Permit CITY OF TIGARD ELECTRICAL PERMIT
V PERMIT #: ELC2005 -00557
I DEVELOPMENT SERVICES DATE ISSUED: 8/4/2005
` °`-" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104AC -01502
SITE ADDRESS: 13060 SW HAMPTON CT ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
Project Description: 3 branch circuits. AC, furnace, GFI
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: 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: 2 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:
LEPIRE, ERIC + ELIZABETH HILLSBORO ELECTRIC
13060 SW HAMPTON CT 21185 NW EVERGREEN PKWY #110
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TIGARD, OR 97223 HILLSBORO, OR 97124
Phone: 503 - 524 -4672 Phone: 503 - 439 -9666
FEES Reg #: ELE 34 -4399C
Description Date Amount SUP 194
SUP 4941 1
S
[ELPRMT] ELC Permit 8/4/2005 $60.15
[TAX] 8% State Surcharge 8/4/2005 $4.81 REQUIRED ITEMS AND REPORTS
Total $64.96
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 1 404-332 -2 4.
i
Issued By: �, c� Permittee Signature: P>t al)
OWNER INSTALLATION ONLY r
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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 afthe time of each inspection.
• . From:HILLSBORO ELECTRIC LLC. • 5036013680 08/03/2005 14:33 4229 P.002
,l
Electrical Permit�,Al>r n,Iicatioric • ilia oi�ricEIN ()NIA'
City of Tigard R e`� 1 VO'�
b Datc /Bv: 0 -I 0� Q Permit NOrd..601.005 -OU5 7
13125 SW Hall Blvd., Tigard, OR ,017223, Plan Revi w
°e •4w! ,1;�•� r1 Other Permit:
Phone: 503.639,4171 Fax: 503. )960 �' Dote /Bv - -
Inspection Linn 503.639.4175 �„ Date Resdy /By: 1 s ' - HS ea age or
Internet: www.ci.tigard.or.us Notified /Method: supplement ut tnfurmattnn
( yip g PEE OF /W.ORK - • . • PLAN REVIEW
D New construction N' Addition /alteration/replacement Please check all that apply;
OService over 225 amps, comm'i ❑Hazardous location
0 Demolition ❑ Other. OService over 320 amps - rating 0 6ui)dng over 10.000 sq. ft.,
CATEGORY OF COHSTRIICTiON- of 1- and 2- family dwellings 4 or more new residential
• vp 1 and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building :System over 600 volts nominal units in one structure
MuIU- family Master builder ❑ Other: ❑Building over three stories ' ❑Feeders, 400 amps or more
❑Occupant load over 99 persons El Manufactured structures or
.JOB SITE INFORMATION' AND LOCATION . .,. ..':, ,:' :... • ❑Egress /lighting plan RV park
[Health -care facility ❑Other:
Job nu.: A i / Job site Address: 1jv to j fi -a . Submit 2 sets of plans with any of the above.
City/State/ZIP: ‘ / q-12.243 The above are not applicable to temporary construction service,
. Suite/bldg, /apt, no. : o Project name: s • FEE" SCHEDULE • .'
.l - Naserletian Qty F. Tet5I
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
. Includes attached garage. _
• 1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea, add'l 500 sq. ft. or portion 33,40 I
Limited energy, residential 75,00 2
Tax map /parcel no.: Limited energy, non- residential 75.00 2
•.: DESCRIPTION O IC .:::>:•' :•h > ,.:;� .1
vvo>R
:: ' :!7••,:::. -' • Each manufactured or modular
dwelling, service and/or feeder 90.90 2
L ��. 1 / Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2
201 amps to 400 amps )06,85 2
. •..:... � ,PROPERTX OWNER .. . ,.. .. .... ❑=TENANT= '':,:.,. ; � �....,�; �;;:;
401 amps to 600 amps 160.60 2
Name: dita ..1 1! ` 601 amps to 1,000 amps 240,60 2
Address: . J : L4 } A' 4 /11 -e,i Over 1,000 amps or volts 454.65 2
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Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone:) rici Fax: ) 200 amps or less l _ 66.85 I
• Owner installation: This installation is being made on property that l 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 600 amps _ 133.75 2
Owner signature: . . Date: Branch circuits - new, alteration, or extension, per panel
Q APPLICANT '' .,k i.. :j ❑. CON.TACT PERSON':;; ' A. Fee for branch circuits with
service or feeder fee, each •
Business name: N `` ,i branch circuit 6.65 2
B. Fee for branch circuits •
Contact name: witluu/ service or feeder fee, k
each branch circuit 46.85 •
Each ad 'I
E � branch circuit
Address: 6.65 -
7 _
City / State/ZIP: Miscellaneous (service or feeder no included)
Fax: Pump or irrigation circle 53,40 2
Phone: ( ) . Sign or outline lighting 53,40 2
• E - mail: Signal circuit(s) or limited- •
: -.., •:: , , .. -; :.: • ., CONTRACTOR .,..: `�_ energy panel, 1, alteration or
extension. Describe: Page 2 2
Business name: Hillsboro Electric L.L.C. . .
Address: Each additional inspection over allowable in any of the above
21185 NW Evergreen PKWY Ste #110 Per inspection 62.50 _
City/State/ZIP: Hillsboro, OR. 971 24 Investigation per hour (i hr min) 63.50
Phone: (5 0 3) 439-9666 Fax: ( 5 0 3 6 01- 3 6 8 0 Industrial plant per hoar 73,75
_ ELECTRICAL PERMIT FEES* `
CCB 0c:134481 J Electrical Lic. :3 4- 4 9 9 C Suprv. Lic.: 4947 S Subtotal ('Q ' t •
Suprv. Electrician signature, required: ' V ,J [.r. .� Plan review (25% of p ermit fee) }t
( � Stale surcharge (8% of permit fee) r 3
Print name: Joey vita cco J Date: `�9,1�
`I TOTAL PERMIT FEE , t i l-0'
Authorized signature: • This parntlt application aspires au permit is not obtained within 1 80
days after it has been accepted as complete
Print flume: Date: • Fat methodology set by Tri- County Building Industry Service Board
" Number of inspections per permit allowed.
i ; \{leilding\Pannne \E1,C- Parntil Apll.dee I ,250 441046 1517 I II/s2 /CUM/WEo
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2005«00557
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/4/2005
Phone: (503) 639 -4171 4 "��r�+�q�� 'ihlt.
Inspection Requests (24 Hrs.): (503) 639 -4175 — __
INSPECTION WORKSHEET FOR DATE: 8/17/2005 TIME: 7:05Am PAGE: 93
SITE ADDRESS: 13060 SW HAMPTON CT CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: LEPIRE
DESCRIPTION: 3 branch circuits. AC,se, GFI
OWNER: LEPIRE, ERIC + ELIZABETH, PHONE #: 503 - 524 -4672
CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 503.439-9666
Inspection Request Scheduled For: Date: 8/17/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 013664 -01 503-538-2953 V
Corrections /Comments /Instructions:
A /c- . FA-A/e-e___ -d , 1T
A- c_ ufk4 ,-r -v c— ,
E _____ ' 11. is cotiiAv cc_ c Q 74-41-1 (-U
0
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4 PASS . PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL /ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ■■ Date: gj 9' C7 Phone #: (503) 718-