Permit ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT D: /26 /2 07-00280
COMMUNITY DEVELOPMENT
DATE ISSUED: 4/26/2007
TIGAR 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S125CD-04105
SITE ADDRESS: 09880 SW LANDAU PL ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: MANDAVILLE
Project Description: 3 circuits
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:
MANDAVILLE, JON E SUNSET HEATING & COOLING
9880 SW LANDAU PL 0607 SE IDAHO
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: 503 - 452 -2325 Contact #: PRI 503 - 234 -0611
FAX 503- 234 -0439
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 4/26/2007 $60.15 LIC 161085
[TAX] 8% State Surcharge 4/26/2007 $4.81 SUP 4638S
Total $64.96 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: Permittee Signature: Api t
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.
T 25 07 03:30p p. 4
' Elec Permit Application 1Olt (1)i 1.1(`11 1 Sl: 11\ 1.1 Recei Permit No.: ,,2067 -O ZD,2 $t
City ®f 'Tigard evED DatdB : i!�/LL
13125 SW Hall Blvd., Tigard, OR 97 x EC O � Pl Review
Phone: 503.639.4171 Fax: 503.598. ' . i 0 u �, At, - Other Permit:
�'" *' I i ' Date/I3
Inspection Line: 503.639.4175 R 2 5 2 = a •f � _ Date Ready/By: 1��s: 91 See Page 2 for
AP G n u Noufied/Method Supplemental Information
Internet www et ngard or us 1+R
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• '• uc t „�! r p Please check all that apply:
❑ New construction ® Ads + v • teration/re lacement
❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
v* , a� I .. .. t E r . Nra. 2"'f. ..� ° ,Xk xrit i k r ,y.,.r * d a ,z. h}�v;
;11 v . r� 12/ n . t � § *� s ,:" of 1 - and 2 family dwellings 4 or more new residential
+ka � rvti h .9^
-n . 5'f , . � F,x .- � .. p,. ..:. , . .�.?z= 5, °w.�a .. :. C,r "++ ,.
$ . •. •.... . - •, units in One structure and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ['System o 600 volts nominal
❑Building over three stories ID Feeders, 400 amps or more
❑ Multi family 0 Master builder ❑Other ❑Occupant load over 99 persons ❑Manufactured structures or
� ,F+'i: y,;ugir sir^ l fl" :t f :ti s a `" as "' 7 NK r��« i i 54y '3 f RV park
} s , t„ ta xt � s� n4,,, ❑Egresw. p
,` ' ��2r+ �. r�e >an�i,tt...,�;f;;K,,.,.:�„ +.a ,,::.�,•�.r,u.�,w.. ».a..,�a3 �b .a,'Sks«�:�
Zt ❑Health -care facility ❑Other•.
Job no. I `? ? Job site address: (.) --\, ‘t.,, t.;t t i i
Submit 2 sets of plans with any of the above.
City/State/ZIP: -_ .I !": (; r i' _? The above are not applicable to temporary construction service.
Suite/bldg./apt. no Project name: 1h3i(sti � 1, ; s . .. Liz nexrio. Qty F. 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 l
Limited energy, residential 75.00 2
-
Tax map /parcel no.: Limited energy, non - residential 75.00 2
+K. ::v4 , ".. ..,,.+Q....Fa: W ff, L a`N 1±3 l.'',: t4 a= a y '.
,., 1Trs : :'n�'n,.-e 2 i'�` '" .`., , -w-M0 r v= race ; , : ... et'> %xlam;�• a.,n�.:u�, x.
. `''=,r' ,sue; ^..<(': ,��a w..:� ; �yr�y� : iw .€3 „r:z!;;., , �.,;,,,; s; �= � >; .n.,� „7::?s�,,.,r Each manufactured or modular
VS; t.°:; slv. 2c- r�`-' s. T;:§ cv- w` zsttk: 3,^t +_deaY"1vr: ^8c' ..�...., ..xxr.r..,
( ' .. dwelling, service and/or feeder 90.90
'4' i - S (.( - ,h i 1` . 4 , {- '1-i") Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
. , ,, 1.:` :,..:, ., .,, <- r it :04,11: 4. 201 amps to 400 amps 106,85 2
- x ,,;, t „r z "::. , f -W; ,,,...M, u. �w p p 160.60 2
�� ,,; �'a ; , -°,ar ta;, � � ,�. „ xa� ,• �� 401 amps to 600 amps
Name: '71,1,;(.)4, tl t,/ ;< ;,'-, ;r±,, -jJi + i/1 ; ‘1,,,/_, 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
Address: i ` 5�� ,5 t ,:.. );`YSf t,7:1...` i 66.85 2
i R econnec t on
^ ` `• `'> Temporary "
CCity/State/ZIP: 'T' ?�' 1; , 2/•i_, - Tem services or feeders installation, alteration, and /or
rY
relocation
Phone: (` , <a) = lkr %r. l 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 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
«• ''`' "lra w `• A. Fee for branch circuits with
s "n,�Y V `::'a, iC: ; ` A ■f; K;..:*<, 3. ".� A?w,kxi'i rFE tw g:o,.,ty...:aty i' i--.:; "•"s-
; t' ; t,.,
,;��,, �st�;rt; h ";? � '� f � y'..,,._,�"•r..,,. . "_, .r,,. �...,e<,+ , ,. -.. service or feeder fee, each 6.65 -,
Business name: branch circuit _
B. Fee for branch circuits
Contact name: without service or feeder fee, t, ; r i,;�:, -- 2
first branch circuit l 46.8 r ` w�
Address: Each add'I branch circuit
I 6.65 ' % 2 . 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 2
E -mail: a Signal circuit(s) or limited -
mix su a, ` I&' r'c,a r �1" „ t,, t '' fri s,14 'w; ffa; ? : �;; i .,- energy panel,
a `, :;s;.a' alteration, or
Page 2 2
...�.. ti m7a. � � - "° �' extension. Describe: g'
Business name: Sunset Heating and Cooling
Each additional inspection over allowable in any of the above
Address: 0607 SE Idaho Per inspection 62.50
City/State /ZIP: Portland, OR 97239 Investigation per hour (I hr min) 62.50
Industrial plant per hour 73.75
Phone: (503) 234-0611 I Fax: (503) 234 -0439 , E 4 �-- 1 4=
CCB Lie.: 161085 Electrical Lic.: CI 17 Suprv. Lie.: 4638S Subtotal °U . rt
Suprv. Electrician signature, required: ` Plan review (25% of permit fee)
,�
,t , at . 1 i State surcharge (8% of permit fee) 4 ' io, us
Print na f ai 1.Gw ESS ,, Date: E...1 ; c' �,,,„ i. k,) i
TOTAL PERMIT FEE R I Cp' ' 7
Authorized signature: v This permit application expires if a permit is not obtained within ISO
d ays after it bas been accepted as complete
Print name: ,�►1 yt z2/ y? j _ yy)tg 16'- Date: 41, 3 4 ` 3 ), Li t • Fee methodology set by Tri- County Building Industry Service Board
}
•• Number of inspections per permit allowed.
i:\ Building \Penuits\ELC- Pemi1App.doc 12/03 440- 4615T(l0 /02/COM/WEH
;- ,. ,--- ,-
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00280
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/26/2007
Phone: (503) 639-4171 /Ail i
,... ktiit
Inspection Requests (24 Hrs.): (503) 639-4175 L.
INSPECTION WORKSHEET FOR DATE: 6/712007 TIME: 7:00AM PAGE: 66
1 .
SITE ADDRESS: 091380 SW LANDAU PL CLASS OF WORK: •
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: IVIANDAVILLE
DESCRIPTION: 3 circuits
OWNER: MANDAVILLE, JON E, PHONE #: 503-452-2325
CONTRACTOR: SUNSET HEATING & COOLING PHONE #: 503-2340611
Inspection Request Scheduled For: Date: 6/7/2007 Pour Time:
Code # Inspection Description Confirm # Contact #
199 Electrical final 049577-01 503-462-2326 PA
orrections/Comments/Instructions:
or C.
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r o4,
/ do i Fot-tif' ot...it - ... A-frt r' k
Iliraik
• 'NEI.
WIPPr .
F ASS IP '' 'TIAL APPROVAL 0 CANCEL NO ACCESS
n FAIL I/ ' LL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspector: /1111111■. th/f_2_
Date: . Phone #: (503) 718-
11