Permit •A
. „CITY 1 OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00206
• ., COMMUNITY DEVELOPMENT DATE ISSUED: 4/6/2007
-- TIGARD- 13125 SW HaII Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S110DD - 10400
SITE ADDRESS: 10990 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.6 LOT : 320 JURISDICTION: TIG
PROJECT: LEAR
Project Description: Panel change - out.
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: 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:
JACK AUERBACH LEAR ELECTRIC
10990 SW HIGHLAND DR PO BOX 573
TIGARD, OR 97224 GRESHAM, OR 97030
Phone: Contact #: PRI 503 665 - 9840
FAX 503 - 661 -6389
FEES
Description Date Amount Reg #: ELE 26 -41 I C
[ELPRMT] ELC Permit 4/6/2007 $80.30 LIC 52278
[TAX] 8% State Surcharge 4/6/2007 $6.43 SUP 3786S
Total $86.73 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 a ore : • 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those ru •s are set forth in AR 9 -0 1 -0010 through OAR 952 -001 -0100. You may obtain co ' hese rules or direct questions to OUNC at
503.246 6699 or 1.800.332.234 .
Issued = : kirLA / Permittee Sigri ure: , , � 1J.1�A
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: C%(/` tl°'t 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.
04/04/2007 08:34 5036616389 LEAR ELECTRIC CO INC PAGE 02
Ele Permi Application FO OFFICE USE ONLY
-City �' TQ and Recei
y Received
Date /B ' y �
Plan Review Permit No.: he' 4 7->iv , O
13125 S W Hall BI vd., Tigard, OR 97223 ��
�
Phone.: 503.639.4 171 Fax: 503.595.19 f EC /41; Date/El : Other Permit:
Inspection Line: 503.639.4175 A � � , , f Date RmdyBy: PM Ed See Page 2 for
Internet: www.ci.iigard.or.us IaPR - Notitied/Me Supplemental Information
TYPE OF�.5t � PLAN REVIEW
❑ New construction. IKAdditior itttf I1 - ilacement Please check all that apply:
[1] Demolition ❑ Other: 7 ❑Service over 225 amps, come! ['Hazardous location
❑Service over 320 amps — rating ❑ Buildng over 10,000 sq. tt.,
CATEGORY OF CONSTRUCTION of I - and 2- family dwelling 4 or more new 1541 I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ID System over 600 volts nominal units in one structure
❑ Building over three stories ❑Feeders, 400 amps or more
El Multi- family El Master builder D Other:
JOB SITE INFORMATION AND LOCATION ['Occupant load over 99 persons ❑ Manufactured structures or
RV
❑ Egress:lighting plan park
Job no.: Job si,1e.address:‘ C)••*0h
❑Health -care facility ❑Other:
Submit 2 sets of plans with any of the above.
City /State /ZIP: T C . d t Fi (�- r The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: 1 l Project name: �[� p y� FEE* SCHEDULE
� �>P r •. -ii t D,ncription I Qty. I Fee, I Tidal «y
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'I 500 sq. ft. or portion 33.40 l
Tax map /parcel no.:
Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
( �� dwelling, service and /or feeder 90.90 2
— Pe�.��k ""-.Q� Services or feeders installation, alteration, and /or relocation
� 200 amps or less 4._ 50.30 ( i0,3() 2
4 PROPERTY OWNER ❑ TENANT
201 amps 400 amps 106.55 2
401 amps to 600 amps 160.60 2
Name:
J ,
- thP.+(bQCkl 601 amps to 1,000 amps 240.60 ?
Address: Over 1.000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) Fax: ( ) relocation
200 amps or less 66.85 I
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 600 amps 133.75 2
Owner signature: Date: Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each
Business name: branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
Address: first branch circuit
Each add'l branch circuit 6.65 2
City /State %ZIP: Miscellaneous (service or feeder not included)
Phone: Pump or irrigation circle 53.40 2
( ) Fax: )
• Sign or outline lighting 53.40 2
E-mail: Signal circuits) or limited-
CONTRACTOR energy panel, alteration, or
1 extension. Describe: Page 2 2
Business name: Lau- C . t , eGA1 L
` (,o .�( ' ,
Address: o 6 3 "'{ �e Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Gy23y l J E1� qi so,?') Investigation per hour (I hr min) 62.50
Phone: (r�� ) r , Industrial plant per hour 73.75
LtJ RIA� a8�to Fax: V._[ l �`�') I to l� + ELECTRICAL PERMIT FEES*
CCB Lie.: Jo 1� q :a Electrical Lic. o -- (.lt`'� Suprv. Lie.: 31'8015 Subtotal
t.
Suprv. Electrician tfthl . 7 l/0 25 0 8 Plan review .e ",
■
! - .<... ( of permit fee)
Print name: ►ate: State surcharge (8% of permit fee) 4,43
`p .• t TOTAL PERMIT FEE rw r '�3
Authoriz s , gnature: i ew! / �j/f 4 This permit a pplication expires if a permit is not obtained within 180
f days alter it has been accepted ax cnmptctc
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Bard
'" Number or inspections per permit allowed.
i:`.Building%PennlheJa.c 'I wiiApp.dnr I2.ii 445..1 /1 SI< III 112 t'i1M V I:li
1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00206
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/6/2007
Phone: (503) 639-4171 nna ary��� ii� l � 1 ll
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 4/11/2007 TIME: 7 :00AM PAGE: 10
SITE ADDRESS: 10990 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.6 LOT #: 320 TYPE OF USE:
PROJECT NAME: LEAR
DESCRIPTION: Panel change-out.
OWNER: AUERE3ACH, JACK PHONE #:
CONTRACTOR: LEAR ELECTRIC PHONE #: 503 - 665-40
Inspection Request Scheduled For: Date: 4/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046337 -01 5034349 -4096 N
Corrections /Comments/ Instructions:
•
di"
/o PASS / " ARTIAL APPROVAL n CANCEL n NO ACCESS
1 FA V ALL FOR INSPECTION ❑ ADDITIO AL FEES ASSESSED
y o
Inspector: _ g ate: vy Phone #: (503) 718 -