Permit CITY OF TIGARD ELECTRICAL PERMIT
r PERMIT #: ELC2008 -00578
COMMUNITY DEVELOPMENT
DATE ISSUED: 10/9/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 AD - 05900
SITE ADDRESS: 08540 SW PINEBROOK ST ZONING: R-4.5
SUBDIVISION: PINEBROOK TERRACE LOT : 085 JURISDICTION: TIG
PROJECT: MAR
Project Description: Reconnect only.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
APRIL MAR
7043 NE HOYT ST
PORTLAND, OR 97213
Phone: 503 - 708 - 2291 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 10/9/2008 $66.85
[TAX] 12% State Surchar 10/9/2008 $8.02
Total $74.87 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: � :;:;„•\./ ` �2r4
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.
10/09/2008 14:28 5039222510 ALPHA-OMEGA PAGE 01/02
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• Electrical ermi 'cad E cEi v E I ,,,,, (),:i.,(.„ I ISI: QN1...1
City of Tigard Received
Dat- •- : 0 aftK . emit ; -- ■-,-A : : .. - O r-15-7 8 /
13125 SW Hall Blvd., Tiard, OR 97223
IT T 0 9 2o OPenult
ua PumB .
ther
a Flume: 503.6394171, Fax: sna,s9a.1960_ _ Ilate/By: •
------,
Inspection Line: 503.639.4175 , See Page 2 far
: 1 . : ., R 1 •
Internet; www.tigard-or.gov CITY OF TIGAR 1 thaTil d :
ofmrpoiniNGthvisiON0..F...112.1 4.v.t.44 ;, ..w:.' 'honectittYlovivo
. . . , . . . .
, 1 " , ma check all that gaily (submit I sets of plans wiltono checked below):
1_1 New construction . 0 Acklition/altoratirMireplaMarlalt 0 Service or fender 400 amps or war 0 Dalian OWY Ulm sloMm.
1:1 Demol t ... __Oth where the twcilabte Awlt =rant 1;1 Mutes and boatyards.
.•.:-: ' • ' 3 : 'F ,.' ?!!•':! ttari,Gb .0 ity connttenoN.; : • • .• :::•:: . ',.; . exceeds 10,000 amps at 150 volts or 0 Floating buildings.
..: :-..:::::.-;;..'". ..1:.-F: F.-:;;:. . .. -.. , , , .. .. , ..... . - .. .• : - • ...a4.... less to ground. OT exceeds 'motto 0 Commarelal-me agriculuted
N 1- and 2-.family dwelling 0 Commercial/industrial El Accessory building mvs ror all other installations. bull 44n,
0 Multi-family 0 Master Wilder 0 Other: O Fire parov. LI Installation of 75 KVA or
v. . _,., , . _ ......,„ .„, , , , °Emergency awns larger separately derived mown.
'.. .ipt. sp Loc-fuiTi ; Y- - 7' .::: !: ' ''!:. 0 Addition of new motor load of 0
Job no,: I Job si loony or mote.
te address: ovenponey.
0 Slit or more residential units, CIRcercationel vehiele posa,
, . LI Reitith•eans &advt. 0 Supply voltage En more than
City/Statc/Z1P: 145
° • n.e • i . , c II il "- ° 1.- CI Ittizardeus locations. 600 volts nominal,
._
Sakai:Mg./apt. no.; Project name: . in D service or feeder 600 amps or more.
. - - ia (--- '.. — ' gtrg . scaciyuLE;', , _7;. : :: : ,.;::' .:.,;.... :**77.
i
. ,.... . • ..,
Cross street/directions cc) job site: ioregioree ( git j Bit , I UM .. I •
' ' " New residendal single- or inulti-i dwelling nail
u) !Alla 9)kvcA 4. POIVJeler319- Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft or less 145.15 4
Ea. addI 500 s. 11, or pttfo 0 1
Tax map/parcel no.: Limited energy, residential
75.00 2
• DEsaurricet,'0F.Wcau0::!:.'s.' y with abovti
Limited energy, multi-family
\ I\ k')(\ \AmYz,e . 9yik, 0,4 I .(I 04--.0 teSidential (with above ao. R.) 75.00 2
Services or faders installationsIntration, endior relocation ,
-
2130 Mips or Tess 50.30 2
..' - Fit_ ,,.....t.a. jg OWNFile;':::':" : ::: S': : •.:i .. 7.1, : ':■:. :: 1:1:TPIVAAT.::Y. ::.: 201 amps to 400 amps 106.85 2
Nrane: 0 ipAA 0 61 , 401 amps tO 600 amps 160.60
601 amps to 1.000 amps
240.60 2
n, r
2
Address: 1D9 3 f\I -- . . t-it A i- Over 1,000 amps or volts • 454.65 2
City/Stato/ZIP: PfAlut \ . Ckla a , 0-4( °nal 3 Temporary services or tkeders inslallatIon, altrration, and/or
relocation
Fbwle; ( M3 . 12 -22 F ax: ( 553) /2/2-. -75 0 200 amps or lots [ 66.55 • I
Owner installation: This Installation is being e on property that 1 own whh ic if not 201 amts to 400 amps 100.30 2
intended ter sale. I --r6A . , han ., g rQ OR5 447„ 449, 670, and 701, 401 amps to 599 amps 133.75 2
- wrench dream- new ahem ,.•
Owner signature _...,71-., _ ix e or extension _dwr
il'• •••• 'd.?..,!1"! Mr, ,;.., !WV; !;'..!..;Q"..:: cogricr pERpo .6 2
s2:,:..'..,•?•.,:: above service or feeder fee,
63
• -. • • • - - • • ' each branch cheat!
BUSin0R8 B. Fr= for branch circuits
Contact name *Mena service or feeder llse,
:
first branch eircesit 4E85 2
Address: Each add'] branch circuit 6.65 2
• NitsBa : ps jEa ......... _ . _ . _ eons (aervtee or feeder a incl
City/State/ZIP: Each manufactured or modular
" dwelling, service and/or feeder 90.90 2
Phone:( ) Fax ; ( ) Retennom outy 66,85 1 2
. -1..
E-mail: Pump or irrigation circle 53.40 2
.,::, '::"....::'•?.:'.:.:. s •*,':?',:' , t.. - -......!•:::::. '::'. .:•••••, ' . :. • :. CONIRA0/13R. •:..'.: .,. : . '.: :: : .. . :: Sign or outline lighting 53.40 2
Business name: Signal cirovtqs or limited-
. . energy panel, alteration, or
Address: mansion. Describe: • Page 2 2
. ,
City/State/ZIP: • Fad additional inspection over ble In snyof the above
Per inspection 62.50
Phone:( ) Paw: ( ) Invemtigation per hour (3 hr min) ' 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
., ..., ..' : ....::.: ELECnteC.AL PERstrir MS ,..,''.,..:, ./.... . .
Suprv. Electrician signature. requirod:
_---...._ —
Subtotal: _la
—_—_......., ,..
"' review as% of permit fee):
Print aurae: Date:
. State surcharge (12% of permit fee);
Authorized signature
TOTAL PERMIT FEE:
Print name: I Date: This permit appitetwen opens we par/Atli tad obtained vilthtn 1
• days. After it Mt bets attained as complete.
' Number of inspections allowed per INIrlit•
111uli4intranaMELVArmItApaclue 05/23105 440.4615T(11/01/COMAVOI
CITY OF TIGARD
1 BUILDING DIVISION PERMIT #: ELC200Bd10579
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1(UR/200t1
Phone: (503) 639 - 4171 t �
Inspection Requests (24 Hrs.): (503) 639 -4175 „ tl 7I I ..
INSPECTION WORKSHEET FOR DATE: 10/10/2008 TIME: 7:00AM PAGE: 19
SITE ADDRESS: 08540 SW PINEBROOK ST CLASS OF WORK:
SUBDIVISION: PINEl3ROt�1C TERRACE LOT #: 085 TYPE OF USE:
PROJECT NAME: MAR
DESCRIPTION: Reconnect only.
OWNER: MAR, APRIL PHONE #: 503-709-2291
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 10/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message 11 t 0 41,44
call Pk6
199 Electrical final 076551 -01 503708 -2291 Y g0
Corrections /Comments /Instructions:
ci;._ I
,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 44:{ Date: / Phone #: (503) 718 -