Permit i ITY OF TIGARD ELECTRICAL PERMIT
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} COMMUNITY DEVELOPMENT PERMIT #: ELC2007 -00450
DATE ISSUED: 7/11/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DC-17300
SITE ADDRESS: 13236 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT : 028 JURISDICTION: TIG
PROJECT: ATCHISON
Project Description: Install disconnect at condenser /wire from to electrical panel and add a breaker.
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:
SUSAN ATCHISON OWNER
13236 SW LAURMONT DR
TIGARD, OR 97223
Phone: 503 - 590 -4422 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 7/11/2007 $46.85
[TAX] 8% State Surcharge 7/11/2007 $4.28
Total $51.13 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. •
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Issued : •. / • Ii Permittee Signature: T_a /.7tphr'.4
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 Application
• , • TOR OFFICE USE. ONI Y ... - -. '- - . , - '•
,.
t, 0 5 Pe
Received
• - ' s I City of Tigard 1 r- Date/By: - 4 - '2 .-7- Permit N°: EZ.C2 - Oo 4 / 50
C
0 111 1 - -. 13125 SW Hall Blvd., Tig. 7 iEGE 1 \ ! r Plan Review
-.. '' - ' /2 .4 t,, _. Phon%: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
TA a A R D Inspedion Line: 503.639.4175 , U ,. Z./ttl Li ,,, . . i Date Ready/By: flui 0 See Page 2 for
'. ' • • Internet: www.tigard ;'; U I Notified/Method: I( I 6- Supplemental Information
Niili!:•. git***iiigitit 04tRi'i'iiiMiliiiiiiii;:ili:;:iii;iii;:;:!iii;ii:;:iii:1:;:i;:;::;:';:; '::::i:;:;:::::;:
0 New construction ja(AdditamtragijAaVagliN Please check all that apply (submit 2 sets of plans w/items checked below):
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards.
::•::a::::;:;:;:;:;:;::;:;:;:;::;:;:;:;:;::;:i::;:: ::i•,.„:- exceeds 10,000 amps at 150 volts or 0 Floating buildings .
i:-:i:i:'•:]:i:i:;i:iii:iii:iiiii::::::ii:iiiiii:i:.:::::::::::]::::::ii::::::::' less to ground, or exceeds 14,000 0 co erctst-ose agricultural v
tigt...1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
0 Multi-family 0 Master builder 0 Other: 0 Fire pump. 0 Installation of 75 KVA or
larger separately derived system.
::::•;;VMiTi40**glift*Wit#W#4.0$00:80 0 Addition of new motor load of 0 -A- -E- -1_2- -1_3-,
Job no.: Job site address: /3 2 3 4 54 totkot_maawr £ 100HP or more occupancy.
.. j 0 Six or more residential units. 0 Recreational vehicle parks.
City/State/ZIP: as ( 4. I 1 . 2 ._ 3 ..„-- T 4.,,frev-i, 0 Health-care facilities. 0 Supply voltage for more than
i . 1 0 Hazardous locations. 600 volts nominal.
Suite/bldg./apt no.: I Project name: 5;4-5 a Pi I1/4 5 1:764 0 Service or feeder 600 amps or more
..**: ..... . .. ....
............................................................................
Cross street/directions to job site: 4 d 1 2 4-art .?t.. Description I QIY. I Pee. j Total I
o 147 ,5 - put, r (Ai oi , v et eiaj o vtli ii. 1 tiver 4 in multi-family dwelling unit.
Subdivision: Lot no.: 1,000 sq. ft. or less 145A5 4 .
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map/parcel no.: Limited energy, residential
75.00 2
PP 1*: (with above sq R.
Limited energy, multi-family
75.00 2
Dckad Volt 5 crobbici e co,t1)&5se- c o t re i-r 4_0 residential (with above sq. ft.)
Services or feeders installation, alteration, and/Or relocation
e tr_ f o pit_ es LP) GrE icat
s or less 80.30 2
P
4iikiiiiiti::::ciiisiiii::::::::;:::::::::::::::.:::ii::::::::::::::1;tfigiiiiii::::::::::::::::::::::::::::::::::::::::::::::::::::::., 200 am 201 amps to 400 amps 106.85 2
::':r::: :.:::.:::::::::::::.:::-.:.:.:::,:::::.
Name: 4 vt... 4 'A p_-7-,,t, L s Q (A 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: t 3 2, - z, 1 5„3 (a. LA.r aril- P a.. Over 1,000 amps or volts 454.65 2
)
City/State/ZIP: ' , C-A G A 11--D Temporary services or feeders installation, alteration, and/or
relocation
Phone: (536 ) '15 .t67 5 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This ivistalld'6 s b.:A g made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, r/ . 40 C3. i• t, according to ORS 447, 449, 670, and 701.. 401 amps to 599 amps 133.75 2
/ //
, 7 Branch circuits - new, alteration, or extension, per panel
p/Owner signature: / A Date: i/ -2/7 A.
--,, • Fee for branch circuits with I
ig g3 ...) : . .!..: :: E1ii 1 each branch circuit
iW***** . : : : :: iiiil giii!:;::::::iiii above service or feeder fee , I 6.65 2
'' ,.;., .." A , / 5
Business name: •5 .44 a 41/4---T t 0,- -
B. Fee for branch circuits
without service or feeder fee, i i l
Contact name: 4 t4....5 .-t.-1
first branch circuit 46.85 2
Address: (3 2- 3 s-3 Eat-L(t-L. crr' er-- f‘ , Each addl branch circuit 6.65 2
) Miscellaneous (service or feeder not included)
City/State/ZIP: *fr, ( tri24) o a_ 1 7 7 2 3 Each manufactured or modular
90.90 2
t . dwelling, service and/or feeder
. Phone: (5193) 51' p , 4,4 q....q____ Fax: : ( ) Reconnect only 66.85 2
E-mail: 54.4-c,ki Si c e... C.,41.-4 IA 44-c 6. r, CVM Pump or irrigation circle 53.40 2
i. sign or outline lighting 53.40 2
Signal circuit(s) or limited-
Busmess 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
tfktttfOV:.it**t 07*,.:;.
,
Suprv. Electrician signature, required: Subtotal: !!' - -'' '''' '-':?' "5/6155
Plan review (25% of permit fee):
Print name: Date:
State surcharge (8% of permit fee): . , 2...‹
Authorized signature: TOTAL PERMIT FEE: .
This permit application expires if a permit is not obtained wi in 180
Print name: I Date: ' 0
,iii,
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00 0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/11/2007
Phone: (503) 639 -4171 /oryPu�i'�I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7619/2007 TIME: 7:03AM PAGE: 50
SITE ADDRESS: 13236 SW LAURMONT DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER. LAKE PARK LOT #: 028 TYPE OF USE:
PROJECT NAME: ATCHISON
DESCRIPTION: Install disconnect at condenser /wire from to electrical panel and add a breaker.
OWNER: ATCHISON, SUSAN PHONE #: 503 - 590-4422
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/19/2007 Pour Time:
Code # ss.ection Description Confirm # Contact # Message
145 NC or heats nit circuit 052343.01 503 -590 -4421 N
. rrections /Comments /Ins ruction .:
•
N
A PASS PARTIAL APPROVAL CANCEL _— ❑ NO ACCESS_
n CALL FOR INSPECTION • ❑ ADDITIONAL FEES ASSESSED
Inspector: C.7 Iv e) L Date: ° 1 f j et 09 Phone #: (503) 718-. 46
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