Permit IllIl CITY OF TIGARD ELECTRICAL PERMIT
El PERMIT #: ELC2008-00565
COMMUNITY DEVELOPMENT DATE ISSUED: 10/6/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103CC 11400
SfTEADDRESS: 12240 SW HANCOCK CT ZONING: R - 4.5
SUBDIVISION: WHISTLER'S WALK LOT : 061 JURISDICTION: TIG
PROJECT: FORBES
Project Description: Service for hot tub. Job No. 3782
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: 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CHARLES FORBES WILLAMETTE ELECTRIC INC
12240 SW HANCOCK CT PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 10/6/2008 $80.30 LIC 75059
[TAX] 12% State 10/6/2008 $9.64 SUP 4226S
Total $89.94 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 - - - -t 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.•:99 or 1 .: a0 - 2 -
Issued : : _ / )h .LL Al Permittee Signature: d.Q f �>
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: .'(.. ''' - ,t "Qf7J:"' DATE: 40/4 e
,
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.
- 1..0/06/2008 MON 9:35 FAX 5036242938 Willamette Electric a002/002
■•• la Y t . , q," t 47 v t �it I '� �
Electrical Permit Application \O , IFOROFFIeEUSV . , ( ii .
d v `J Cl of Tigard p\ Date Received ,d v Gg �, Permit No.: f Le „'OD�- ( "05 - 4
,
13125 SW Hall Blvd -, Tigard OR X,r ^ L �C, •"
, •.•;. Phone: 503.639 4171 Fax: 503.5•'• , .1' . • .' . o an Review
(�� R , Other Permit:
TIGARD Inspection Line: 503.639.4175 i�' % .,• a,)' ady /fay: El See Page Z fm
internet: www.tigard- or-gov G�` .1 "ified/Method: Supplemental Information
: -T a I F OF W ORx(►_ ', * `: PLAN RE t' IE }�
❑ New construction ❑ Addition /alteration / - ent Please check all that apply (submit 2 sets of plans whims checked below):
1 - 10-1 ❑ Service or feeder 400 amps or more ❑ Building over three stories.
Demolition Other: ( ( 6 f if where the available fault current ❑ Marinas and boatyards. • ` " CATEGORY.. -'OF, CONSTRUCTION . exceeds 10,000 amps at 1 SO volts or ❑Floating buildings.
,... .: . - . .. `- . -.- .. .. . - - ' ` less o ground, of exceeds 14,000 0 Commercial-use agricultural
I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations, buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of75 KVA or
-, .. .• .. Emergency system. larger separately derived system.
' ..,. J O B SIT ; IN FO RM A T I O N > A N D . ' ` : •
..:� �.'. :.: ..:: ; � . , . ... . . ... .. of new motor load of i 1-
,. Addition f n ., �.: •: •, 2 •• :. 3 ,.
J.•, (; , ci 100HP or snore- occupancy.
Job no.:7 ` ;', ,V
. [ Job site address: / 2 ' pJ�;tbt<f =r
❑ Six or mom residential units. ❑ Recreational vehicle parks.
City/State/ZIP: y 77 4)(2_0 C , ❑ Health -care facilities. 0 Supply voltage for more than
— —_._ ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt, no.: Project name: 0,0 i +' ' r o ❑ Service or feeder 600 amps or more.
• Cross street /directions to job site: nr« ' FEE SCIiFDiiliE.., :..: Total
New residential single- or multi - family dwelling unit.
Includes attached garage,
Subdivision: Lot no.: 1,000 sq. ft or less } 145.15 4
Ea. add•/ 500 sq. ft. or portion 33.40 1
Tax map /parcel no,: Limited energy,
g 75 0
:::`!. °.; ......: ...:..a . ..';[ION. :O .WOR„... ,'......r . :. :.":; :: {_'.: :.:.`, (withabovesq.fl� 0 2
Limited energy, multi - family
fl't^ t" 1 ��- tlo I Ui10 residential (with above sq. R.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less / 80.30 , O. . 2
($j.PROPERTI' .OWNER' . : :';: -., : .';;; ❑' 201 amps to 400 amps 106.85 2
/'1 P p
Name: 4N6 5 k,2 L! !� 401 am s to 600 am s 160 2
,/ 601 amps to 1,000 amps 240.60 2
/ %/
Address: �
, 2 61 it /i Over 1,000 amps or volts 454.65 2
City /State /ZIP: ��t R2� Q2 Cl 7e't � 3 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits will
A ....:.....
AG :PPLICAN < T :;':'. ' ., ❑: GOATT : .: above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
- - - — Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular
90.90 7
dwelling, service and /or feeder
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: Willamette Electric Inc Signal circuit(s) or limited-
energy panel, alteration, or
Address: PO Box 230547 extension. Describe: Page 2 2
City /State /ZIP: Tigard, OR 97281 Each additional inspection over allowable in any of the above
I----- Per inspection am 62.50
Phone: (503) 624 -3631 I Fax: (503) 624 - 2938
Investigation per hoar (I hr min) 62.50
CCB Lie.: 75059 Electrical Lie.: 34 -283C Suprv. Lie.: 4226S Industrial plant per hour 73.75
, :.. ;,,:.:::. ELEC'ERICAI;',PERMi - -
Suprv. Electrician signature, required: . . • -,----••• . • , - . ...... I Subtotal: (.;. (,)
Date: / Plan review (25% of permit fee):
Print name: David Fife
(� (�C t C State surcharge (8% of permit fee): `(, 6
Authorized signature: TOTAL PERMIT FEE: -. C I J
Print name: Date: permit application expires if a permit is not obtained within 180
bate: days after it has been accepted as complete.
' Number of inspections allowed per permit.
Iathuildin4 Term itslbt -C -Per mitApp.doc 05123,06 440- 46I5'r(I 1 /05 /COMA \'rt3
1 .••• •
CITY OF TIGARD
BUILDING DIVISION
A PERMIT #:
ELC2008
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1(3/612008
Phone: (503) 639-4171 grapiloAl -
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
10/17/2008 7:02AM 42
SITE ADDRESS: CLASS OF WORK:
12240 SW HANCOCK CT
SUBDIVISION: LOT #: TYPE OF USE:
WHISTLER'S WALK 061
PROJECT NAME:
FORBES
DESCRIPTION: SE..4vice for hot tub. Job No. 3782
OWNER: PHONE #:
FORBES, CHARLES
CONTRACTOR: WILLAME., I E ELECTRIC INC . PHONE #: 503-624-3631
Inspection Request Scheduled For: Date: 10/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
150 Hot tub/spa/pool 076768-01 971-506-3639 N
Corrections /Comments/ Instructions:
, .
' 4 r ill PA
PARTIAL APPROVAL CANCEL fl NO ACCESS
Ill-FAIL CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: ''''' Date: i0/74)e Phone #: (503) 718- Z-S47