Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00593
4'1°0 DEVELOPMENT SERVICES DATE ISSUED: 10/19/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2 S 109 DA -10900
SITE ADDRESS: 12920 SW PINE VIEW ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT : 098 JURISDICTION: TIG
Project Description: Hot tub hookup.
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:
ERIC & KAR WEAKLAND CITY ELECTRIC & SUPPLY CO
12920 SW PINE VIEW ST 8900 SW BURNHAM ST. F -27
TIGARD, OR 97223 TIGARD, OR 97223
Phone: 503 - 670 -4979 Contact #: PM 503 -443 -1092
FAX 503 - 625 -3052
FEES
Description Date Amount Reg #: ELE 26 -289C
[ELPRMT] ELC Permit 10/19/200( $53.50 LIC 42422
[TAX] 8% State Surcharge 10/19/200( $4.28 SUP 35925
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 da of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utili otificatio . Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct tions t UNC a 03- 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature' 2
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 Applicationi> % t__ , ! /1 1 ∎ — � ' FOR OFFICE IUSF ONL.V
City of Tigard r Y�' Received Pemtit No.: `� , •
g DateB . 11 . " 9 i , i G) (C c
0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' � . Phone: 503.639.4171 Fax: 503.598.1 9 6 �° �eIB , Other Permit:
TIGnK)
Inspection Line: 503.639.417 2�U `° Date Ready/By: NM ® See Page 2 for
• Internet: www.tigard- or.gov Notified/Method Supplemental Information
�RtC j.;
TYPE 00 - 4PLAN REVIEW
7� 7` j ? 7T f1 T (1�
❑ New construction ddition/�I r:Iti ' ' • Please check all that apply (submit a 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.
• dwelling less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
- and 2-family g ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", `Ts ", "I - ", "I - ",
Job site address: i /� Q IOOHP or more. occupancy.
Job no.:
1 oC 1 �0 �w (tLL �/� 4. ❑ Six or more residential units. ❑ Recreational vehicle parks.
. City /State/ZIP: 1 r ` ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Description FEE SCHEDULE
J I Qty. I Fee. I Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: 30 Iywk Q I Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
4 a 4. 'J b I v ) . residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
„ p4ROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: ` ,/ 401 amps to 600 amps 160.60 2
f' a"'a �l w '�` I` l 601 amps to 1,000 amps 240.60 2
Address: 1'.1 LC IA VIA Sh. Over 1,000 amps or volts 454.65 2
City /State/ZIP: ''r‘, 0 r Temporary services or feeders installation, alteration, and/or
relocation
Phone: (i cj 670 - 4.1/79 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
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit _
n
• Business name: l ' it/ 1 ic�� 01.4.1 5,..,Pi CD. B. Fee for branch circuits ,
�e'r K without service or feeder fee, 46.85 4) , 115 2
Contact name:
g C � ' � �"`- F /t first branch circuit
8 c
coo cW rsW frurnthu P-27 Each add'I branch circuit I 6.65 4 ,65 2
MFscellaneotis (service or feeder not included)
City/State/ZIP: q. Each manufactured or modular
1 � a v C 90.90 2
dwelling, service and/or feeder
. Phone: ( 3) 4,W A _ 109 2 Fax: : (5 (, 2$- 3052 Reconnect only 66.85 2
E -mail: Pump or irrigation c 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: C t (eC c., a•.A Spi It Co , energy panel, alteration, or
Address: 8900 Sn �/ 5‘, �.27 extension. Describe: Page 2 2
City/State/ZIP: T ` �d O r c i 1 ,23 Each additional inspection over allowable in any of the above
J Per inspection 62.50
Phone: Fax: 503 b 25- 5Z Investigation hour (I hr min
c5�) yw3 r og 2 ( > � � per c ) 62.50
CCB Lic.: y 214 22 I Electrical Lic.: 2i 9L Suprv. Lic.: 35423 Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 5 3,50
Print name: CI .K Ffke5e�, Date: I b _11_04
Plan review (2S% of permit fee):
State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE: - 11,
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1ABuitdingWermin \ELC- PermitApp.doc OSn3 /06 4404615T(t tro5/COM/WEB
Electrical Permit Application - 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 - 260 -260)
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\Pamiro\ELC- PamitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006 -00593
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/19/2006
Phone: (503) 639 - 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/23/2006 TIME: 7 :04AM PAGE: 30
SITE ADDRESS: 12920 SW PINE VIEW ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 2 LOT #: 098 TYPE OF USE:
PROJECT NAME: WEAKLAND
DESCRIPTION: Rot tub hookup.
OWNER: WEAKLAND, ERIC & KARA PHONE #: 503- 670 -4979
CONTRACTOR: CITY ELECTRIC & SUPPLY CO PHONE #: 503-443-1092
Inspection Request Scheduled For: Date: 10/23/2006 Pour Time:
Co. _ • - - • I Description Confirm # Contact # Message
1� i mma i „'�- 1= 038642 -01 971 -404 -1714 Y
1 •
■ ections /Co m- s nstruc .ns:
NT
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �` , v� -� Date: � 2 O Phone #: (503) 718- Z