Permit '" CITY` OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00588
.. 1 DEVELOPMENT SERVICES DATE ISSUED: 10/18/2006 il 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S125DB-05700
SITE ADDRESS: 07220 SW SHADY LN ZONING: R - 4.5
SUBDIVISION: SHADY DELL NO.2 LOT : 030 JURISDICTION: TIG
Project Description: Ground rod. Original located.
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: PER HOUR: 0
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:
TUTTLE, JOHN L AND ALYCE M OWNER
7220 SW SHADY LN
TIGARD, OR 97223
Phone: Contact #:
FEES
Description Date Amount Reg #:
[UREELC] Reinspection 10/18/2001 $57.87
[URETAX] Reinsp 8% St 10/18/2001 $4.63
Total $62.50 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: diaL,A& Qyb Permittee Signature: X ‘ . 2- 47:96 - t -------
X9
- a
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 Apphea i 6 ', FOR OFFICE USE ONLY
' t; rP - •I
City of Tigard Received e . 10 i' O.b • i EM e _ Gld 9 - oo5. .
13125 SW Hall Blvd., Tigard, OR 97223 C Plan Review
' II Phone: 503.639.4171 Fax: 503.50 601 8 2006 Date/B . Other Permit:
TI G A R D Inspection Line: 503.639 Date ReadyBy: ® See Page 2 for
• Internet: www.tigard- or.gov ' Notified/Method: Supplemental Information
i C 7 , s.... ,... ' r. 1 �: C
.5 1Y
TYP y � 9 ii ' - r TJ `. PLAN REVIEW
❑ New construction ❑ Addit alteratiot�/t�eplacement
3 1 t 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: -7 100HP or more. occupancy.
. / � 1U Sc �Ved ( � o"-t- ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: -771etx., 0 C(.-.7-7--.. ❑ Health -care facilities.
❑ Hazardous locations. ❑ Supply voltage for more than
600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I ttty. I Fee. I Total 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'I 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
_ ' pz.� h D "� C residential (with above sq. ft.)
0 n - ` dt� Services or feeders installation, alteration, and /or relocation
' ( ///111 200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: VOtibt L — (-e 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: --7,..- S 5/
2-. Over 1,000 amps or volts 454.65 2
L
. City/State/ZIP: l i 9 a_Yd_ t� 7 X7-3 Temporary services or feeders installation, alteration, and /or
L relocation
Phone: Fax: 200 amps or less 66.85 1
3) ��4 —� r L1/ D � ( ) 201 amps to 400 amps 100.30 2
Owner installation: This installation is being made on property 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 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,
each branch circuit 6.65 2
Business name: B. Fce for branch circuits
Contact name: without service or feeder fee 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
l l ' n n energy panel, Signal circuit(s) r limited-
Business name: A lV/v
energy p aalteeratt or ion, or
Address: extension. Describe: Page 2 2
. City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (1 hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
. Suprv. Electrician signature, required: Subtotal:
Print name: Date: Plan review (25% of permit fee):
• State surcharge (8% of permit fee):
Authorized signa re: TOTAL PERMIT FEE: (: ,.SZ)
� This permit application expires if a permit is not obtained within 180
Print name: J O i , I t> 1( (Y Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
I:\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(I I /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*
E l B urglar Alarm
❑ G arage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
El 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
• El Boiler Controls
El Clock Systems
❑ Data Telecommunication Installation
• ❑ Fire Alarm Installation
El 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 \Permits\ELC- PamitApp.doc 03/23/06
CITY OF TIGARD.
BUILDING DIVISION • PERMIT #: ELC2006-00588
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /0/1812006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/25/2006 TIME: 7:03AM PAGE: 61
SITE ADDRESS: 07220 SW SHADY LN CLASS OF WORK:
SUBDIVISION: SHADY DELL NO.2 LOT #: 030 TYPE OF USE:
PROJECT NAME: TU Y LE
DESCRIPTION: Ground rod. Original located.
OWNER: TUTTLE, JOHN L AND ALYCE M, PHONE #:
CONTRACTOR: OWNER PHONE #:
Inspectio• ' - = • - - .eduled For: Date: /012512006 Pour Time:
ode # Inspection Descn...on Confirm # Contact # Message
199 Electrical final 038618 -01 503 - 244 -8405 Y
Correction . -- • c ions:
) 10 A6
•
•
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PAPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL IT CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: . • N ca'
Date: 0(2+ aO Phone #: (503) 718 - liffio
, V
CITY OF TIGARD
BUILDING DIVISION " PERMIT #: ELC2005- 00588
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/19/2006 TIME: 7 :02AM PAGE: 81
SITE ADDRESS: 07220 SW SHADY LN CLASS OF WORK:
SUBDIVISION: SHADY DELL NO.2 LOT #: 030 TYPE OF USE:
PROJECT NAME: TUTTLE
DESCRIPTION: Ground rod. Original located.
OWNER: TUTTLE, JOHN L AND ALYCE M, PHONE #:
CONTRACTOR: O'ER PHONE #:
Inspection Request Scheduled For: Date: 10/19/2006 . Pour Time: •
e # Inspection De . i•tion Confirm # Contact # Message •
195 Misc. inspection 038451 -01 • 503- 244 -8405 'Y
'.1' C•1111-- ructions:
•
\ F - 0 (cAAN0,1
411, .
•
•
•
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
'0 FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Ivo�J at q b Phone #: (503) 718 - vitit.
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CITY. OF.TIGARD
BUILDING DIVISION - PERMIT #:
13125 SW HaII Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 6394171 .
Inspection Requests (24 Hrs.): (503) 639 -4175 �+�' ``�I I
INSPECTION WORKSHEET FOR DATE: TIME: S PAGE: =�
SITE ADDRESS 22 Q S vA 5 \ NIJ ( L( CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: 7 L
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions:
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I I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: '� Q s Date: °, t Tr l1 �6 Phone #: (503) 718- 21-141
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CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A
Inspection Requests (24 Hrs.): (503) 639 -4175 Jam'" ^• f L
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS1 % LA • CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: - T■511 . LE
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • 1v bES Date: 1 tic,40 Phone #: (503) 718 - 3i4410 •
� DIVISION
' PERMIT #: PLM200&0 74
:13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/13/
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 *')
INSPECTION WORKSHEET FOR DATE: 10/16/2006 TIME: 7:03AM PAGE: 27
SITE ADDRESS: 07270 SW SHADY LN CLASS OF WORK:
SUBDIVISION: SHADY DELL NO.2 LOT #: 030 TYPE OF USE:
PROJECT NAME: TUTTLE
DESCRIPTION: Replace water main
OWNER: TUTTLE, JOHN L AND ALYCE M, PHONE #:
CONTRACTOR: AFFORDABLE PLUMBING & DRAIN PHONE #: 503 - 977 - 0560
Inspection Request Scheduled For: Date: 10/16/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
330 Water ser 038243 -01 503 -977 2 0560 N
•
Corrections /Comments /Instructions: •
•
•
1
•
•
•.
n PASS RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL • CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: I" G '� Date: 6, I tii6P y Phone #: (503) 718-