Permit , �<` ELECTRICAL PERMIT
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CITY OF TIGARD
COMMUNITY DEVELOPMENT PERMIT #: ELC2007-00800
DATE ISSUED: 11/28/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134BD-04000
SITE ADDRESS: 11930 SW HAZELWOOD LP ZONING: R - 4.5
SUBDIVISION: ENGLEWOOD NO.2 LOT : 128 JURISDICTION: TIG
PROJECT: SOWER
Project Description: (3) branch circuits. Elec. to hood fan, ceiling fixtures.
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: 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:
KEN& CHRISTY SOWER OWNER
11930 SW HAZELWOOD LOOP
TIGARD, OR 97223
Phone: 503 - 579 - 5424 Contact #:
FEES
Description Date Amount Reg #:
I ELC Permit 11/28/200' $53.50
[TAX] 8% State Surcharge 11/28/200' $4.28
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.
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Issued By: 4p. / Permittee Signature: X �? J.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
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OWNER'S SIGNATURE: ►
t /) 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.
. Electrical Permit Application FOR OFFICE USE ONLY
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City of Tigard Date /B Received, J a : Permit N ta `0 � 1/
- ° 13125 SW Hall Blvd., Tigard, OR 97_ Plan Revie
Phone: 503.639.4171 Fax: 503.598.1 M Date /B . Other Permit
TI,GQRD Inspection Line: 503.639.4175 NOV 2 ,^ 2007 Date Ready /By: torts l See Page 2 for
Internet: www.tigard - or.gov Notified /Method: Supplemental Information
CITY OF TIGARD PLAN REVIEW
❑ TYPE O a,M replacement �i DIVISION
New construction Addition /aallttccration / P lease 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.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
$1- and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E ", "l - "I - ",
Job no.: Job site address: //I 5o 14,1 (�j4-te t u i " " l , /J Six or or more residential Recreational ' _ % J - 0 or more residential writs_ ❑ Recreational vehicle parks
City /State /ZIP: ❑ Health -care facilities 0 Supply voltage for more than
/ /�' �� ,) 9 7 �� ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: { Project name: k ei,) Tide f ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: .314.) .57A/A/C---L/44/j> J C"� /�G�4� Description Qty. I Fee. 1 Total I *
� / , f New residential single- or multi - family dwelling unit.
SCA/ /otp S' S M/A)GhJ 7 ddp d /1/9 e/!,t✓%) Includes attached garage.
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
DESCRIPTION OF WORK •(with above sq. ft.) 75.00 2
/ Limited energy, multi- family 75.00 2
acid. 120 V GVA NGA G fa?) f pt. Ov/ tD f ^67 ,dd Mn/ residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
•
r 9( e _' ,3 db/ tu be clot" CJA f 4/ /Go /eeerse >/ /1 1 ,Aft45 200 amps or less 80.30 2
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
]f�� / 401 amps to 600 amps 160.60 2
Name:
F'� � nr/f f Se)4 601 amps to 1,000 amps 240.60 2
Address: irq 2 j 54) /4 / id , Dc d [- Over 1,000 amps or volts 454.65 2
City /State /ZIP: ! �, 9 m__ ? 7 , _ 3 Temporary services or feeders installation, alteration, and /or
relocation
Phone:L3 ) s 7," 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, r exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
7 Branch circuits - new, alteration, or extension, per panel
Owner signature: f ( Date: ,!• 24.-- A. Fee for branch circuits with
. 14 APP CANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
ij each branch circuit
� & , a . Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, 46.85 fb ` 1 " 2
Address:
t / ` ��_/.. V / Sd
first branch circuit i
Each add'! branch circuit 6.65 f 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
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: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour ( hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: .5 ') .
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): I • a * v
Authorized signature: TOTAL PERMIT FEE: 5 "7 ? g
\ /� lw/�,\^ X Date: This permit application expires if a permit is not obtained within 180
Print name: J , /.. Z G1 days after it has been accepted as complete.
* Number of inspections allowed per permit
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CITY OF TIGARD 171`7T a:6(
BUILDING DIVISION l Ah , P ERMIT #: ELC?007- ooet10
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11120/,0;7
Phone: (503) 639 -4171 u'4ppiplpI��
Inspection Requests (24 Hrs.): (503) 639 -4175 -
INSPECTION WORKSHEET FOR DATE: 10/31/2008 TIME: 7 :00Alvi PAGE: 60
SITE ADDRESS: 11930 SW HAZE WOO[) LP CLASS OF WORK:
SUBDIVISION: ENGLFWOOD NO .2 LOT #: 1 TYPE OF USE:
, PROJECT NAME: SOWER
DESCRIPTION: (3) branch circuits. Elec. to hood fan, ceiling fixtures.
OWNER: SOWER, KEN& CHRISTY PHONE #: 503..579 -64241
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: . 18/31/20Q8 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 EIectlical final 077410 -011 603-579-5424 N
� * Corrections /Comments /Instructions:
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n PASS I I PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTIO ❑ ADDITIONAL FEES ASSESSED
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Inspector: • T ; Date: d Vill% Phone #: (503) 718-
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| BUILDING DIVISION ' ' PERMIT #: B[2[07-00600
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/79V2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 AA « ��..
INSPECTION WORKSHEET FOR DATE: 1/30y2008 TIME: 7:03AWi PAGE: 62
SITE ADDRESS: 11930 SW HAZELWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.2 LOT #: 120 TYPE OF USE:
PROJECT NAME: soVVFR
DESCRIPTION: (3) branch circuits. Dec. to hood fan, ceiling fixtures.
OWNER: S0WFR.NEN&CHR\8TY PHONE #: 5O3-579-5424
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/38/2008 Pour Time:
Code oda # Inspection Description : Contact Message
120 E]wc±/imdruuuiriu 6��1 \
503-679-5424
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y \ f:ASS pi ri PARTIAL APPROVAL CANCEL ri NO ACCESS
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FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
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Inspector: ~" ° »~^��~�� Date: `' ��~ ��� Phone #: /5O3)718'�`� �w'
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CITY_OF TIGARD r.
BUILDING DIVISION PERMIT #: E( „C 007 Oflt3fl0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 -4171 azeifig
Inspection Requests (24 Hrs.): (503) 639 -4175
. INSPECTION WORKSHEET FOR DATE: 1/2/2008 TIME: 7:01AM PAGE: 30
SITE ADDRESS: •41930 SW HAZE{ WOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWO(D NO.2 LOT #: 128 TYPE OF USE:
PROJECT NAME: SOWER
DESCRIPTION: (3) branch circuits. Elec. to hood fan, ceiling fixtures.
OWNER: SOWER, KEN& CHRISTI'' PHONE #: 503-579-5424
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/2/2008 Pour Time:
Code # Inspection Description onfirm # Contact # Message
120 Electrical rough -in 062386 -01 603 - 67.3.5424 h!
Corrections /Comments /Instructions:
R:0 10 - � csCrg ® cAc 1 RscL:
Hoo / '(A $
PASS PARTIAL APPROVAL (l CANCEL NO ACCESS
4 FAIL '�[J CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: CT ----; IN 66 LE Date: 1' OS Phone #: (503) 718 -