Permit q CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00088
COMMUNITY DEVELOPMENT DATE ISSUED: 2/8/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BA - 14700
SITE ADDRESS: 09500 SW MARTHA ST ZONING: R -
SUBDIVISION: COPPER CREEK STAGE 4 LOT : 112 JURISDICTION: TIG
Project Description: Bathroom conversion.
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:
BARBARA BROWN DICKENSON'S ELECTRIC
9500 SW MARTHA ST 8449 SW BARBUR BLVD.
TIGARD, OR 97223 PORTLAND, OR 97219
Phone: 503 - 624 -9448 Contact #: PRI 503 - 246 -3550
FEES
Description Date Amount Reg #: ELE 26 -140C
[ELPRMT] ELC Permit 2/8/2007 $53.50 LIC 65534 •
[TAX] 8% State Surcharge 2/8/2007 $4.28 SUP 31005
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 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: ":37: �% Permittee Signature: SR R , t, \ gy p
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.
PAGE 01/01
02/06/2007 07:16 503627 � i vFI N LAN IBDSHI
• -
Zlectrica Permit 44 alicativn
P i.chti(irrri l lr.()N1,1
City of Tigard F L3 0 8 2007 D ?•►.,
1 7 G O c
: 1 4 __ 13125 SW Hall Wed,' ,card, OR 97223 —
Phone: 503,639.4171 Pax 503598 :l�a,9966��0
T i <, . i, r, Inspection Line: 503.6 .9.4175 x,1 Y Ur i ilI • /p . • othetPemzic
Internet wwwtigard -c ;goy . �T T r niiii N Judi: H S ene l Inf
Il Suppl
• . TlTg Oa.WORK. . '• • •::'.• :_...
❑ New eonsttuction ,dditi m/alt�eration/replacetnent . Hesse thuds all that apply (submit 1sets of plans w cbedoe belo , :
❑ DGmojitlQn 0 Other: ' Q Service or feeder 400 amps or mom 0 Building over tunec stories
where the available fault current 0 Marines nerd bas:yards.
' • : ......... i.. ' :. • ' ': I GAT:g4 1164.01y ONS I tUCl1O1y • • .. ; , . .. ; , . camas 10,000 000 amps m 150 volts or 01 towing buildings.
1- and 2- m lly dwelling Q onchnoercittl/mdihsttyal E 3 Accessory building - leas to ground, or exceeds 14,000 Q Castmmas! -use agricultural
El Multi- amps for ail other installations. buildings. ❑ i 4 asta builder 0 Other: O Fire pump. Q lestetlad of 75 xvA or
• SOB bl'i ]!�i F 1TION 'i►i�ID LOCA1T0 1:' 0 maim. l rely derived system
Q Ad&tiasraFoaw motor lead of CI nA °, 'E","1-2",
Job no.: b site t ddross: r G ta v� I� 10011por occupancy.
CI siltur mate =Ideate! Mgt. O Recreational vehicle parka.
City/Stale/ZIP: r O xealtbtme fatal idea. l7 Supply voltage for mine than
17 Hazardous locations. 600 wits nominal.
Suitelbldg./apt no.: 'rojext name: Q sarvi4e or feeder t;ao amps or more
Cross street/directions to job site : — ,' FE .6CHED17LE.'
.,� "� Fee.
1 files r .. . 'A ,• r •
•
New residential single -or multi•family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. it or less 145.15 ' 4
Tax map /parcel no.: 1a WWI 500 sq. R orpwt�iem 33.40 1
y . Limited energy, residential
. : .. . DPS 'R1P I'ION' O # . (aitb above M. R.) 75.00 2
Limited energy, multi-Sunny 75.00 - 2
residential (with above se. ft) i
Services or feeder, iustaItatton4iteration, and/or reloc . ; , a
r: BOFE . . OyY1!1> E 2 or less 80.30 2
:.Q :TgNAr rr :. .:: 201 amps to 400 amps 106.85 2
Name: 401 apps to 600 amps 160.60 2
Addr 601 amps to 1,000 amps 240.60 • • - 2
Over 4000 amps or volts 454.65 2
City /State/ZIP: • Temporary services or itseders Installation, alteration, and /or
relocation
PlWrte: ( )
— Fax: ( ) 200 amps or leas 66.85 1
Owner installation: This installed m is being made on property that I own which Is not 201 amps to 400 amps . 10030 2
intended for sale, lease, rent, or exc lunge, according to ORS 447, 449, 670, and 701. 401 amps to 599 ahps . 133.75 2
Owner signature: Date:
Branch elreatts new, alteration, or e�cteaaioa,per panel
i3 4�� v .; z _ . :
i ' ' - A. Foe for branch circuits wait
<<p,ai r :�:` :r' i; ., . ' . .D A;et tf:: above
,ti0[!It ; r. servicear feeds See,
each branch circuit 6,65 2
Business name B. Fee 8or branch scants
Contact name: •
i,ti without service ice o feeder fee, / 46.85 2
Address: . Each add'I branch circuit / 6.65 2
City /StBtt/ZIP: Miaceisneous (service or fe not Included)
Each manufactured or mo 90.90 2
pb ; ( ) Fax:: ( ) dwelling and/or feeder
Reo unectonly 66 -85 2
E-mail: • Pump or irrigate circle 53.40 2
. •'t Fr • IZA CTOR Sign or outline lighting 53.40 2
Business name: i J Signal cirmit(s) or limited..
—.= energy panel, alteration, or
Address: ' C • 4 V . 4 l - extension. Describe: Page 2 2
of the above
`)dS i { 9 , Z LV Each additional CS tate1ZIP: r� ' inspection over alto kle In a>, w e
Pal our
Phone: (' 24 <7 21 2 --- Fast: y/ ,3- -6(,,9 62.50
I.ic : , ■ •
GCB laveseigatioo pa hoar (tar ono 62.50
, � 9 1 Elect ical Elea -/4. _ Supry t e'G.' 5 1odo�'ial plant per hour 73.75
SUM. • Electrlcialt Signature, requin d / --e . CxR1ICC�L PEBMI'c t i :
, _ Subtomt
Print name: : Plan review (25% of permit tee):
State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:' 7x-
Print rtarpe: � _ •
1 Date:
7hb permit appbeadue septsas;t a penal' b not *beamed wttbtn I80
1 day* site it has berm acespeed as complete.
L1Boildmg111paallel6l pe,mi
• Number of inspections allowed Par pvm9t.
��' 440-4etSTp tlol'COtaw5u
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC ?,007 -00088
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/812007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 L
INSPECTION WORKSHEET FOR DATE: 2/9/2007 TIME: 7:04AM PAGE: 24
SITE ADDRESS: 09500 SW MARTHA ST CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: B;hroom conversion.
OWNER: BROWN, BARBARA PHONE #: 503 -624 -9448
CONTRACTOR: DICKENSON'S ELECTRIC PHONE #: 503 -246 -3550
Inspection Request Scheduled For: Date: 2/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 043198 -01 503-201 -9665 N
Corrections/Comments/Instructions:
e siZ. (7 ' /-4 (-
• " 1
' / PASS
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: e-4/1F Date: Z /77 Phone #: (503) 718 -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007.000f38
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2 /ti/20U7
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 .. 1-
INSPECTION WORKSHEET FOR DATE: 2/3312007 TIME: 7,01 AM PAGE: 10
SITE ADDRESS: 09600 SW MARTHA ST CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Bathroom conversion.
OWNER: BROWN, BARBARA PHONE #: 503.634 -9448
CONTRACTOR: DICKENSON'S ELECTRIC PHONE #: 503 -246 -3550
Inspection Request Scheduled For: Date: 2/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 043610 -01 503 -201 -9665 N
Corrections /Comments /Instructions:
6%e•
•
0 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C,filP Date:. Z Z■ 0 Phone #: (503) 718-