Permit */ oB Lt"- — t w.-t I .
514 CITY OF I GAR E PERMIT
° PERMIT #: ELC2008 -00243
° COMMUNITY DEVELOPMENT DATE ISSUED: 5/1/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S135DC -00700
SITE ADDRESS: 11870 SW LINCOLN AVE ZONING: R -7
SUBDIVISION: TIGARDVILLE PARK LOT : 008 JURISDICTION: TIG
PROJECT: NASS
Project Description: Replace service panel. 5/5/08, ADDING (2) BRANCH 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: 1 W /SERVICE OR FEEDER: 2 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:
KRAIG NASS OWNER
11870 SW LINCOLN AVE
TIGARD, OR 97223
Phone: 503 - 267 - 2265 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 5/1/2008 $80.30
[TAX] 12% State Surchar 5/1/2008 $9.64
[ELPRMT] ELC Permit 5/5/2008 $13.30
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $104.84
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be d • • - . • accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more th- • 80 days. • ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 9:2- 001 -0010 through BAR • : - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issue • By: 0 , Permittee Signature:
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE: .
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1 ,
Electrical Permit Applita_ti T°' n FOR OFFICE USE ONLY
Received it, pa Permit No.: E4
City of Ti C r: ' : DateB : 5,a b r 4-co ea 1312 SW Hall igard, OR 97223 Plan Review
' � - gil . Phone: 503.639.4171 aN 5t13:1 0$ Date/By: Other Permit:
T I G n I(D Inspection Line: 503.619 4I'75 Date Ready/By: Juris: 63 See Page 2 for
Internet: www.tigard or.gov _ }y :'j Notified/Method: Supplemental Information
G� r E ( OIj- 1 �iro w�
PLAN REVIEW
❑ New construction '•Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: h / , �!�, p IOOHP or more. occupancy.
v �� ✓ 1 n �I f I" \' ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: --J rd O2 9 7 Z Z 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.. Project name: 1`-' A SS ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
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 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
ti e p1C . se (� V I t _ °_ �� t o Q I residential (with above sq. ft.) _
Services or feeders installation, alteration, and/or o on
200 amps or less / 80.30 X 0 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps _ 106.85 2
Name: r�l 4 S S 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: i O 51. LA h c-G 1 ' n 1� % .1 . Over 1,000 amps or volts 454.65. 2
City/State /ZIP: - / 7 2.- —...S Temporary services or feeders installation, alteration, and/or
1 ' ✓ d 0 relocation
Phone: ( 5o3) x/07_ ZZ 45' 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 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Owner signature:
Date: $-J -�
A. Fee for branch circuits with
❑ APPLICZNT I ❑ 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 2
first branch circuit
Address: Each add'I branch circuit 6.65 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
Business name:
Address: /( Signal circuit(s) or limited -
��/ u energy panel, alteration, or
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 g
Suprv. Electrician signature, required: Subtotal: i •
Print name: e �� S Date: s , —cb
State surcharge review (25% of permit fee): —63-- rg' v ge (12% of permit fee): 9 •
Authorized signature:] TOTAL PERMIT FEE: g4 9
� r This permit application expires if a permit is not obtained within 180
Print name: i q t p 3 Date: S - — OW days after it has been accepted as complete.
lets
• Number of inspections allowed per permit.
I:\Building\Permits\ELC- Permit . oc 05/23/06 440 4615T(I I /05 /COM/WEB
Electrical Permit Apilication - City of Tigard
_Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
( RESIDENTIAL WORK ONLY:
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
•
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PertnitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B -00243
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/2008
Phone: (503) 639 -4171 km, r F III
Inspection Requests (24 Hrs.): (503) 639 -4175 =� -
INSPECTION WORKSHEET FOR DATE: 8/29/2008 TIME: 7:00AM PAGE: 17
SITE ADDRESS: 11870 SW LINCOLN AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: NASS
DESCRIPTION: Replace service panel. 5/5/08, ADDING (2) BRANCH CIRCUITS.
OWNER: NASS, KRAIG PHONE #: 503 - 267 -2265
CONTRACTOR: OWNER PHONE #:
COKN1e'6L Cr(L1 6u(ZI.
Inspection Request Scheduled For: Date: 8/29/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 074861 -01 503-639-8686 N., Y
Corrections /Comments /Instructions: ^n ONLl
N ,• . � \. _ 7cAv_.� :ac s• +.4!J`��.: k.` .41:.C.2 ' 4 .
\ V . '
4 k_ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (5 PvO61.- Date: l'�C't ` Phone #: (503) 718- 1.-0"
CITY OF TIGARD �$ s
BUILDING DIVISION - A 0 A A PERMIT #: ELC2008-00243
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1/2008
Phone: (503) 639 -4171 :r ,' "'� (It
Inspection Requests (24 Hrs.): (503) 639 -4175 P :_..
INSPECTION WORKSHEET FOR DATE: 5/6/2008 TIME: 7:00AMM1 PAGE: 29
SITE ADDRESS: 11870 SW LINCOLN AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 008 TYPE OF USE:
PROJECT NAME: NASS
DESCRIPTION: Replace service panel. 515108, ADDING (2) BRANCH CIRCUITS.
OWNER: NASS, KRAIG PHONE #: 503- 267 -2265
CONTRACTOR: INN PHONE #:
Inspection Request Scheduled For: Date: 5/6/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Messes - vi--
1'15 . Electrical service 069423 -01 503.267 -2265 411. i Z
Corrections /Comments /Instructions:
( 7_______Ifa es9u c)1)5
ter., r
■. PAS V PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
• FAIL ►, CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, _>
Inspector: Date: .c te Phone #: (503) 718 -Z7