Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT D : 10 ELC2007-00709
COMMUNITY DEVELOPMENT
DATE ISSUED: 10/16/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
. PARCEL: 2S102BC -05500
SITE ADDRESS: 12575 SW PATHFINDER CT ZONING: R -4.5
SUBDIVISION: YOLO ESTATES LOT : 004 JURISDICTION: TIG
PROJECT: NASS
Project Description: 1 br. circuit to hot tub.
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: 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:
•
CARRIE NASS GRF ELECTRIC
12575 SW PATHFINDER CT 15460 S PARADISE LN
TIGARD, OR 97223 • MULINO, OR 97042
Phone: 503 - 481 -4459 Contact #: PRI 503 -829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 10/16/200' $46.85 LIC 76751
[TAX] 8% State Surcharge 10/16/200' $3.75 SUP 1655S
Total $50.60 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 thr ugh 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: da-jt cetz /J�'�
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.
•
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Ele Per _ �' FOR OFFICE USE ONLY
1_1 . Received A A Electrical �7
1 J .� " V , Date/By: / / /� d) 1' I W / -0074
� I V Permit Flo.:
City of Tigard Planning Approva Sign
`J
13125 SW Hall Blvd. °CI 6 2001 Date/By: Permit No.: Plan Review Other
Date/By:
A P ost- Rev Permit No.:
Tigard, Oregon 97223 Land Phone: 503- 639 -4171 Fax: �5(313•�59� -,0 _ � , w ,,, , e
,.., Post-R iew LanLandN Use
Internet: www.ci-tigard.or.us !' ' c� ! �
®
,� y Contact � ' .. Sec Page 2 for
24 -hour Inspection RequestlL5 Name /Method: Supplemental Information. • . ,''';. TYPE'OF:woRK. •, . .,.:. PLAN REVIEW:(Pleaie check all-that aPP1Y) :".•;:..• :. -
❑ New construction Demolition ❑ Service over 225 amps - ❑ Health-care facility
commercial ❑ Hazardous location
Addition /alteraation/replacement n Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
- CATEGORY'OF :CONSTRUCTION .: I & 2 family dwellings four or more residential units in
("1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stones ❑ Feeders, 400 amps or more
❑ Accessory Building [] Multi - Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
JOB SITE INFORMATION And :LOCATION' Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: 1 Z S 15 S tA:. PA-41-1-C ,nele .': _ .:. - Y. ' ,. ,' SCHEDULE_....:: :0 :::• : ,•.'•• ..,,.
Suite #: I Bldg. /Apt. #: Gt- Number of inspections per permit allowed
Project Name: e\) As. s :.cscriptlort ■ Qty Fee(ca.) Total : 1
Cross street/Directions eCt10IIS to job site: New residential-single or multi- family per
dwelling unit. Includes attached garage.
Service Included:
1000 sq. ft. or less 145.15 • 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Subdivision: I Lot #• Limited energy, residential 75.00 2
Limited energy. non residential 75.00 2
Tax map /parcel #: Each manufactured home or modular dwelling
, ' . service and/or feeder 90.90 2 -
v�sRlrrlan: ol�:wox:IC_ =:: ;
' ' Services or feeders - Installation,
alteration or relocation:
r � �� • ,, y 200 amps or less 0 2
r V �� tf I 201 amps to 400 amps 106 85 2
401 amps to 600 amps 160.60 2
,. 601 amps to 1000 amps 240.60 2
C] PROPERTY.OWNiER ` r`: �' [] "TENANT':: %" Over 1000 amps or volts 454.65 2
Name: r ,/,‘ rte p (V LIS Reconnect only 66.85 2
Address: ) Z'S 1 c S (,J rio,< 't',.,.L, y,`,(P� Temporary services or feeders - installation,
alteration, or relocation:
City/State/Zip: p: 'fl ,„ve_ °J 7 2-7-3 200 amps or less 66.85 I
201 amps to 400 amps 100 2
Phone: g 5: 401 to 600 amps 133.75 2
0 APPLICANT- ;;'_if:' .< :" . -'_ ::': LI .CONTACT :PERSON ; : . Branch circuits - new, alteration, or '
Name: extension per panel:
A Fee for branch circuits with purchase of
Address: o service or feeder fee, each branch circuit 6.65 2
City /State/Zip: B. Fee for branch circuits without purchase of r
service or feeder fee, first branch circuit 1 46.85 /J- " 2
Phone: I Fax: Each additional branch circuit 6.65
E -mail: Misc.(Service or feeder not included):
- :r� .., : i ,.r Each p ump or irrigation circle 53.40 2
.::.;i;," • -., -:: :::'1 . 1', ::i C.ONWRACTOR• : :,'.: . : 1 :.--;1'`= , . . .- qi ..
- Each s or outl l 53.40 2 ,
Job No: Signal circuit(s) or a limited energy panel,
Business Name: V p f. alteration, or extension Page 2 2
Address: 1 51fr(f '- S , pik Y '. tl .,2 4 ,
Clty /StatelZlp: I e U 17 �. Z Each additional Inspection over the allowable in any of the above: =
Per inspection per hour (min. 1 hour) i 62.50
Phone: s 3 , Q y,G! / , i-t • p Fax: 5b 3 - $ z. - 5 -7,-r-7 Investigation fee:
CCB Lic- #: -] jp �, Lic. #: 3 , f _ e-9- C other: ` a:. .. ;r ;_Electrical oP.eci ilt-Ferirt-= . . . : : :. ,-
Supervising electrician - r t..
` n Subtotal $ 4 • r
_ signature required: .. • i 0 I i 4 ) v Plan Review (25% of Permit Fee) $
Lic. #: L S $ State Surcharge (8% of Permit $ t Fee) 1 V
Print Name: 1n/ ,71 % 4.,,,, I r ���?�
X 11 /0. /o TOTAL PERMIT FEE $ C on • Authorized Notice: This permit appllcaton expires if a permit is not obtatlied - wl
Signature: Date: 180 days after it.has been accepted as complete.
*Fee methodology set by Tri -County Building Industry Service Board.
(Please print name)
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CITY OF TIGARD . Alio
BUILDING DIVISION PERMIT #: ELC2007- 00109
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/16/2007
Phone: (503) 639 -4171 Wpyl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/13/2008 TIME: 7:02AM PAGE: 9
SITE ADDRESS: 12576 SW PATHFINDER CT CLASS OF WORK:
SUBDIVISION: YOLO ESTATES LOT #: 001 TYPE OF USE:
PROJECT NAME: NASS
DESCRIPTION: 1 hr. circuit to hot tub.
OWNER: NAS h, CARE2IE PHONE #: 503 - 481 - 1459
CONTRACTOR: ORF ELECTRIC LI N b el PHONE #: 503-829-4146
Inspection Request Scheduled For: Date: 3/1312008 Pour Time:
Code # Inspection Description Confirm # Contact # ' sage
129 Electrical fill 06666001 503-829-4148 s c t Y
Corrections /Comments /Instructions: 1 0 • I IAA I N
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 0 be) Date: a • 13 1 Phone #: (503) 718- lit' ITV