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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00685 COMMUNITY DEVELOPMENT DATE ISSUED: 12/4/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DC-12500 SITE ADDRESS: 13338 SW SHORE DR ZONING: R -12 SUBDIVISION: ARI GREEN LOT : 016 JURISDICTION: TIG Project Description: Inspection on minor label ELS 95914. 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: 1 201 - 400 amp: 1st W/O SRVC OR FDR: 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: ROGER GRONKE CONDUIT ELECTRIC 13338 SW SHORE DR 19461 SW 89TH AVE TIGARD, OR 97223 TUALATIN, OR 97062 Phone: Contact #: PRI 503 - 692 -1428 FAX 503 - 692 -3652 FEES Description Date Amount Reg #: ELE 26 -905C [ELPRMT] ELC Permit - 12/4/2006 $62.50 LIC 109669 [TAX] 8% State Surcharge 12/4/2006 $5.00 SUP 4501S Total $67.50 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: Permittee Signature: S'D .Q c)N 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. • 2tO6 /PF•C /04 /MON 11:11 AM Conduit Electric FAX No. 5036923652 P. 001 Electrical Permit A 1p g .. ED FnR Orel(. E. USE ON1.1 City of Tigard DEC ©4 2006 s Revel e n - � -a , ir ' 13125 SW hall Blvd., Tigard, OR 97223 Plan Review Mei- Permit: ia;rF Phone: 503.639.4171 Fax: 503598.1960 .r ∎ -. 't I` Date/13 - Inspection Line: 503.639.4175 ClTY Cii- T,,. .44 -a : I 1 ., Date �,d , 121 See Page 2 for __ � :. Internet:. www.citigard.or.us BUILDING DI • iuiv - Nontedmtetbod • Supplemental Information ., ='dam `�( :; i. °.' ?-= ';�C�° r'r'� " "Vi=i.' : :C'f*�' l' -i �a Y!:' ;�t�' :r7: ��` :,w-,�� 4tif "• �cti '��• i f r � ^.•yN' .. � .. , .rY �:` :�'���: ,. ... Srw7 •�. j7., �b 'iG a r : r•a i. =i� +•� - .Y.2.S �; . rx'� % .. r......e�11-•- ...1arh,.Yl... �._ _. •. 't . J .. �i .- h +s-� .. . -. : - ��� ._.r : :F�I.,.t,., . :�E.,Ul•- �l�fii .. •;f� ^� n .. : .,.. -.. ,. .c.e1 :.x *.� : \9 °=Y •.v ❑ I New construction a Addition /alteration/replacement Please check all That apply: ❑ Service over 22,5 amps, comm'l ❑Hazardous location ❑ Demolition ❑ Other: El Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft., 1-and 2- famil t.. '•ri : f . -;i; tF sk[ : ••,::! ' 1;• ;y :•!I . ?. .: ,,�• :. of y• dwellings . .4 or more new ' residential ..,::•ik: r.. C, AGORYr tUF�CUNSO� 't]O1�T�;_ ,• ;;s , i ' ;;�.4. . ,..: • �4.. ❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ❑Building over t stories OFeeders, 400 amps or more ❑ Multi - family ❑ Master builder . Other: ❑Occupant load over 99 persons ❑Manulhetured structures or , R ..• :. :�,_ ir . k , w..� :f Y- 1W pack :` P^ t2;`s;; z : ``'`r,0.;rOxYUIV;�AfiIA•gGA3Q s' ...:•.•., ❑EgressQighting ❑Other M� Job no S J sq6 Job site address: ,, ��r C o� El Health-care facility t= L Q 3� Submit 2 sets of plans with.any of the above. City/ State/ZIP: 1 t • 6 6 lb r q - _ The above are not applicable to temporary construction service. S1Y ! d.•1:ti' A: 1 L,d`.Y@i'c.+1 :" , 1 l WN° ,__,_. t'Y° _,„__ •.0 ti i tNly�;', rGti, ' Cg,11: Suite/bldg./apt no.: Project name: G,►?lnkjl.. C be«Pe;on Qtr. F. hold I •• Cross strect/ditections to job site: New residential single- or multi - family dwelling unit. Includes attached garage- , 1,000 sq. ft. or less • 1 145.15 4 • Subdivision: Lot no.: Ea. add') 500 �. ft. or portion • , 3 3.40. _ • ) • . Limited energy, residential • 75.00 • 2 • Tax map /parcel no.: Limited energy, non- residential 75.00 • . 2 . c '`r ; Y r' .: i '4,tr�3;4 % i�2l.•." - ,Y�110 #.0 ...,,�0 . *YOaV .e. ': ! �t + ` f ,t.'�i :. Lsf'y"�t l t, Each menu/tinned or ;, rt - � ;. _ ; a` y _;' ., . modular dwelling, service and/or feeder . • 90.90 • • 2 - • - 't 6.* I I it ' A 1 . ,.• • N Services or feeders installation, alteration, and /or relocation 200 amps or less J • 80.30 l 2 • ;x 201 s to 400 amps 106.85 2 .. . F .. �. :.iA : :: : :..�.•, :'f•.: a mp P • .R41 :r. .�' }IjO6\�41t l r F�7:1 - A� , Y. %•.._r r . -t:• l' r.w • ._... •. , 401 amps to 600 amps • 1 60•• -2 Name: o • • -'/ . 601 amps to1,000 amps 240.60 2 VD Address: Over 1,000 amps or volts • 454.61 2 • ' • Reconnect only 66.85 • . 2 City /State/ZIP: Temporary services or feeders luatallation, alteration, and/or . relocation Phone: ( ) I Fax: ax: (' . ) 200 amps ar less 66.85 • l - Owner installation: This installation is being made on property that I own which is not 201 arnys to 400 amps . ' - • • • 10030 2 intended for sale, lease, rent, or exchange, according to ORS 447, 419, 670, and 701. • 401 amps to 600 amps 133.75 2. Owner signature: Date: _ Branch c ircuits - -ne_w, alteration, or extension,. per panel z ;';' , , ,• : , jti�:+ "j ",,g ' % .. ,;: �'`' :v latiSA ,�.�\+ or ask, :: °� :,, P Fee for branch circuits with �i E'.., r71 :iYC .?+k r, „`. S' t -,. .^f ".t : :.• :F " : , :� ��- ' ° �.. �' . selvi or feeder fee, each Business name: • branch circuit 6.65 2 . B. Fee for branch circuits • Contact e: fi without service or feeder fee, 46.85 2 �" each branch circuit • Address: • ' • Each add °1 branch circuit 6.65 2 _ .._.__ City / State /ZIP: - - - -- -- — — ' - - -- -- - ---- - - Minillitire anr( 9er viee - uotinetaded) --- • - - - - -. • Pump or irrigation circle 53.40 2 Phone: ( ) • I Fax: ; ( ) Sign or outline lighting 53.40 • 2 E - mail: • Signal circuits) or limited . —� : ., ...:::,... cw� : > +s 4:a ;<c.; -.i" s?,+• :;;`✓ .. energy panel, alteration, Or • - • tr ' 3 extension. Describe: Page 2 2 Business name: Conch `.1/ j I - r Each additional inspection over allowable in any of the above Address: • J y / 5 14 Per inspection 6230 14 �' City / State/ZIP: (i 1 ri f) c J' i n ei C]�L)/ 0 Q Investigation per hour (1 hr min) 62.50 -- //� p. / - lndusaialgilantlier -hour —73-75- — Phone: ( ,) WQ� Iy�l Fax: � �� :t'r :; �.,•• c'f C` 1. 3j r a,;; : RI (rte! ;ri;�a ni; = :� �. IES+± : : : :<i; .t : . CCB Lic.: /63 I Electrical Lic.: gD d S .rv. Lie.: ' . Subtotal c Suprv. Electrician signature, required: ' ': Plan review (25% of permit fee) p0 G %/ b // -- State surcharge (8% of permit fee) . Print name: L° Dom I . :/ V C� • TOTAL PERMIT FEE l 01 Authorized signature :. This permit application expires if.a permit is not obtained within 180 days after it ban been accepted as complete Print name: • • . . Date: • . • Fee methodology set by TA- Count/ Building Inddstry•Scrvice Board • Number of inspections per permit allowed. t. fluildmglpormtta.- C.PamiiApp.doe 17/03 44646157(1WO2/COMIWEB • Label Number: EL S 95914 - . 0 CO • z • Contractor Name: CONDUIT ELECTRIC Property Owner: ROGER GRONKE Installed By: PATRICK COUNTS c Plume: 503- 692 -1428 Phone Number: (503) 521 -0909 Installer License: 167081 o Fax: 503 - 692 -3652 Job.Address: 1 3338 SW SHORE DRIVE Install ?ype: 1 & 2 Family Address: 19461 SW 89TH AVE TIGARD 97223 Issued Date: 7/26/2006 TUALATIN OR 97062 Work Description: REPLACE BRIM 30 DEL PI; INSTALL Install Date: 8/1/2006 0 License: 26 -905C 213OXES FOR KIT LT - bap Rpt Sent: 11/30/2006 CCB: 109669 Comment,• ELS 95915 FAILED P Ins R t Rcvd: z .4upvLic: — 1st / 2nd /3rd Pass/Fail ° Supv Reg: X k j . ` ❑ r Metro N: D rn , r BCD MINOR LABEL PROGRAM - MINOR LABEL TRACKING FORM AND INSPECTION REPORT o Phone: 503 -378 -2804 Fax: 503- 378 -2799 .D JURISDICTION: TIGARD, CITY OF minor label # EL S 95914 Contact log - Three contacts must be attempted within five (5) working days of receipt Date Time Time Initials Results 14- F _ x o �,--�- - n.c -�- u� Ti 1) I 1 a y r yiP o v � co ‘2440( ' '•2 p G-L L -F i v s5 c - . a44:4=',p 9 • • c° '111). O &' P •3d t A SS : "aS utD a'ER.nv1' * L4 2.00b • 0068b' 1�y(ob 1E :, �43& 3 ❑ No Contact ❑ Owner Denied t • o; e g o Lithe owner is unavailable or refuses the inspection, the jurisdiction must notify the Service Center within 10 working days. '11 q- Cnspection Approved Date Approved: 1 • # 1...0' 01 c). lithe inspection is approved, the jurisdiction must send or fax a report to the Service Center within 5 working days. - o ❑ Inspection Failed Date Contractor Notified of Failure: G o . If the inspection fails, the jurisdiction must notify the contractor immediately. Contractors who wish to dispute the inspection results "' . must notify the Service Center within 10 days of notification by the jurisdiction. Contractors who accept the failure determination must call the jurisdiction for a re-inspection and pay the jurisdiction's hourly re- inspection fee. . CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2Q06 00 35 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/4/2006 Phone: (503) 639 -4171 i Inspection Requests (24 Hrs.): (503) 639 -4175 '1. -.. INSPECTION WORKSHEET FOR DATE: 8/28 /2007 TIME: 7:00AM PAGE: 66 SITE ADDRESS: 13338 SW SHORE DR CLASS OF WORK: SUBDIVISION: ARI GREEN LOT #: 016 TYPE OF USE: PROJECT NAME: GRONKE DESCRIPTION: Inspection on minor label ELS 95914. OWNER: GRONKE, ROGER PHONE #: CONTRACTOR: CONDUIT ELECTRIC PHONE #: 503692 -1428 Inspection Request Scheduled For: Date: 8/28/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 054708 -0 503-484-5983 N Corrections /Comments /Instructions: 7 .-- ---- - [PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: r / Date: Phone #: (503) 718- CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00685 COMMUNITY DEVELOPMENT DATE ISSUED: 12/4/2006 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DC-12500 SITE ADDRESS: 13338 SW SHORE DR ZONING: R -12 SUBDIVISION: ARI GREEN LOT : 016 JURISDICTION: TIG Project Description: Inspection on minor label ELS 95914. 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: 1 201 - 400 amp: 1st W/O SRVC OR FDR: 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: ROGER GRONKE CONDUIT ELECTRIC 13338 SW SHORE DR 19461 SW 89TH AVE TIGARD, OR 97223 TUALATIN, OR 97062 Phone: Contact #: PRI 503 - 692 -1428 FAX 503 - 692 -3652 FEES Description Date Amount Reg #: ELE 26 -905C [ELPRMT] ELC Permit - 12/4/2006 $62.50 LIC 109669 [TAX] 8% State Surcharge 12/4/2006 $5.00 SUP 4501S Total $67.50 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: Permittee Signature: S'D .Q c)N 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. •