Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT D: ELC2008-00429
COMMUNITY DEVELOPMENT
DATE ISSUED: 7/25/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CC -12800
SITE ADDRESS: 10345 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT : 179 JURISDICTION: TIG
PROJECT: LAUNDER
Project Description: Replacing 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: SIGNALJPANEL:
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:
LARRY LAUNDER TDS ELECTRICAL CONTRS.
10345 SW HIGHLAND DR PO BOX 22773
TIGARD, OR 97224 MILWAUKIE, OR 97269
Phone: Contact #: PRI 503 - 710 -0866
PRI 503 - 698 -7519
FEES
Description Date Amount Reg #: ELE C164
[ELPRMT] ELC Permit 7/25/2008 $80.30 LIC 170193
[TAX] 12% State Surchar 7/25/2008 $9.64 SUP 5351S
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 u�spe ed for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Th ' "� s 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 50 , 2.2344.
i
Issued B . _ - j_ Permittee Signature: r
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.
Electrical Permit Application FOR OFFICE- USE ONLY
,
Ili --''S• City of Tigard � Date y: 7 4 - a,- /-7 J - Permit No.:. p'( � �(i {
13125 SW Hall Blvd., Tigard, OR 97 ���/// Plan Review
Phone: 503.639.4171 Fax: 503.598 960 q �QQ IS Date/By: Other Permit:
T CG Au D - Inspection Line: 503 \�� Gt O ^ A Date Ready /By: fort ® See Page 2 for
Internet: www.tigard or.gov J O �� I G O Notified/Method: Supplemental Information
TYPE OF WOR11/0 ��r ‘SO
PLAN REVIEW
El New construction Addition/alterati pIke 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.
less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
1 and 2- family dwelling ❑Commercial /industrial CI Accessory building amps for all other installations. buildings.
\ Multi- family ❑Master builder ❑Other: ❑ Fire pump. buildings.
of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E "1 - ", "1 - ",
Job no.: Job site address: IOOHP or more. occupancy.
/ 0 3 y �g (,e/ f i l l, Li ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: r� Q 2 ` Z ❑ Health -care facilities. ❑ Supply voltage for more than
l rtie t I ❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: u Project name: (. j{— ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total
I • ' 1 New residential single- or multi- family dwelling unit.
c...., c...., ��J., Q ., \ (i Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
( l Limited energy, multi - family 75.00 2
p A t/L-t ` ( o'n 1 N residential (with above sq. ft.)
�l / Services or feeders installation, alteration, and/or relocation
200 amps or less I 80.30 ,T, ?D 2
[ OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name:
LG( —tom k ky a� 4 � C 401 amps to 600 amps 160.60 2
I 601 amps to 1,000 amps 240.60 2
Address: /6 3 y 5 S w 7 Li ,, et 2
Over 1,000 amps or volts 454.65 2
City/State /ZIP: t 9 a r r� / 0 ,2 ` Q'7 2 2 y 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: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT . ❑ CONTACT PERSON above service or feeder fee,
6.65 2
h each branch circuit
Business name: I! 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
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
Signal circuit(s) or limited -
Business name:
b S 6,7 _ G Kit C. (0,-,s1 , L. energy panel, alteration, or
Address: p 6 6 o ' I S ( extension. Describe: Page 2 2
City/State /ZIP: C I Q c_. ' CA5 a 6, s— Each additional inspection over allowable in any of the above
j Per inspection 62.50
Phone: (53 ) 7/0 . 6 , s - 0 � o Fax: (5b3 ) 9 ' 7 5'/ ct Investigation per hour (1 hr min) 62.50
CCB Lic.: (70 I c 3 Electrical Lic.: C r ( ii Suprv. 'c.: S3 S' 1 S Industrial plant per hour 73.75
ELECTRICAL :PERMTT FEES
Suprv. Electrician signature, required: it _ Subtotal: - L�,'3C)
Print name:
:ill Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): 'Jrt Gp
Authorized signature: TOTAL PERMIT FEE: qli
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
* Number of inspections allowed per permit.
I:\Building\Permits\ELC - PermitApp.doc 05/23/06 440- 46!5T( I 1 /05 /COM/\EB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
r RESIDENTIALWORK.ONLYr
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
n Burglar Alarm
n Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
n Vacuum Systems*
n Other:
COMMERCIAL, WORK_ ONLY.:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
n Instrumentation
❑ Intercom and Paging Systems
n Landscape Irrigation Control*
n Medical
n Nurse Calls
❑ Outdoor Landscape Lighting*
❑ 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
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: ,= l_C20013 00 29
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7125/200(3
Phone: (503) 639-4171 442 00 , 10i i
Inspection Requests (24 Hrs.): (503) 639 -4175 I
INSPECTION WORKSHEET FOR DATE: 7/28/20018 TIME: 7:0' AM PAGE: 33
SITE ADDRESS: 10345 ` W HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO A LOT #: 179 TYPE OF USE:
PROJECT NAME: LAUNDER
DESCRIPTION: Replacing panel
OWNER: LAUNDER, LARRY PHONE #:
CONTRACTOR: TDS ELECTRICAL CONTRS. PHONE #. 503.698
Inspection Request Scheduled For: Date:
7/28/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 073280-01 503.710 -0866 N
Corrections/Comments/Instructions:
cil Biz..00.,.6. CZ .c).''i p e` i 0 \1-?&. Si
E-teL * R PNL. t \ck Ng. ,t3-. I c, _
- •vc faa J P-
o sv ; 1
qa kAt-kt GRCS VON Rd CoN q62
6 1 a " fra, ek(Et. 3Q3 A 0 $ kf co .
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
A FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: • N 66 L.. Date: I •1i' • 01 Phone #: (503) 718- 1-1 "I (0'
CITY OF TIGARD
BUILDING DIVISIOPJ PERMIT #: ELC2008.00429
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/75/2008
Phone: (503) 639 -4171 t j�
Inspection Requests (24 Hrs.): (503) 639 -4175 ,..'!i ..
INSPECTION WORKSHEET FOR DATE: 7/3012008 TIME: 7:01AM PAGE: 11
SITE ADDRESS: CLASS OF WORK:
10345 SW HIGHLAND DR
SUBDIVISION: SUMMERFIELD NO .4 LOT # 179 TYPE OF USE:
PROJECT NAME: LAUNDER
DESCRIPTION: R eplacing panel.
OWNER: LAUNDER, LARRY PHONE #:
CONTRACTOR: TDS ELECTRICAL CONTRS. PHONE #: 503-698-7519
Inspection Request Scheduled For: Date: 7/30/7008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 07345 ,01 503 - 710 -0865 Y
7104339
Corrections /Comments /Instructions: t__Arrky
N.
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
` FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G' • Noe Date: 1 Phone #: (503) 718- Z7 ik