Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00443
• COMMUNITY DEVELOPMENT
DATE ISSUED: 6/28/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DC-17500
SITE ADDRESS: 13270 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT : 030 JURISDICTION: TIG
PROJECT: GREENWOOD
Project Description: 2 branch circuits. Bath fans, lights, switches.
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:
GREENWOOD, CAROLYN K OWNER
GREENWOOD, BARRY J
13270 SW LAURMONT DR
TIGARD, OR 97223
Phone: Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 6/28/2007 $53.50
[TAX] 8% State Surcharge 6/28/2007 $4.28
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 • � nter. 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 OU .t 5k 3 • ..6699 or 1.800.332.2344.
Issued By: Iv . J 4 _ �� Permittee Signature:
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 Applicatio p .,,,.,,..,....., .
r FOR OFFICE USE ONLY
City of Tigard 7 Received ; Q • PermitNo.:�X _. j/ v9
JUN 2 8 20 0 1 /B . ��
a 13125 SW Hall Blvd., Tigard, OR 97223 plait D a t Revle
C t Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
f IG A R D Inspection Line: 503.639.4175 CITY p 4 A / .4 Ready/By: Juris: See Page 2 for
Internet: www.tigard- or.gov Y � r j'i�lt 1 .. ied/Method: Supplemental Information
TYPE DI `TG DIVISION PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction Er Addition/alteration/replacement
❑ 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 ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
['Addition of new motor load of ❑ "A ", "E ", "l -2 ", "l -3 ",
Job no.: Job site address: J3 -7D ..U) utuse f0 1 :0 tZ 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: 'Tr (,, A - (2.4. OIL cr.) 2-2- 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite /bldg. /apt. no.: Project name: 6',p_l.r 4 ❑ Service or feeder 600 amps or more.
FEE 'SCHEDULE
Cross street/directions to job site: eFF is 011 jZs` Description Qty. ► Fee. Total
I
35411 rT) p� i W H f�. O 0 , 1 - S n C M J�/ F t! .�1,� New residential single- or multi- family dwelling unit.
Lr— l ►1 I U Yr- -( 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 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
,,' ^ Limited energy, multi - family
I t +J� Rid--; t f p C � L-1 F� G FL residential (with above sq. ft.) 75.00 2
p, . /� Services or feeders installation, alteration, and/or relocation
i p i gy l L �1 & ' 1 �y,� MOO f K O • (z,) ro'IQ C44 l� �E 200 amps or less 80.30 2
[,PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name:
"
'1 6oc 401 amps to 600 amps 160.60 2
� f`� ��� 601 amps to 1,000 amps 240.60 2
Address: 1'3 () -t j J a-11 4j i 17 Over 1,000 amps or volts 454.65 2
City /State /ZIP: TT 6 f'P'10 ar-- '7-Z.3 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 5'2....-LI /,a 33 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This r • t llation is being made on property that I own which is not
201 amps to 400 amps 100.30 2
intended for sale, lease, `- = tt . ge actor ing to ORS 447, 449, 670 )and 70 . 401 amps to 599 amps 133.75 2
gn ,a, mr i _
Owner signature: Date: (I! � 0 —7 Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLI V, ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee / 46.85 ,1 Z 2
first branch circuit
Address:
Each add'I branch circuit / 6.65 ( (6 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: ( energy panel, alteration, or
Address: extension. Describe: Page 2 2 '
City/State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 53 , 5 b
Print name: Date: Plan-review-(25% of permit.fee):
I�C/I '
�f State surcharge (8% of permit fee): ._
n , .2.._
Authorized signature: 1 TOTAL PERMIT FEE: / , 7 D
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- PemtitApp.doc 05/23/06 440- 4615T(I1 /05 /COM/WEB
, •
CITY OF ��U��������
��m n n n�'n TIGARD
BUILDING DIVISION ~�~°,,~~�,,~~° ~°"°"~,,~~,° � PERMIT #: ELC2U0��D[449
13125SVVHaUB�d.. Tigard, ORO7223 DATE ISSUED: ��a/J(�y7
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A0�' s
INSPECTION WORKSHEET FOR DATE: 10/30/2007 TIME: 7:02AhA PAGE: 17
SITE ADDRESS: 13270 SWL/&/Rh40NTDR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 030 TYPE OF USE:
PROJECT NAME: GREENWOOD
DESCRIPTION: 2 branch circuits. Bah fans, Iihts, switches. Boines Feny Electric is doing the Serv See
ELC2007-00444.
OWNER: GREENWOOD, CAR{)LYNK. PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 103012007 Pour Time:
Code # ion Description Confirm Contact # Message
199 Electrical final 1 503-735-5652 N
Corrections o �`
uctions: ^, /
.. _''
.
.
�
��� I
APPROVAL - - -- ||j�{�A{%�ES8' -�
| �l�\L ~~
I I CALL FOR INSPECTION | I ADDITIONAL FEES ASSESSED
' �\�� ~+�
Inspector: ���—' ����k�� iQ�^ Date: 4A_______10 Phone #: (503) 718- 10'
`- . '
CITY OF TIGAR.D
BUILDING DIVISION , PERMIT #: ELC2007-00443
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/28/2007
Phone: (503) 639-4171 Apeettiq
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 8/21/2007 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 13270 SW LAURMONT DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 030 TYPE OF USE:
PROJECT NAME: GREENWOOD
DESCRIPTION: 2 branch circuits. Bath fans, lights, stivitches. Boones Ferry Electric is doing the Semice. See
ELC2007-00444.
OWNER: GREENWOOD, CAROLYN K, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/21/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 0E4383-01 503-735
Corrections /Comments/ Instructions:
• ' JAVIC 1
/
2A Cq 4-ta
PASS 1414 III°
1 PARTIAL APPROVAL CANCEL NO ACCESS _ _
I FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: , Date: 1 24 / C) Phone #: (503) 718-
.
ARD
'kW/kJ O F TI G
BUILDING DIVISION L. . p ''' PERMIT #: ELC2007 -00443
13125 SW Hall Blvd., Tigard, OR 97223 I DATE ISSUED: 6/28/2007
1G
Phone: (503) 639 -4171 114sit R' ; � i "{
Inspection Requests (24 Hrs.): (503) 639 -4175 _
INSPECTION WORKSHEET FOR DATE: 8/10/2007 TIME: 7:00AM PAGE: 47
SITE ADDRESS: 13270 SW LAURMONT DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #: 030 TYPE OF USE:
PROJECT NAME: GREENWOOD
DESCRIPTION: 2 branch circuits. Bath fans, lights, switches. Boones Ferry Electric is doing the Service. See
ELC2007- 00444.
OWNER: GREENWOOD, CAROLYN K, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 8/10/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 053782 -01 503 - 735.5652 N
Corrections /Comments /Instructions:
,r4/k 41) .0/4W 6A /(11)2"' ,
I - -I- PASS X_ PARTIAL _APPROVAL I�I_CANCEL I I NO ACCESS
FAIL j 1 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: / Date: 5 Phone #: 503 718 -
p )