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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00436 COMMUNITY DEVELOPMENT DATE ISSUED: 6/27/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S114BB-00800 SITE ADDRESS: 10125 SW SERENA WAY ZONING: R -4.5 SUBDIVISION: PICKS LANDING NO.1 LOT : 007 JURISDICTION: TIG PROJECT: PALOMA Project Description: Install (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: MAUREEN PALOMA MILESTONE ELECTRIC 10125 SW SERENA WAY 1800 NW 169TH PL. SUITE B700 • TIGARD, OR 97223 BEAVERTON, OR 97006 4 Phone: Contact #: PRI 503 - 645 -5323 FAX 503 - 690 -4843 FEES Description Date Amount Reg #: ELE 34 - 618C [ELPRT] ELC Permit 6/27/2007 $46.85 LIC 153480 M [TAX] 8% State Surcharge 6/27/2007 $3.75 SUP 45745 Total $50.60 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 =! Permittee Signature: ep /i(_'t / QYJ �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 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. _r f Jun ? 26. 2007 11' ' '''1 Milestone Electric No. 6941 P. 1 Electrical Permit . 1 0 ∎ FOR t�FFI(k USE ONLY ft. Ci _ �`.'of� Tigard R eceived Permit No.: 31I 25 SW Hall Blvd. Tigard, OR gat PlanR �l �2� t S ()l�' _ `- I ! � i e Phone: 503.639-4171 Fax: 5O-56O is I D ian Review j ; . IV, * . t r : /r� I ` DatrJBy. Other Penult: Inspection Line: 503.639.4175 JUN 2 6 : ,�,L `j . Date Ready/By hurls: ® Sco Page 2 for Internet www.ci.tigard.or.us Notified/Method • T' ' Supplemental Information Oi PLAN REVffW ❑ New construction ----- lUdjfigaleWthigNaVs461 ON Please cheek all that apply. 0 Service over 225 turps, comrn'l ❑klazardous location [] Demolition _ ](her: ❑ Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., .CA,icliY OF CONSTRUCTION.. ; , • . , . _ • ' of 1 - and 2- family dwellings 4 or more new residential and 2- family dwelling Q ;orisrnercial/industrial 0 Accessory building 0 System over 600 volts nominal units in one structure Multi- family faster builder ❑ Other: ❑Building over three stories" ©Feeders, 400 amps or more ['Occupant load over 99 persons ❑ Manufactured structures or JOB SITE 0 MATION • AND LOCATION DEgress/lighting plan RV park Job no. :727 Job site (dress: /0/2S 5, wt Set W� ❑Bealrh -care facility E Other: -_ .. _- Submit i sets of plans with any of the above. City / State/ZIP: r 97 z-2-3/ The above are not applicable to temporary construction service. Suite/bldg. /apt. no.: io}ect name: AtealO . I Qtr. 1 Few I 'row I "• Cross street/directions to job site: Q c.r— .4 Jam_ 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'l 500 sq. It. or portion 33.40 1 Tax /parcel no.: • Limited energy, residential 75.00 2 Limited energy, non- residential 75.00 2 DESOIPTION OF. WORK .. . Each manufactured or modular i^ j � L dwelling, service and/or feeder 90.90 2 '� 5 '` r / � (�/ Services or feeders installation, alteration, and/or relocation 200 amps or less 8030 2 . 20 amps to 400 amps 106, 85 2 Er PROPERTY. U'!�]'El� :• 1] .TENANT ' • ' ; . 401 amps to 600 amps 160.60 2 Name: iL.4 .J. P ®.._ 601 amps to 1,000 amps 240.60 2 Address- Over 1,000 amps or volts 454.65 2 Reconnect only 66.85 2 City / State/ZIP: Temporary services or feeders installation, alteration, and/or Phone: ( ) ! Fax: ( ) relocation g made on property 200 amps to or 400 66.85 1 Owner installation: This installatior is being p party thaz 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 circuits - new, alteration, or extension, per panel ' 0 ,&LTU ' CAI • r,' • ' . D CONTACT. FI RSON A. Fee for branch circuits with • service or feeder fee, each 6.65 2 Business name: branch circuit B. Fee for branch circuits Contact name: without service or feeder fee, i 46.85 f. 2 Address: each branch circuit r Each add°( branch circuit 6.65 2 City/State/ZIP: Miscellaneous (service or feeder not includedZ Phothe: ( ) f Fax:: ( ) Pure , or irrigation circle 53.40 V 2 Sign or outline lighting - 5.3.40 2 E -mail: Signal circuit(s) or limited- - ... ' . L..... CONTRA.CTOR • ' . . . ' • energy panel, alteration, or Business name: ( extension. Describe: Page 2 2 4(/ /P,f"(,,LC' ? deft -, G. r. Address: /800 � t (,_ L /� p S� a f '7 p Each additional inspection over allowable in any of the above 4 Per inspection 62.50 City / Sta te/ZIP: gi 7 9 9 � Investigation per hour (1 bx do) 62.50 ^ -- Phone: (co ) W /f37...3 Fax: (SU3) 690_ e Ar Industrial plant per how 73.75 ELECTRICAL' PERMIT FEES* CCB Lic.: 'S'3 (fX' Electrical Lie.: 3/(-{42/8"C.... Suprv. Lic.: 95 5r' Subtotal ( �S" Suprv. Electrician signature, required: . ..-_.M Subtotal Plan review (25% of permit fee) ` D State surcharge (8% of permit fee) 3 • Print name: / 67/ 2.6-07_ % , 519 " TOTAL PERMIT FEE 6 - _ Authorized signature_ i/4 e et ° tits permit application expires if a permit is not obtam ed within 180 days after it bag been accepted as complete Print name: � / .,- _ ...01° Date: . . . Q • Fee methodology set by Tri- County Building Industry Service Boated • • Number of inspections per permit allowed i Maui lding \Permitsu?I,C- Pctro itApp•doc 12/03 440. 45157(10 /0z/COM/WE8 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2007- 00436 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/27/2007 ' Phone: (503) 639 -4171 � Inspection Requests (24 Hrs.): (503) 639 -4175 5+- "I �.. INSPECTION WORKSHEET FOR DATE: 7/6/2007 TIME: 7 :06AM PAGE: 33 SITE ADDRESS: 10125 SW SERENA WAY CLASS OF WORK: SUBDIVISION: PICKS LANDING NO.1 LOT #: 007 TYPE OF USE: PROJECT NAME: PALOMA DESCRIPTION: Install (1) branch circuit for hot tub. OWNER: PALOMA, MAUREEN PHONE #: CONTRACTOR: MILESTONE ELECTRIC PHONE #: 503-615-5323 Inspection Request Scheduled For: Date: 7/6/2007 Pour Time: Code # Inspection Description 7Corifirm Contact # Message 199 Electrical final , 051527 -01 \ 503.6455323 N Corrections /Comments /Instructions: Q__, -- ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Zr' m ®V Date: w ) • 6' 01 Phone #: (503) 718 -1-44L'