Permit P . 6 CITY OF TIGARD ELECTRICAL PERMIT
IN
��' { ° PERMIT #: ELC2007 -00075
COMMUNITY DEVELOPMENT
D ATE ISSUED: 1/29/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25101 DC -03702
SITE ADDRESS: 07185 SW SANDBURG ST 110 ZONING: C -
SUBDIVISION: SANDBURG BUILDING LOT : JURISDICTION: TIG
Project Description: (3) branch circuits to connect new furnace, heat pump and condensate pump.
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/ FOR: 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:
LJ PROPERTIES + DOUBLE E ELECTRIC INC
BROWN, LARRY H + 2626 SE SPRUCE ST
ARNSBERG, JOHN S HILLSBORO, OR 97123
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 807 -5156
FAX 503 - 430 -5966
FEES
Description Date Amount Reg #: ELE 34 -627C
[ELPRMT] ELC Permit 1/29/2007 $60.15 LIC 152985
[TAX] 8% State Surcharge 1/29/2007 $4.81 SUP 4620S
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
suspended f ore tha 80 da s. ATTENTION: Oregon law requires you to follow rules adopted by th regon Utility Notification Center.
Those rul are set forth in • - - 9 2 -0; -0010 through OAR 952 -001 -0100. You may obtain cop' of these rules or direct questions to OUNC at
503.246 699 or 1.800.33 c / /
Issued y: , _ __A /,l i . _ ....d , Permittee Si nature: pi
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:
- • NTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: ' C ) _p19/61 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 An • �0 v FOR OF I( F, t Sr ONI,1
City of Tig Recei ` Pethnit No.: 7 Grip
Inv. , Tigard, � 10�1 ��
• ' Phone: 503.639.4171 F 13125 SW Hall .598.)9(A P \ Q at B i le," Other Permit:
T i G I: D Inspection Line: 503 "j ��? ON Date ReadylB ® See Page 2 for
Internet www.tigard-or4 '`y 0 r O`v Notific shod � Sn pprem entar Information
igighlA ORK PLAN REVIEW
El New construction Addition/alteration/replacement
placement please check all lien apply (submit 1 sets of pltms w /items chocked below):
0 service or feeder 400 amps or more ['Building over three stories.
❑ Demolition ❑Other
where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less ❑ l and 2 family dwelling ( Commercial/mdustrial ❑ Accessory building amps fo roaod. m exceeds i4.000 � �� ��
amps ftn all other installations. buildings.
❑ Multi family ❑ Master builder ❑ Other. OF ire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system.
❑ Addition of new motor load of ❑ "A », E', "I -2 ", - 1 -3 - ,
Job no.: Job site address: 7 1 $S S S -t .) 3 A S i lo0itp or more occupancy.
❑ Six or m re
ore sdenliat units. ❑ Recreadoosl vehicle parks.
CCity/State/ZIP: _ 4 4 its, ❑ more than
D Hazardous locations 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: 0 Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I qty. I Fee. I Total I •
New residential single- or multi-family dwelling unit
Includes attached garage.
Subdivision: I Lot no.: ],000 sq. ft. or less 145.15 4
Ea add' 1 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. ft.) 75.00 2
ES
6bN� N Eyv �ZrvP G C Limited energy, multi-family C residential (with above sq. ft.) 75.00 2
LCaivoeti SA C p P• Services or feeders installation and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I
❑ TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
Address: _ 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66.85 1
-
Owner installation: This installation is being made on property 201 amps to 400 amps 10030 ; 2
g p perry that I own which is not
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 I 2
Branch circuits — new, alteration, or extension, per panel
Owner signature: Date:
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
ch
Business name: B. Fee for branch circuits
Contact name: withou service or feeder fee, � 46.85 8f 2
first branch circuit
Address: Each add'I branch circuit L. 6.65 _434° 2
Miscellaneous (service or feeder not in cluded)
City/ State /ZIP Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax:: ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CO Sign or outline lighting 53.40 2
Business name: f�713 L u �►:...I. EC? ` Signal a or limited-
�/gy p panel, alteration, or
Address: Z(=Zic $ rd, s p e-J Gc, VI , extension. Describe: Page 2 2
City/State/ZIP: (4 t t_ a p g.p 6g. critz3 Each addhional inspection over allowable In any of the above
Phone: (S.Z) " 7 — S I 5.6 I Fax: 603) 4 9r Per inspection 62.50
Investigation per hour (1 br mm) 62.50
CCB Lic.: i s2 Electrical Lic.: -421 I Suprv. Lic.: Lk=5 . Industrial plant per hour 73.75 ,
ELECTRICAL PERMIT FEES
Supty. Electrician signature. required: Subtotal < S
Print name: Fger, E.i< STIa M D aze: I /z j 10q_ Plan review (25%of permit fee):
State surcharge (8% of permit fee): 4. - s I
Att[horized sigtature: TOTAL PERMIT FEE: . lvv
Print name; Date This permit application expiry if a permit is not obtained within 180
days after it has been accepted as complete.
t :1BUildiag\PeraoiitelE2 Gptr, p doe 05/23/06 • Number of inspections allowed per peen it.
440-4615T(1 l/05/COMM'EB
Z 996g-OSb wol)s)13 paid d£O :ZO LO 6Z ue
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: ELC2007 -00075
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/29/2007
Phone: (503) 639 - 4171A '
Inspection Requests (24 Hrs.): (503) 639 -4175 �' 1.L.
INSPECTION WORKSHEET FOR DATE: 2/1/2007 TIME: 7 :Q1AM PAGE: 3
SITE ADDRESS: 07185 SW SANDBURG ST 110 CLASS OF WORK:
SUBDIVISION: SANDBURG BUILDING LOT #: TYPE OF USE:
PROJECT NAME: SPEC SPACE
DESCRIPTION: (3) branch circuits to connect new furnace, heat pump and condensate pump.
OWNER: LJ PROPERTIES +, PHONE #:
CONTRACTOR: DOUBLE E ELECTRIC INC PHONE #: 503-807 -5156
Inspection Request Scheduled For: Date: 2/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042855 -01 503- 807 -5156 N
Corrections /Comments /Instructions:
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 03 V' Date: 11 O Phone #: (503) 718- 7 414\