Permit 'V
CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 -00538
COMMUNITY DEVELOPMENT DATE ISSUED: 8/2/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S111DB
SITE ADDRESS: 15430 SW OAKTREE LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.10 LOT : 548 JURISDICTION: TIG
PROJECT: ALKEMA
Project Description: Service panel change.
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: 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:
MARGO ALKEMA ELECTRO WIRE INC
15430 SW OAKTREE LN 18857 SE SUNNYSIDE RD
TIGARD, OR 97224 BORING, OR 97009 -9271
Phone: NA Contact #: PRI 503 - 658 -8136
FAX 503 - 658 -7019
FEES
Description Date Amount Reg #: ELE 26 -667C
[ELPRMT] ELC Permit 8/2/2007 $80.30 LIC 67879
[TAX] 8% State Surcharge 8/2/2007 $6.42 SUP 27175
Total $86.72 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: 4i k, Permittee Signature: dYI 2 C.C r ‘µ-
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 - :,= ' FOR OFFICE -SE ONLY
City of Tigard i 1.- ,,.' I # Dale/B � I / D 7 13 6 Permit No.0 7 -0e) 6.5V
1 11111 - ° 13125 SW Hell Blvd., Tigard, OR 97223 Review
Phone: 503,639.4171 Fax: 503.598.1960 0 2 Other Permit
J , I ^ eBy
Inspection Line: 503.639.4175 ` .' J Dare Ready/By: Juris: 0 See Page 2 for
T 1 G A Ii D
Internet wwa.tigard or.gov Notifiod/Wiethod Supplemental Information
i 1 t ' a 1 / t 1t n ; . f- Ai i� <
( r PLAN REVIEW
❑ New construction ®Ad i HO Ion /alter 0 $ p ercent; tv ��� a_ '" - k-1 tease check all t apply (submit a sets of par ;: ks w(ilems checked below
T ❑ Ser ice or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where, the available fault c:arcnt ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 volts or ❑ Floating buildings.
l es s 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 PwnP. ❑ Installaationof 75 KVA or
❑ Emergency system. larger sepa ately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ 'A ", "E'. "1- 2 ".'•1 -3 ",
• t 100HP or rase. oa � " n ' •
Job no.: lob site address: l5 y 5 ee�. - ❑ Six cr more residential units. ❑ Recreational vehicle parks.
1 ) ❑ Health -care facilities. ❑ Supply voltage for more than
City /$tHte�rZ1P: I�j � ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no f' P roject name: ❑ service or feeder 600 amps or more
FEE SCHEDULE
Cross street/dire ctions to job site: 0e41 Description I e,4. I Fee. I Total I •
New residential single- or mult -family dwelling unit.
Includes attached garage.
Subdivision: I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'1500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
? 5.00 2
with above s ft
DESCRIPTION OF WORK ( q. ) -
Limited energy, multi - family 75.00 2
5 , - ' 7 �� I c e0 q � residential (with above sq. R.)
` r "L Services or feeders installation, alteration, aad/o'r relocation
200 amps or less / 80.30 a Y L 2
❑ PROPERTY OWNER 1 ❑ TENANT 201 amps to400 amps 106.85 2
Name: '7 G,-1-7 4.€41..rLe)---- 401 amps to 600 amps 160.60 2
• 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
CityrState/ZIP: 7 a a? 7 Temporary services or feeders lostallation, alteration, and/or
relocation
Phone: ( ) 1 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: A. Fcc for branch circuits with
❑, A,PPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
. City /State/ZIP: Each manufactured or modular ' 90,90 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 66.85 2
E- mail:_ Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
— t Signal circuit(s) or limited -
Business name:
Sia�s?x.13 _ t t ) 1 orgy panel, alteration, or `
_ iN extension. Describe: Page 2
Address: i j fci S 7 S x,411 ._ 1` c
City /StateiZIP: a � 1 f 7 c� Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (50') ( 5 g.— S2 i 3 !a Fax: (.03) to 5 53' - 7 Q /v le investigation per hour (1 hr coin) 62.50 _
CCB Lic.: 6 iS' 79 I _Electrical Lic.:06 — 4, � _ Lie.: Z 7
Industrial plant per hour 73.75
���� t f? J ( p ELECTRICAL PERMIT FEES
Suprv. Elect ig re, equ ` i , c .r t `� S Oa Subtotal: ;gyp ,. 3 tr1
Plan review (25% of permit fee):
Print name: 4 i^ L, f 7, -i--.,n l Date V I O 7 State surcharge (8% of permit fee): ,1 /Z
Authorized signature: ! TOTAL PERMIT FEE: g' „7
This permit application expires If a permit Is not obtained within 150
Print name• I Date: days after It has been accepted as compiete.
e Number of inspections allowed per permit.
i' 1 ` Sruild irng`Permits'ELC- Perm:tApp.doc 05/23/06 440.4515T(11105/COMIWSO
r Z d LO :ZO LO l.0 6ny
CITY OF TIGARD •
BUILDING DIVISION PERMIT #: E( -02007 005 6
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 002007
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 . I..
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7 : 00A(yl PAGE: 58
SITE ADDRESS: 16430 SW OAKTREE LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.10 LOT #: 540 TYPE OF USE:
PROJECT NAME: ALKEMA
DESCRIPTION: Service panel change.
OWNER: ALKEMA, MARGO PHONE #: NA
CONTRACTOR: ELECTRO WIRE INC PHONE #: 503 -658 -6136
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description CCOrifirm #--- Contact # Message
199 Electrical final 063390 -01 ' 503-539-4395 N
Corrections /Comments /Instructions:
4 1i
V 1
►_ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G W Date: 1 Phone #: (503) 718- Pii% '