Permit A- CITY 9F TIGARD ELECTRICAL PERMIT
«. PERMIT #: ELC2006 -00476
44i1 DEVELOPMENT SERVICES DATE ISSUED: 8/24/2006
•
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S103DB -03500
SITE ADDRESS: 11270 SW QUELLE PL ZONING: R-4.5
SUBDIVISION: GENESIS NO. 2 LOT : 033 JURISDICTION: TIG
Project Description: (3) branch circuits for bath addition.
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: 2 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:
HAGLUND, LINN G AND DEBRA M VAST ELECTRIC
11270 QUELLE CT 1525 SEATTLE SLEW DR. SE
TIGARD, OR 97223 SALEM, OR 97301 .
Phone: Contact #: PRI 503 - 780 - 8597
FEES
Description Date Amount Reg #: ELE 24 -52IC
[ELPRMT] ELC Permit 8/24/2006 $60.15 LIC 160065
[TAX] 8% State Surcharge 8/24/2006 $4.81 SUP 4360S
Total $64.96 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
suspend more 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those
rule re set forth in 0A -0 - 10 through OAR 952 - 001 -0100. You may obtain copies of these rules or ' c questio - • • UNC at
50 - 246 -6699 or 1 -800 -3 2
Is ed By: IN LIii J A P Permittee Signature: �„,, /�
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 , - • LATIO ONLY
SIGNATURE OF SUPR. ELEC'N: ■ /.",�` L - v DATE:, if A
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 FOIL OFFICE USE ONLY
City of Tigard o w / Permit No.: f (y'(p -lib Trio
, u 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 D _ Other Permit:
TI C n It D Inspection Line: 503.639.4175 Date Ready/By: 12111 ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction O Please check all that apply (submit 2 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.
less 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 pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "I - ",
Job no.: Job site address: (ra 7Q
� S ( l�lr Je f IP. I OOHP or more. • occupancy. ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ' ` ^e ❑ Health-care rati es. ❑ Supply voltage for more than
❑Hazardous locations. 600 volts nominal.
Suite/bldg /apt no.: rJ Project name: 4 4.5 ✓N ,, ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qtr. I Fee. I Tots I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: 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
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
o c l0 f �nr,
Limited residential energy, multi-family
above i sq.
beriture6141 I � Q> J/ l �,,,, r resi (with aoe sq. ft.) 75.00 . 2
Services or feeders installation, alteration, and/or relocation _
200 amps or less 80.30 2
❑ PROPERTY OWNER 1 ❑ TENANT ' 201 amps to 400 amps 106.85 2
Name: _ 401 amps to 600 amps 160.60 2
"J 601 amps to 1,000 amps 240.60 2
Address: 1 r? 70 SW Qr; o lk PI. Over 1,000 amps or volts 454.65 2
City/State/ZIP: I ,,, Temporary services or feeders installation, alteration, and/or
Q relocation
Phone: ( ) . I 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. Fee for branch circuits with
❑ APPLICANT 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 aZ 6.65 /7 • ' C 2
- Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular'
dwelling, service and/or feeder 90.90 2
Phone: ( ) I Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
I / E ie � Signal circuit(s) or limited -
Business name: u t t panel, panel, alteration, or
Address: / 6 — 5 5ez[ ee S(Chi 10,, 5E extension. Describe: Page 2 2
City/State/ZIP: .5 ,4 , �3 j 7 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: (5 7?0, _g ' 7 I Fax: 03) 5 9 Investigation per hour (1 hr min) 62.50
CCB Lic.: ( (965 N '
> 0 Electrical Lic fd 1 f prv. Lic.: 5-n s Industrial plant per hour 73.75
i 7 , ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required• -('‘'r /
Print name: �- Date: i Subtotal: Plan review (25% of permit fee): C.p • />
t wl U Dt v tC3'e 5 p �`„241 O State surcharge (8% of permit fee): its k/
•
Authorized signature: TOTAL PERMIT FEE: 4,1/ , 9
Print name: Date: This permit application expires if a permit is not obtedwithin 180
days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\Building\Permits\E1.C- PermitApp.doc 0523/06 440.4615T(1I/05/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 •
1:\ Building\Pamits\ELC- PamitApp.doc 0323/06
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: ELC2005 -00476
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: B/241200f
Phone: (503) 639 -4171 j , lI
Inspection Requests (24 Hrs.): (503) 639 -4175 '
INSPECTION WORKSHEET FOR DATE: 9/14/2006 TIME: 7 :00AM PAGE: 14
SITE ADDRESS: 11270 SW QUELLE PL CLASS OF WORK:
SUBDIVISION: GENESIS NO. 2 LOT #: 033 TYPE OF USE:
PROJECT NAME: HAGLUND
DESCRIPTION: (3) branch circuits for bath addition.
OWNER: HAGLUND, LINN G AND DEBRA M, PHONE #:
CONTRACTOR: VAST ELECTRIC PHONE #: 503-780 -8597
Inspection Request Scheduled For: Date: 9/14/2006 Pour Time:
Code # - - .. - IN - cription Confirm # Contact # Message
199 Electrical final 036543 -01 503 - 780 -8597 N
Corrections omments /Instructions:
' V
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ Cr w ksia L Date: if 14 4 Phone #: (503) 718- 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #2, d q 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: �
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: 102 b Ooze U - CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: (?- .02..c Pour Time:
Code # Inspection Description Confirm # Contact # Message
1 Z gla 41/ 6 '7 St - 8s l 7
Corrections /Comments/ Instructions:
LA PA NEL P 1 044 LeL
R \k Smokes (b Q G
•
)lkASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Y" Date: t.2-g
• L-t7 " Phone #: (503) 718-