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Permit
C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00252 COMMUNITY DEVELOPMENT DATE ISSUED: 4/19/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 111 AD -17700 SITE ADDRESS: 14786 SW JONAGOLD TERR ZONING: R -4.5 SUBDIVISION: LADY APPLE LOT : 001 JURISDICTION: TIG PROJECT: STEN Project Description: Airconditioning connection. 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: 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: MATT & SASHA STEN BOB'S ACTION ELECTRIC INC 14786 SW JONAGOLD TERR 2700 NE BURTON ROAD #A TIGARD, OR 97223 VANCOUVER, WA 98662 Phone: 503 - 515 - 3955 Contact #: PRI 360- 254 -7200 FAX 360- 254 -8219 FEES Description Date Amount Reg #: ELE 37 -43 I C [ELPRMT] ELC Permit 4/19/2007 $46.85 L1C 53136 [TAX] 8% State Surcharge 4/19/2007 $3.75 SUP 4322S Total $50.60 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. Issued By: �� aee Permittee Signature: , 4 ca//o7 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 App t i ,,' FOR OFFICE USE ONLY „,; ai l , ' i �.- s,,, City of Tigard DateB Permit No.: 13125 SW Hall Blvd., Tigard, AP ard, OR 97223 / y - es i Other Permit: Phone: 503 639.4171 Fax. 503.598.1960 ew ZO � 14 Nikki DateBy: Plan Rev Inspection Line: 503.639.4175 �I T �Q O � � Date ReadyBy uric E( See Page 2 for Internet tvww ct tigard on 81-lit (1�/ D iN � ,,,(((777 11 � // ` j�, 4 j '',:';'-",,-,.:';:i',:::::3,'",', Notified/Iviethod Supplemental Information :. 4 .... TYPE O j// W©tcil i0 - LAN P REVIEW 11] Newconstruction ❑ Addition/alteration /replacement Please check all that apply: ❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑ Hazardous location ❑ Service over 320 amps — rating 0Buildng over 10,000 sq. ft., " CATEGORY OF °CONSTRUCTION` r- of 1 and 2- family dwellings 4 or more new residential y [ 1- and 2 family dwelling ❑ CommerciaUindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories ❑Feeders, 400 amps or more ❑ Multi - family ❑ Master builder ❑ Other ❑Manufactured structures or ❑Occupant load over 99 persons -o N ," RV ark • ,' , . dOB SI TE t IN F ORMAT I ON AND L , OCA TIO, h. ; : . : ❑ Egress /lighting plan p Job no .: J ob site address: ❑Health -care facility ❑Other: 07 -424 14786 SW Jonagold Terrace. Submit 2 sets of plans with any of the above. City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: Project name: '= tf:'Z;.i'- FEE* ;SCHEDULE Description Qty. Fee. Total 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 1 Limited energy, residential 75 00 2 Tax map /parcel no.: Limited energy, w c ., ._ on - residential 75 00 2 gy, s ;DESCRIPT ION OF WORK ,, sue` ` Each manufactured or modular dwelling, service and /or feeder 90.90 2 A/C connection Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 x vs 201 amps to 400 amps 106.85 2 . ,'. - ® PROPERTY OWNER :.„ t- E TENANT'. 401 amps to 600 amps 160 60 2 Name: Matt & Sasha Sten 601 amps to 1,000 amps 240.60 2 Over 1,000 amps or volts 454.65 2 Address: 14786 SW Jonagold Terrace Reconnect only 6685 2 City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or relocation Phone: ( 503 ) 515 -3955 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 600 amps 133.75 i 2 Owner signature: • Date: Branch circuits — new, alteration, or extension, per panel ` x '° A Fee for branch circuits with ® APPLICA COl�TPiCT EER service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, each branch circuit 1 46.85 46.85 2 Address: Each add'l branch circuit 6.65 2 City /State /ZIP: Miscellaneous (service or feeder not included) Pump or irrigation circle 53.40 2 Phone: ( ) Fax: : ( ) Sign or outline lighting 53.40 E - mail: Signal circuit(s) or limited - ,.: :` ....'w. Q. ..' a . m <,, : „.µ;.CONTRACTOR .. '." ' .. ,: _ a . µ.: energy panel, alteration, or extension Describe. Page 2 2 Business name: Bob's Action Electric Address: tt tt Each additional inspection over allowable in any of the above 2700 NE Burton Rd. A Per inspection 62.50 City /State /ZIP: Investigation per hour (1 hr nun) 62.50 Vancouver, WA 98662 ( 3 60) 254 -7200 ( 360) 2 54 -8219 Industrial plant per hour 73.75 Phone: Fax: ;1 .'.M, "._._��'...... ..�- . _;._ " .,,;,,,„ FLECTRICAL,PERN[IT- ;<FEES * ;�� ,. CCB Lie.: 53136 Electrical Lic.: 37 3 - uprv. Lic.: 4322S Subtotal 46.85 Suprv. Electrician signature, require- �--/' Plan review (25% of permit fee) State surcharge (8% of permit fee) 3.75 Print name: Kevin Broselle Date: 4/17/07 TOTAL PERMIT FEE 50.60 Authorized signature: This permit application expires if a permit is not obtained within 150 days after it has been accepted as complete Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board ** Number of inspections per pemut allowed. CITY OF TIGARD BUILDING DIVISION ' ,'-.- l P PERMIT #: ELC2007-00262 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/19/2007 I Phone: (503) 639-4171 4 , 0 4 1 /At Inspection Requests (24 Hrs.): (503) 639-4175 11. INSPECTION WORKSHEET FOR . DATE: 6/4/2007 TIME: 7:00AM PAGE: 67 SITE ADDRESS: 14786 SW JONAGOLD TERR CLASS OF WORK: SUBDIVISION: LADY APPLE LOT #: 001 TYPE OF USE: PROJECT NAME: STEN DESCRIPTION: Airconditioning connection. OWNER: STEN, MATT & SASHA PHONE #: 603-616-3956 CONTRACTOR: BOB'S ACTION ELECTRIC INC PHONE #: 360-2547200 Inspection Request Scheduled For: Date: 6/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 047492-01 360-254-7200 Y 4-724 4 Corrections /Comments/ Instructions: r .- % PASS PARTIAL APPROVAL n CANCEL 0 NO ACCESS _ I I FAIL fl CALL F R INSPECTION Ft ADDITIONAL FEES ASSESSED Date:. / Phone #: (503) 718- • . „ - .