Permit CITY OF TIGARD ELECTRICAL PERMIT
� PERMIT #: ELC2007 - 00698
COMMUNITY DEVELOPMENT DATE ISSUED: 10/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 104CA -07100
SITE ADDRESS: 13443 SW HILLSHIRE DR ZONING: R -7
SUBDIVISION: HILLSHIRE LOT: 071 JURISDICTION: TIG
PROJECT: THIELEN
Project Description: (2) branch circuits to wire new covered patio and repair kit for island outlet power.
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: 1 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:
THIELEN, JOE C + PAULA J BEAR ELECTRIC
13443 SW HILLSHIRE DR P.O. BOX 389
TIGARD, OR 97223 DONALD, OR 97020
Phone: Contact #: PRI 503 - 678 -1355
FAX 503 - 678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
[ELPRMT] ELC Permit 10/10/200' $53.50 LIC 20919
[TAX] 8% State Surcharge 10/10/200' $4.28
SUP 4902S
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-e! 4 through OAR 952 - 001 -0100. .0 may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: `� �1' 7 J/ Permittee Signature: / 9 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: 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.
lir )7 WED 8:23 FAX 5036781108 Bear Electric, Inc. Z001 /002
1
Electrical Permit Application Foxo >r> ICEUSEON . ;_ - ::.::•..,;.' >,:.:.
City of Tigard 1ZeDaeeteE 0 , l 1 } tT Pc No�/ TJV 131SW Hall BlvdTigard, OR 97223 Jl
Phone: 503.639.4171 Fax: 503.598.1960 :.' (" Dat Other Per:
Inspection Line: 503.639.4)75 O C� a k L -a1r- 6 !I '/ ,- Date Ready/By: _Timis: / E3 See Page 2 for
w
Internet: ww.Ci.tigard.or.us $ MID : D NotifiedMethod: _ / 1 Supplemental Information
. >v,;,: ":'T=.!r'J�71 - ': m:n > i'` t3, t + ::v.. :. , tq't _
,�YP•,�:. .z; - , �kr :: ;.. =p.: RE NEW`'` .. - . • .h:: �: J4Ai?:
:Q � .::.�.: " � :•j.< , : `_ •'� --" �.: .: t. .. .. •ve f.. �!'�'� }' i.. ; .- q :.: -.. -. .....
New construction [ Additio ' 'eration/replacement Please check all that apply:
❑ Demolition Q Other: ❑Service over 225 amps, comm'l ❑Hazardous location
vt; AF;; ;._ _ ;�. x�.,tsd ^.. N „ ❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
pia . =u:
0
��7=� 'O�' =0� RTPCT iON'. ~;�1 •: -:Y = ``'��" "��� w 4 or more new re idential
i'y c'i2.; ?E�CS.�: _�..- i= sti,Ata.:>� si„`'F�,"�e�tZ- ,�G. -c. :.v "�.sa�;. ...,.x:e;. - ;�w�..::r;•t;::. `' ?:� %;���_ :.- .:- .•.,.,.. � °.. ,.. of 1 -and 2- family dwellings O O s
[?� I - and 2 dwelling Q Commerciallindusttial Q Accessory building ❑System over 600 volts nominal units in one structure
Q Multi - family Q Master builder Q Other: ['Building over three stories ['Feeders, 400 amps or more
Y ,; ,,•_, y * „ ; ,;_ ,, _,,� ,_ ` , _ ,.., r ,, ,, ,, . � V f ,�? ❑Occupant load over 99 persons ❑Manufactured structures or
" ! itg•N •; aFfi gnJOritSa "::. 0 ' Q TIC= ��C $:; ; - :.:)1 ":_< � t . RV park
.-- ::;., ?:.��..- ,..�.....,.,_,� x<.• F,. k rc:-, e:,.. A ��,, r. �: �: � n...,"- �:, 4�=; s :;:.:'h: >�<� -':> ❑ Egress /li
Job no.: I Job site address: / 3 i f q 3 Sty t` 4 )).k ❑ Health -care facility ❑Other:
Q S ubmit 2 sets of plans with any of the above"
City /State/ZIP: -ri.' 4t ref 0 1\ ' 7 z 7' 3 The above are not applicable to temporary construction service.
Suite/bldg. %aptno.. LProjectname: -te5S;w "..::�:;a�f�..:�E�::-• _ <...., `'... ':..: . :
Description ., Qty. .• Fee :.' Totut
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: I Lot no.: Ea. addl.' 500 sq. ft. or portion 33.40 ` l
Fax map/parcel no.: I Limited energy, residential 75.00 2
^4s,"1, 1 , 4 ,, _ :,:.� t;xr - c- y :irk: w „., Limited energy, non-residential 75.00 2
: ?:li'F't,,:Y ; a5; : w - Wls: : - 4 " r`<- 1, ',S '"t •�'ct i-, '� tiVell ..£1; 1Y, ' S:.:°ll' •., 1 1 *•T � , c i 2�+: 2. ,,:. *Tg
, -.... ,,,--- .<, - - 9 i, ` :, , t t;V..314- :�'- fa%setae.a�;:r" ,,, ,... r...-:, �y t _. r ;•.,u,...;e- '._4..,_k•ftrC,r.•t .:-<4,%'131;i :s4, 663 Each manufactured or modular
• i
W F La /t( c7 (OU'e Pa..4Jc� �• fee��4 ,-7, I S'l� dwelling, service rs installation, feeder 90.90 2
• Services or feeders installation, alteration, and /or relocation
d u#4,1 �a ti 200 amps or less I 80.30 2
...Z '=.:z,' °s -, -«.:.t.r,•.,.. ;.>, ,:. t -•.r:ri20•:- v:z iS: is � ,tg g ti".m.T ni : ; .L a 201 amps to 400 amps 106 "85 2
t * c? w„ „ xP - ;�'-ER tY = ., .. , a ' OZI:. ;i4c . =' �:>y1i ] I>I A)I T CPe.:,5 ts at .r '_ ; ,. : ' P P
::a�:?j: .:.r :frrr ^•.o•..; «.. .c,s _..':..ti: ' `'ive: r� ?...i.�. .sa.:.,.....a: Sri... .,.,-
401 amps to 600 amps 160.60 2
Name: 601 amps to 1,000 amps 240.60 2
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: ( ) I Fax: ( ) relocation
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 600 amps 133.75 2
Owner signature: - Date: Branch circuits-new, alteration, or extension, per panel
-•S•3 r vys -:. c= ."a'i' � T ..e. - q.,., :%) . a �c. rn-•, Y , f :557.
.. - i s T ;+ 1?.' - �. i." : k r . < , v -i ;g: ; A. Fee for branch circuits with
*t�vyLT •Y:•,. ..,. . ,.: ... `' .,._ ; - L„ r?;'_<'it; § �"•< '.• • ..: :...�%a, � 1 _ . Pv " '•"•"' [,, <r,� r
" ''' '-' . service or feeder fee, each
Business name: branch circuit 6.65 2
Contact name: B. Fee for branch circuits C
without service or feeder fee, ( 46.85 4/6 / ,Y5 2
Address: each branch circuit
Each add'l branch circuit ( 6.65 G .(0 5 2
City / State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax: : ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
^�ai is <^"'-'>i,'�t�'!"^� >s ,,r,`.� .5g-. '', ;._ :^`''t"' "'•< rrit::c''� e.- - :1fi ..c= :9AIIC-43.. ;:t energy l alt
S;ys :z z f4>.> K ' '-, �Cp ` Cs: O •,. srn�. -: - •,• z �_ er ane alteration, or
�,,w - r 1<t;c$L&c., .•, � .> ���-, •R':•�;a.:::,.;..;:h;c:.f_t: =s� "�� ^ : • h sn'- �:x•:3 gYP
"'" ` "Q: / "" y " R . extension. Describe: Page 2 2
Business name: 86,4 V . 6 4 i° 1,,:o , - - -
Address: T• t 3 q Each additional inspection over allowable in any of the above
• Per inspection 62.50
City /State/ZIP: Apt/y1 OA 9 7 Z 0 Investigation per hour (t hr nun) 62.50
Phone: ( 993 G 7g / 3 5 s I Fax: (503 ) G 79 - //of:- Industrial plant per hour 73.75
5 ,?'i'"�-.'£ r `% ng.:. 0- KAlas >p ign.:* ' . .
CCB Lic.: . 2 0 9/q I Electrical Lic.: ,Z q . fo 7 e.... e.... I Suprv. Lic.: y go z S Subtotal 5 3, so
Suprv. Electrician signature, required:
• .•i vim' n(sw--, Plan review (25% of permit fee)
Print name: // / Date: �� �J State surcharge (8% of permit fee) T ,, Z 6,
, YL f /lr�t ld SS'>" ( !� �9 r TOTAL PERMIT PEE 5 7_ 7
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: • Pee methodology set by Tri- County Building Industry Service Board
•• Number of inspections per permit allowed.
~'
J
CITY OF Id ��nm o ��o TIGARD 04
BUILDING DIVISION 5 1 " — PERMIT #:
13125SVVHaUB|vd Tigard, OR i�� ` ��^ DATE �^°�°`'''""°~'
Blvd., ' � ���'pv~- ' � 1[�>0�OU7
Phone: (503) 630-4171 / m��7
Inspection Requests (24Hmj:(S03)83Q'4175 Iwi' ^L
INSPECTION WORKSHEET FOR DATE: TIME: PAGE: � 10/1772007 � 7:02AM � 26
SITE ADDRESS: CLASS OFVVORK�
�
� 13443
SUBDIVISION: LOT #: TYPEOFUSE�
� HILLSHIRE � 071 �
PROJECT NAME: � TH|[]�]N
O �
DESCR|PON� �
CD branch dK��mtauv�e new covered Deboand r ir��hX�and outlet power.
OWNER: � PHONE #:
THIELEN, � PHONE #:
� BE/��ELE{�[R|(� � 603-078-1365
Inspection Request Scheduled For: Date: � Pour Time:
1W17/2007 '
Code # Inspection Description Confirm # Contact # Message
120 E|nci/ica|,omoh'n 067767'01 503- 67t11355 N
Corrections/Comments/Instructions:
p 19 - 14,- - &xi-
il e 9 miziA)-k-- 1 k(tob kk ---
PASS 0 PARTIAL APPROVAL 0 CANCEL WNO ACCESS
* IL �� ALL FDR |NSPE�OON �� ADDITIONAL FEE8 A88ESSED
-_ ��
Inspector: �Jw^~� Date: / 0
Phuno #� (503> 718' �. � (503) '
.
CITY OF TIGARD
BUILDING DIVISION , ; PERMIT #: ELC2007 -00698
13125 SW Hall Blvd., Tigard, OR 97223 '. DATE ISSUED: 10/10/2007
Phone: (503) 639 -4171 /ai M i #
Inspection Requests (24 Hrs.): (503) 639 -4175 ''Ti L
INSPECTION WORKSHEET FOR DATE: •10/19/2007 TIME: 7:01AM PAGE: 23
SITE ADDRESS: 13443 SW HILLSIIIRE DR CLASS OF WORK:
SUBDIVISION: HILLSHIRE LOT #: R71 TYPE OF USE:
PROJECT NAME: THIELEN
DESCRIPTION: (2) branch circuits to wire new covered patio and repair Idt for island outlet power.
OWNER: THIELEN, JOE C + PAULA J, PHONE #:
CONTRACTOR: BEAR ELECTRIC PHONE #: 503 - 678 -1355
Inspection Request Scheduled For: Date: 10/19/2007 Pour Time:
Code # Inspection Description c anfirm # Contact # Message
120 Electrical rough-in \ 057957-01 603- 670 -1355 V
Corrections /Comments /Instructions: � F
XPASS PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G'' I N vA Date: i 0 11 11 t Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00698
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/26/7007 TIME: 7 : 00AM PAGE: 62
SITE ADDRESS: 134143 SW HILLSI DR CLASS OF WORK:
• SUBDIVISION: HIt. I_SH1RE LOT #: 071 TYPE OF USE:
PROJECT NAME: THIELEN
DESCRIPTION: (2) branch circuits to wire new covered patio and repair 1dt for island outlet power.
OWNER: THIELEN, JOE C + PAULA J, PHONE #:
CONTRACTOR: BEAR ELECTRIC PHONE #: 503-678-1355
5
Inspection Request Scheduled For: Date: 10/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Me
199 Electrical final 0:8426 -01 503.678.1355
Corrections /Comments/ Instructions:
01Q f C�. - /( A-4
1A 2
❑ PASS pi PARTIAL APPROVAL n CANCEL NO ACCESS
FAIL Ij1 FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
ZO
Inspector: Date: P r�
fl Phone #: (503) 718-
CITY OF ��uu n n.�m nn�m�mnn��
BUILDING DIVISION '
~~~~"~~~°""~~° ~�"°"~,.~~"~ PERMIT #: ELC200700898
1312GSVV Hall Blvd, Tigard, ORO7223 DATE ISSUED: 10/10/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 630'4175
INSPECTION WORKSHEET FOR DATE: 10/30/2007 TIME: 7:02Am PAGE: 27
SITE ADDRESS: 13443EWH|LLSH|HEDR CLASS OF WORK:
SUBDIVISION: |i|LLSM|RE LOT #: 071 TYPE OF USE:
PROJECT NAME: l}1|ELEN
DESCRIPTION: (2) branch circuits to wire new covered patio and r ir kit for island outlet pmer.
OWNER: TH|ELEN. JOE C+ PAULA J. PHONE #:
CONTRACTOR: BEAR FLECJlR\C PHONE #: 503-678'1355
Inspection Request Scheduled For: Date: 1030/2007 Pour Time:
Code # Inspection Description fi Contact # Message
/
199 Electrical final 01 ` 603-67B-1355 `^ Y
•
Corrections/Comments/Instructions: • - '
•
PASS PARTIAL APPROVAL CANCEL 1 NO ACCESS
| I FAIL ri CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G* itS 6 1.-E" Date: 1013109 Phone #: (503) 718- ViLitr