DEVELOPMENT DATE ISSUED: 9/30/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 102CA -00102
SITE ADDRESS: 09765 SW FREWING ST ZONING: R -4.5
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT : 021 JURISDICTION: TIG
PROJECT: DOAN
Project Description: (3) branch circuits for furnace and heat pump. 10/10/08, ADD 200 AMP PANEL.
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: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 0 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 0 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:
JEFFREY & JULIA DOAN SIMPSON ELECTRICAL CONST.
9765 SW FREWING ST 2145 NE MCDONALD LN # C
TIGARD, OR 97223 MCMINNVILLE, OR 97128
Phone: 503 - 538 -1950 Contact #: PRI 1- 503 - 472 -2530
FAX 1- 503 - 435 -0157
FEES
Description Date Amount Reg #: ELE 36 -82C
[ ELPRMT] ELC Permit 9/30/2008 $60.15 LIC 133886
[TAX] 12% State Surchar 9/30/2008 $7.22 SUP 5093S
[ELPRMT] ELC Permit 10/10/200! $40.10
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $112.28
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 1 ys ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 01 -0010 thro■•h e ° 152- 001 -0100. You may obtain copies of these rules or direct questions OUNC at 503.246.6699 or 1.800.332.2344.
Issue By: ` J Permittee Signaurea / It
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.
• '
‘RECENE__,D
Electrical Permit Application S E P -1 0 ` FoRJO:FFic e SE ONL
l Ai
(471 DIVISION l
e4t
City of Tigard 3� OF T0GARD Rice v: Q
Dale Br. It�niel /� • emit No.: `� a C S 5 ►
C ' .. !3125 SW Hall Bled., Tigard, OR � Datea3v: Other Permit: Plan Review
e
Phone: 503.639.4171 Fax: 503 ` 1
.J A }./ • /'._ iris a TiGARb Inspection Line: 503.634.4175 1}utcReady /Bye 1 r =s: >a se<ra�roe
Internet: www.tigard-or.gov Notified /Method:
Supplemental luformxtion J
TYPE OF WORK PLAN REVIEW
�l New construction AdditiorelalterationJreplacernent Please check all that apply (submit 2 sets of plans w /iiemschecked beloml_
1=1 Demolition ID Service or feeder 400 amps or more ❑ Building over three stones.
❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
�:l 1- and 2 dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
Y g ❑ Commercial /industrial 0 Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder 0 Other. ❑ Fire pump. ❑ Installation of 75 Kl A or
JOB SITE INFORMATION AND LOCATION ID Emergency system. larger separately deri ved system.
❑
Addition of new motor load of ❑ "q" "E" "1_2 ••t_3^
Job site address: q-7(o Ll/ 1�000utj,s ix or or more occupancy.
Job no.:
✓/ ❑Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: / / �s rr/, �' ❑ Health -care facilities. 0 Supply voltage for more than ❑ r y o !options. 6D0 volts nominal.
Suite/bldg_/apL no.: Project name: f /',Oar/ ❑ Se Senrtc c or feeder Goo amps or Sore.
Cross street/directions to job site: FEE SCHEDULE
Description 1 Qty. 1 Fee_ 1 Tut el j •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add') 500 sq. ft. or portion 33.40 I
Limited energy, residential 75.00 2
DESCRIPTION OF .WORK . ' . I with above sq. ft.)
,f r n � y^ � �.(/ / Limited energy. multi- family 75.00 2
f ib i ltcLl 1% - residential (with above sq. R.)
}}�y] yt�t /1�r 1 ,�n��� L Services or feeders installation, alteration and /or relocation
C1' a` 1 f 200 amps or less 80.30 ' 12
❑ PROPERTY OWNER ❑ TENANT. 201 amps to 400 amps • 106.85 I 2
Name: L7' /2P /,�„ 401 amps to 600 amps 160.60 2
Address: �t G4 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) I 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: Branch circuits - new, alteration, or extension, er panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
Business name:
each branch circuit
6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee, / 46.85 4 85 2
first branch circuit
Address: Each add'[ branch circuit 2_. 6.65 i 3. 35 2
Cit3dState/Z1P: Miscellaneous (service or feeder not included)
Each manufactured or modular
90.90 2
Phone: ( ) Fax : ( ) dwelling. service and /or feeder
Reconnect only 66.85 2
E-mail: Pump or irrigation circle 53.40 2
CONTRACTOR . Sign or outline lighting 53.40 ' 2
-
Business name: �l rn�,ao-v1 ,� �., 6 /_ O _ Signal at(s)orlimited-
`�-C `.Y) l�(}�nCQ, energy panel, alteration, or
Address: ai t5 )U mr G{1
n _ /d extension. Describe: Page 2 2
rile f)91'0 City /State /ZIP: ale V/1 - (�- / 2 �} Each additional inspection over allowable in any of the above.
Phone: ( t e rC ' I r ,�• n f T L-1. 9! O Per inspection 62.50
`, Z • Fax: ( 5 3) . - a f investigation per hour <i la mi n) 62.50
CCB Lic.: , ?)3CY Electrical Air _ 82c_ Suprv. Lie.: 5rcias Industrial plant per hour 73.75
Suprv. Electrician signature, ELECTRICAL PERMIT FEES
p gnature, required: Subtotal: 60, 45
Print name: .0r) ryi Date: Plan review (25 %ofpermit fee);
State surcharge (12% of permit fee): ?, as
Authorized signature: i 6,7 3
I TOTAL PERMIT FEE:
.Print name: Date: This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
1. \Buildingl'ermieslELC- PecmitApp doe 05/23/06 ' Number of inspections allowed per permit_
440- 4615T( I 1 /05 /COMYWF_B
Z'd LS!.0 NOSdWI NInd>i d9Z :60 90 09 dog
. ...
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ac2ooa-0O2
13125 SW Hall Blvd., Tigard, OR 97223
A 9/30/2001
Phone: (503) 639-4171 _4/It
Inspection Requests (24 Hrs.): (503) 639-4175 DATE ISSUED:
INSPECTION WORKSHEET FOR DATE: 10/10/2008 TIME: 7:00AM PAGE: 45
SITE ADDRESS: 09765 SW FREW NG ST CLASS OF WORK:
SUBDIVISION: FREWINGS ORCHARD TRACTS LOT #: 021 TYPE OF USE:
PROJECT NAME: DOAN
DESCRIPTION: (3) branch Cif CiiitS for furnace and heat pump.
OWNER: DOAN, JEFFREY & JULIA PHONE #: 503-538-1950
CONTRACTOR: SIMPSON ELECTRICAL CONST. PHONE #: 1-503-472-2530
Inspection Request Scheduled For: Date: 10/1(12000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 NC or heating unit circuit 076529-01 503-598-8590 N
_._
Corrections/Comments/Instructions:
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PASS P,;,:i "ARTIAL APPROVAL 0 CANCEL NO ACCESS
FAIL Al CALL FOR INSPECTION iii ADDITIONAL FEES ASSESSED
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Inspector: 1i Date: 1 t 0 . Phone #: (503) 718-
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