Permit CITY OF TIGARD' • ELECTRICAL PERMIT
PERMIT #: ELC2008 -00174
N. COMMUNITY DEVELOPMENT DATE ISSUED: 3/26/2008
TIGARD . 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S135CD-03300
SITE ADDRESS: 09660 SW LEWIS LN ZONING: R - 4.5
SUBDIVISION: RUTH LOT : 003 JURISDICTION: TIG
PROJECT: ORR
Project Description: Replacing 200 amp meter base.
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: 1 W /SERVICE OR FEEDER: 3 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
KAREN & LYNART ORR PACIFIC NORTHWEST ELECTRIC INC
9660 SW LEWIS LN PO BOX 310
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: Contact #: PRI 503 - 657 -1188
FAX 503 - 722 -9058
FEES
Description Date Amount Reg #: ELE C6
[ELPRMT] ELC Permit 3/26/2008 $80.30 LIC 162893
[TAX] 12% State Surchar 3/26/2008 $9.64 SUP 5089S
Total $89.94 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: �e Q C3 /
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.
' '•'3/25/2008 00:52 5037229058 PACIFIC NW ELECTRIC PAGE 01/02
j iectricai. Permit Applicati El Eb rot: r: rricI_ 115F, OLY 1 Received
° 1 3125 SW Hall Blvd„ Ti Dare/B : 36 'sr permit Nn,; ,e ],kJ
i p _ gard, OR 97223 c n Plan Review
a• ct1�7
Phone; 503.639,4171 Fax: 503.598.1960 4.1 4 5 2 O 1) atcBy: Other Permit:
T I G A R n inspection Line: 503,639.4175 T _
lateral: www,tigard�r,gov C' r DaleReadyBy: h;;p
i _ •
, wt T i , Notified/Method: : S See Pam 2 Information
: ,:.1, pp enutllnforronlrnn
..1,1 r .- : .. r7 :1.;1 1i , Pi. ,ly.j li -VA '"o � :4„n a r
y'i " 1 , ' ' ' 7 n ...V' 4 1 „ ".` iill” it x. itl, n., i u"! 11 . 1u I '' il 4a % k ilt.: ..ia: H Cln
� l iC �t'FiY� /, n , i ., . , � :, .. ' 71➢ . ,,i.' � G FIT IF n ' ;�I " (� . . II ; (! l al '` r C:: �Y�Y l a i;, ; , c7•;•,' ,I ;�'r•i1a. ,y.� y�Ig' u �� �y 1 •N - .A ' .1 , "L'm iC ",... ::,.L4 , .:;.b ,rL.0i l, ; 1 ii 'IY nr( I ' ; 1:'.!; Li !; : , : , .
, ❑ New construction E dill r - ' 4 ::: +aRl."1'�� ,•+ aiil!)n' Ogi,i.�ln....,.,���i,� i;j..,..� �i;ui' "1;5� �!ll;�:..:�' 1,..
on /alteration /re I i/ a "o ;:;'a,
' p accnment Please ch eck all that apply (submit 2 sets of plant Wheals checked bel
❑ Service or feeder 400 amps or more ❑ Building over three etnrics,
❑ Demolition ❑ Other:
:- 1iii'.;i� ! r.. ; r. i,ylT i;i:' Fl � ;�, l o . `, y..�y , 3 '� you L' � ` �j� ;1:,!u is va '1 "1 r' ;; acha,:. , where the available fault current ❑ Marinas and boatyards.
•" � , , - .• to;'' 2� , , �IV ..0441 " Im op' , o ,',,,� l,:lva l l�' 11M' I i i t i :�!li♦ii "Lul'I-11 . exceeds 10,000 amps at 150 volts or ❑ Floating buildings
1 - and 2 family dwelling ❑Commercial / industriai 0 Accessory building 'Al lless to ground, or exceeds 14,000 i:3 Commcieini- ascagricultnrnI 3fOrt$ for
er irepumeltetherinstallatione, Installation ❑ Multi - family ❑Masterbuild f,
,,,, 1, r, y�t�p _ Other: ❑ Fire pump. ❑ lnetallaNnn of 7S KVA or
P•;∎11 _ 1`.:'i 1 `.: 1.1 Vii"? ; _1' ii a• ;! ; t ia: , S .. 1 .. P y I i at ❑ Emergency system,
r; :i . , ,,,, ..1, ,li . ,: . , , 1 1179 , 72 ., !;.... .. I� " n f, u,l.l1 I' L: i cy w 111 IArgersep - 3",
Job no.: system.
, b,e "i,lni „7 �,N:,;t:.:,,) Ystcm.
� ❑ Addition of new motor hid of 0 ••�•• - g•• , • '1 2” "1 - ",
Job site address: Y ( 0 �'/ ^ / ,) ei , , I00Fm or more. occupancy.
l v� `•e UW t� 14 Q Six or more residential ouch, ❑ Recreational vehicle parlc4.
City /State /71P: . / 0Hcalth - cite fnei litics.
❑Supply voltage for more Than
c ' L r i
Suite/bldg./apt Project - ❑Hmardous IOCationS. 600 vnlLs nominal.
no,; name: ❑ Service or feeder 600 amps or more,
Cross St ii ( i .: i'y ;!'hXf:�1i! li 1, T, i� ,L', , • r, n:c
street/directions lions to , i .,:, 11,, g'1 ! r'::; a 6'
� job site:
i,rii fli��i9 • `; �.�I)i:ll{, � .. n7. „� J.2.9...." - '
�.: �," �JRIi; �li !� { t , �.
DmeW l i •
- New residential sin or multi-family dwelling unit mat
includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: — Ea. add'I 500 sq, ft, or portion 33.40 I
ii r; ':I'i;j ii(' 'l;!:;15i /- ;!a,:ua'aeyy Limited energy, residential
i
i : . I ,, „I � l' ryyay, t yy q('�{ y,�,y,� p';' I
i 1' gtl'n, 1,,..,.,, 1 l ' V I ,i. " •� I:
..i ,;y •711'�'� I;j';'P;i 1, !11i' rJJtlII�F�Cii4�11111rY �L!', ,,' I n�1l�i�i it �i�'lh Sl lih��;l . >l ' S "IP� ( th
rep/ i � • � �' :i � 'Ili, . u I ," , ,.,,, wilt shave sq. )
cl u 1 0 + �I,r a /,+_/ 4 � Limited energy, multi- family
75.00 2
75.011 2
/ �'�-�r ,/� residential (with above sq. R.)
Services or feeders installation a lteration, and/or relocation
;;`i i; "; '' !1 .�yWl�w �)I� J 7 ,. IN f t I f n I I i r., 200 amps or less / 80.30 R• 3 0 2
''' ii'i 2i a �lfrA�luT,. Eit (ij'i'i jgi';�;;I� `yi !;u, I,�a, I11 1 i 11 1(11'• lQt' 1'i I l dII it,,,1113 s V
. ',h 1 • L, , 1F.� i,� �. lb "i ,.iii 20I amps to 400amP 106,85 2
Nam (oi l fe_ A) d. L yam( Oi 401 amps to 600 amps 160.60 2
Address: 601 amps to 1.000 amps 240,60 2
Over 1,000 amps or volts 454:65 2
City/State/71P: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) 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 maps to 599 amps 133.75 2
:
Owner signature: Dale; Branch circuits - new, alterator extension, r panel
i ig a ` . , ' In b A, Fcc for branch circuits with
Ili'::: C.I'' • , 1 ii:Za x3,111 C+S6ittiN l' �i�'1!li' ;I hii, Pl : I i ' AI!t; SIII" )R'11',:'•u•
�� i 'h�rj���lui,' ' ?�1 l i l ll vl ! ll' Ct1I9 � "i�I t Li�' i
! ..,t • " above or feeder the' 6,65 2
'
,. ,. ,...., o
Business name: /� l /' , , _ each branch circuit
-
Qu vw�sl ��'1 e _ B. Fcc for branch circuits
Contact name: without service or feeder fee,
46.85 2
f , first branch circuit
( .9 b Address: i,), L /t? Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZiP: 0 r �h C./1-121 Z- q7 aall 73 Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: (9 6) 1.--ii i • Tax: ; ( 72 — Qom( Reconnect only 66.85 2
E -mail: ,V , /ef 1 J''JJ
- i4 LA, W�� • �.� .C' t3'1�1 Pump or irrigation circle 53,40 2
, :ilI I'r•i v 11:�
�nii :jl!i ^ . 11 eli!t 7 : : j : i� 1':I a dill i 71' " . U:Il i l 11v, I ' it a ., il l ;t'Itn i'GuC'i iYll�a:ej;x.1:�;,' I. .i�1 ,; . ;!•i11 11, { /1
., u:,i, "�! .r :II :.al, Sign or outline lighting 53.40 2
Business name: Signal circuits) or iimited-
/ ..... — energy panel, alteration, or
Address: extension. Describe; Page 2 2
a
City/State/ZiP: �� r Each additional inspection over allowable in any of the above
-
Phone: ( ) Fox: ( ) Per inspection 62.50
invectigation per hour (1 hr min) 62.50
CCI3 Lic.: t f 3 Electrical Lie.: c_( Suprv. Lie.: cbgq s industrial plant per hour 73.75
5uptw, Electrician signature, required: 1 i hill. "'I ,ril'nii ?j I• • 1P t illl :11 :• .S.ii ^j41ki
t ! tal: to, i
Subto Print name: „Ili � >r �� Plan review (25% of permit fcc): —
/ — State surcharge (i2% of permit fee): , (Cy
Authorized signature:
• I TOTAL PERMIT FEE: l Ci ,I'
Print name: e r / 1 i Tills permit application expires If a permit is not nliainr�r within 180
p t, D ate; �' d days after it hmm been accepted na complete.
• Number of inspec(lons allowed per permit.
1: 1OuildlnplPmnitAOLC•PermllApp.doc 05 /23/a6 440- 4615T(II /OS /COMMBB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B -00174 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2&2008
Phone: (503) 639 -4171 :� , eq,,,
Inspection Requests (24 Hrs.): (503) 639 -4175 I I..
INSPECTION WORKSHEET FOR DATE: 4/4/2008 TIME: 7:02AM PAGE: 27
SITE ADDRESS: 08560 SW LEWIS LN CLASS OF WORK:
SUBDIVISION: RUTH LOT #: 003 TYPE OF USE:
PROJECT NAME: C)RR
DESCRIPTION: Replacing 200 amp meter base. 3/31/08 ADDED (3) branch circuits.
OWNER: ORR, KAREN & LYNART PHONE #:
CONTRACTOR: PACIFIC NORTHWEST ELECTRIC INC V , , ` PHONE #: 503 - 6517
Inspection Request Scheduled For: Date: 4/4/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 067725 -01 503 - 657 -1188 Y
Corrections /Comments /Instructions: d i t) �
u\ Li 1-a
1.•6 � (t. (2.,E v■ l'EL, A - G-& 0/4O wl ("z_-)
E" 1\97 �a� IoQ �� I Cc,.
V
PASS El PARTIAL APPROVAL_ _ 111 CANCEL _NO ACCESS
❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Cr 11V ®e Date: Li I • trio Phone #: (503) 718 - 1)11.ho