Permit • -CITY F TIGARD,- ELECTRICAL PERMIT
PERMIT #: ELC2005 -00031
/howl DEVELOPMENT SERVICES DATE ISSUED: 1/24/2005
,.� I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111 DA -15300
SITE ADDRESS: 08930 SW PIPPEN LN
SUBDIVISION: APPLEWOOD PARK NO. 3 ZONING. R -7
BLOCK: LOT : 146 JURISDICTION: TIG
Project Description: (1) branch circuit for 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: 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: 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:
REHKOPF, MITCHELL OLIVERS PRECISION ELECTRIC CO
8930 SW PIPPEN LANE 17035 SW HIGH HILL LN
TIGARD, OR 97223 BEAVERTON, OR 97007
Phone: 503 - 598 -7879 Phone: 503 - 579 -7747
Reg #: LIC 41435
SUP 2539s
FEES ELE 34 -521C
Description Date Amount Required Inspections
[ELPRMT] ELC Permit 1/24/2005 $46.85
[TAX] 8% State Surcharge 1/24/2005 $3.75 Rough -in
Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at (503)
246 -6699 or 1.800- 332 -2344.
Issued By: Permit Signature: _S.t,-e_ P►
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
•
01/19/2005 12:26 S 5035795907 REVILO SAINTS PAGE 01
Elec ic-a1Perm A it �� l l cat i on • _ 1 Orrlc r I'SF, ONLY
City of Tigard ECE , ived 1 _' 9 65' "Y PermitNo.'t (- C,01aJ5 e ' /
13125 SW ball Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 " I , . Daffy Other Perron:
inspection Line: 5O3.639A175 JAN Z ' 4,1 41 I Jur* Internet www ci tigard -or us L 1 i — Notrfed/M ) '! id See P a for
5r -"'''','-1 •- i . r �+ 'fit 3S' 1Qiy "'"'"" �' �� • ; , rz ! } .. y v y „r an. Y . •'1 s ".��1; •;:. :. t Polemootat informs on
�t , l,, ''!'S• r _
]. 1.,. T r .j f i ii. t; � :s 1 '• ( '1 f4 � :
� . P r. . r• : ;' a F. :
❑ New construction i . t ;: n l I i - , r , I , ., t Please check all that apply: '
❑ Demolition ■Other: ❑S ervice over 225 amts, comm'I Oliazardous location
�1 M: LW } P ! Y T R - y, d4 ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
`?`.°„'' r l `4. �,$ °'> uN 't _. ? t e Ir '' of t- and 2-family dwellings 4 f
Y Ss or more new residential
'i I - and 2 family dwelling ❑ Cor)}n,ercial/industt"ial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
El Multi - family ❑Master builds ❑Other:
['Occupant load over 99 persons ❑Manufactured structures or
4i {�l
A 1 _
, _ ,.., „�-�. � I _ � � � .., .I � : ' . I,�: I , .;•. � ' r 1' .'�. "•t , . , i ; , " . � ! ❑ Egress/iighting plan RV park
Job no,: Job site address: i iermir ❑Health -care facility ❑Other:
Submit" sets of plans with any of the above.
City/StamJZIP: A_' / � The above are not applicable to temporary construction service.
g / IIO.: • l • I
SuiteJbld _ 1 � 'r: tia2 II lei ' ••
Daa Qtr. Fee. TeW
Cross street/directions to job site: I New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33,40 1
'I8Xpar Limited energy, residential 75.00 2
° ,tt,,R r. u ,_ , . .. Limited energy, no res dential 75.00 2
ti'x :':17 17 t " G S .. 2.i c )-...‘,7`', - � .. I ,, `r i ; r fr: ? a . ! .._;
, ,C ,�.. � r L - ;.1. ',' ; '- i, . . l, 8:. 444 .7,v , Each manufactured or modular
L � , ��� dwelling�servrce and/or feeder 90.90 2
' Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 ( 2
'� r ' n er1 , m' r , ' ' IS , n rr ; 'f 'i , S 201 amps to 400 amps 106.85 2
"Y, � �r I ' r- �•: li P r {,, = �
f � sl,�p I It' -'p �''` -
f} +;�,, . I , e . I_ , ._ , , , ;, ,, . ; '' • I `.l` 401 amps to 600 amps 160.60 2
irirr _ i1 4i 601 alms to 1,000 amps 240.60 2
Address: ' • 3 j ,4-' 2 1-, , e r Over 1,000 arms or volts 454.65 2
�� Reconnect only 66.85 2
•' �� /' Temporary services or feeders lnstaUatlon, alteration, and/or
Phone: (, ) !an= Fax: ( ) relocation
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 600 amps 133.75 2
Owner signature: Date: Branch clrcults- sew, alteration, or extension, per panel
' . S - i5 xj ` ,� .',: A. Fee for branch circuits with
i ' 1. . I x r i 1i 11;, (d I 4 ; a o . �iilW ,:-.2., ,-• , r
_ !'
Business name: 0 41= * _ service or feeder fee, each
RI .� branch circuit 6.65 -. 2 -
B Fee for branch circuits
Contact name. ( . �� wirltrnu service or feeder fee,
Address: each branch circuit / 46.85 L,��
I S iy - . ! •�. • Ea ch WI branch citeuit ( , 6.65 1 2
City/State/ZIP: ' ! (i • I_ /lj riDiih , Miscellaneous (service or feeder not included) -
Phone: ► / Pun or irrigation circle 53.40 2
E-mail; ! P8,-3 is t2) . C.0� -,— Sign l outline lighting 53.40 z
Signal circuit(s) or limited-
. :� J ?I ,
i f 't r �+ K rf a !; I 1� .� i I _ � .._. -7 " -7 7. 7.-$7- w '.'.1,' ,lh ' . . : -.; }�� "' • 1:, rte. : : , k ..'''''''.`';'''' a i <I i W: i.., : 4,; :5 :{ U ',0 . al ts1 .- , energy panel. alteration. or
Business name: , it'w a S / _ ex te ns io n . ptscri Page 2 2
• "1111911P , Each additional inspection over allowable in any of the above
• . �� Per inspection 62.50
City /State/ZIP: - L ' 1 r + 40 ■ , -
Investigation per hour (1 hr min) 62.50
Phone: (5 ' ax' Industrial plant p er hour 73.
3 S� (S?J 7 J / 75
,.. • • .
CCB Lie.: ® Electrical Lie.: 39 -51•-t e. Suprv. Lic.: 3 s— S subtotal /1‘ 0 5
Suprv. Electrician signature, required: Plan review (25% of permit fee)
Print name: W r Date: State surcharge (fl% of penult fee) :
TOTAL PERMIT FEE ,S . 1 V n
Authorized signature; This petal! application expires if a permit h not obtained within 180
days alter It has been accepted es complete
Print name:
Date: • Fee methodology set by Trl -Country Buildtag Industry Service Board
" N umber of Inspec per perun allo
ENBuildmgtPeol®nELC- raeiaAmsstm 17/03 44a4sismonniCOM,WEB
CITY OF TIGARD 24 -Hour
BUILDING , Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business" Line: (503) 639 -4 1 MST
/ r BUP
Received 5 Date ReA4a7 sted c9-4 AM PM BUP
Location -MO ' ' G` Sui MEC
Contact Person J. . %. ...' _ _LA �A • •h ( 5 '— / _i PLM
Contractor (
• WR
BUILDING Tenant/Owner 1 7� —��� —° ��< a 0 3
Footing
Foundation ELC
Ftg Drain Access: S�r�.�2 � � 2X Tom, �P' �� � ELR
Crawl Drain
Slab Inspection Notes: �7 SIT
Post & Beam �Xn
Shear Anchors ,./J,/_ / / / � '� /a' ' (/� t/ l
Ext Sheath/Shear avv'
Int Sheath/Shear
Framing
Insulation K
D
Drywall wall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling -
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
P PART FAIL
RI
Service
Rough -In
UG/Slab
Low Voltage
l 'F ' e ►
PART FAIL E Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
41. ❑ Please call for reinspection RE: r E=I Unable to inspect — no access
Fire Supply Line �—
ADA
Approach/Sidewalk Date 2-- 7- 0 ` Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record fr the job site.
PASS PART FAIL