Permit CST\ OF TIGARD
PERMIT
PERMIT #: ELC2005 -00283
1� DEVELOPMENT SERVICES DATE ISSUED: 4/27/2005
cif II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103AB -04700
SITE ADDRESS: 11411 SW SHROPE CT ZONING: R -4.5
SUBDIVISION: WALNUT GLEN LOT : 005 JURISDICTION: TIG
Project Description: 2 branch circuits. AC and outlet
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: 1 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:
ROE, TRAVIS & AMY GRF ELECTRIC
11411 SW SHROPE CT 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 442 -1472 Phone: 503 - 829 -4146
FEES Reg #: LIC 76751
Description Date Amount SUP 3
ELE 3 -48-48 4C
[ELPRMT] ELC Permit 4/27/2005 $53.50
[TAX] 8% State Surcharge 4/27/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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 ''0-
1- 33 -2344.
Issued By: /` c ,�w , � Permittee Signature: 4' i _
� )
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.
Apr 26 05 09:OOa GRF Electric 5038295747 p.1
Elec , , FOR OFFICE USE ONLY
E l Permi °� -11� ;�.i,,
Received electrical
Date/By: ai Cc •aI� Permit No.: L(j
C �) j —C!) ,/-
City • and of Ti 211U5 Planning A rove( Sign
Tigard AP R 2 6 Date/By: Permit No.:
� ' 13125 Hall Blvd. Plan Review Other
Tigard, Oregon 97223 . CITY OF TIGAR'' Date/By: PermitNo.:
Phone: 503- 639 -4171 Fax: 50 g Divi ! Post - Review Land Use
' �^ <hr� +� Contact Case No.:
Internet www.Ci.tigafd.Or.us �I I Contact Juris.: ® See Page 2 for 1
24 -hour Inspection Request: 503 -639 -4175 J Name/Method: r /C, Supplemental Information.
•
lV '1,.,. „u _ :,:'::....,:.41,N. ... -
:.fy'? J�' 'El o ?.1i'I!ORif� ..: :'' , ':-.* . PI;AN'1tEViEW'(Please check all'that a 1 1
i
IN New construction • Demolition 0 Service over 225 amps- ❑ Health -care facility
commercial
12 Addition/alteration/r •lacement r Other: Service ❑ Hazardous l
❑ over 320 amps - rating of ❑ Building ilding over 10,000 r 10,000 square feet,
liatiaaRM oQ iCA.91 :: a • :ZF.CO • ' .1CTIO .. . • . l & 2 family dwellings four or more residential units in
IE 1 & 2 -Famil dwellin: • Commercial/Industrial ❑ System over 600 volts nominal one structure
,11 Access Buildin 1 I-- ❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
• II Master Builder • Other: ❑ Egress/lighting plan ❑ Other:
" , pB N ',1 1 Q ' TION'ad'd:•LO'CATION ::-. "' :' ;=:,' • Submit sets of plans with any of the above.
The above are not applicable to temporary construction service.
Job site address: - , '.'• . . .z:::. ; EEE *SCHEDULE.:..'."':, : . •
Suite #: Bld _. /A • t. #: Number of inspections per permit allowed
Pro'ect Name: L P Dc.ertptlou . 1 Qty - Fee (ea.) Totst J
Cross street/Directions to job site: New residential - single or multi- family per +
l dwelling unit. Includes attached garage.
Service Included:
. _ 1000 sq. ft. or less 145.15 4 i
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2 1
Subdivision: Lot #: Limited energy, non residential 75.00 2 '
Tax ma .l • arcel #: Each manufactured home or modular dwelling
Mir n' o •. . • t. .a • ' . ., °` service and/or feeder 90.90 2.
Serv ices or feeders - installation,
- �R _ alteration or relocation:
200 amps or less 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
all 7 414 1Mi , 601 amps to 1000 amps 240.60 z
Over 1000 amps or volts 454.65 2
Name: A II ` ' (_ • • Reconnect only 66.85 2
Address: . Temporary services or feeders - installation,
alteration, or relocation:
200 amps or less 66.85 I
Phone: — - Fax: 201 amps to 400 amps 100.30 2
401 to 600 amps 133.75 2
l f ai..�.�� k ' {t ilk' ' ONTA'. : ' ,2;11 -' ' Branch circuits - new, alteration, or
Name: extension per panel:
Address: service order fee, each ranchcircu t 6.65 2
Ci /StateiZI' • - • B. Fee for branch circuits without purchase of -
• service or feeder fee, first branch circuit l 46.85 t 1 t, • 4 s 2 -
Phone: Fax: • Each additional branch circuit 1 6.65 � ,r
E -mail: Misc.(Service or feeder not included): . td -G!
, . 1D },,, ,f 4g L 7 Each pump or irrigation circle • 53.40 • 2
s • a.= Each sign or outline lighting 53.40 2
Job No: Signal circuits) or a limited energy panel,
Business Name: G 0 - - r alteration, or extension Page 2 , • 2
Description
Address: S / • '
- Each additional inspection over the allowable in any of the above:
' U _ • Per inspection per hour (min 1 hour) 62.50
Phone: j► - _ _ - , ax: ► 3 - 8 011M16111 Investigation fee:
CCB Lie. #: Other.
• `:'*i. ;;�_�,, ;: ` . � •. �., ;r:.: � ^.. �`.
Supervising electrician . <'0
Subtotal $ � . 3
Si a t ature r - .uired: Plan Review (25% of Permit Fee) $ '
Print Name: A , i ■ _ _ State Surcharge (8% of Permit Fee) $ `t - __
TOTAL PERMIT FEE $ —
Authorized Zi,[ l ( r7 Notice: This permit application expires if a permit is not obtai within 8
Side; • Date: 180 days after It has been accepted as complete.
*Fee methodology set. by Tri •County Building Industry Service Board.
- (Please print name)
•
•
i•tt)sts\Perrnir Frnms \ElePermitApp.doc 01/03
CITY OF TIGARD . . + •
BUILDING DIVISION PERMIT #: ELC2005-00283
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/27/2005
Phone: (503) 639 -4171 � �e ,� F 1 1 1 l l\
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 4/28/2005 TIME: 7:24AM PAGE: 60
SITE ADDRESS: 11411 SW SHROPE CT CLASS OF WORK:
SUBDIVISION: WALNUT GLEN LOT #: 005 TYPE OF USE:
PROJECT NAME: ROE
DESCRIPTION: 2 branch circuits. AC and outlet
OWNER: ROE, TRAVIS & AMY, PHONE #: 5034411472
CONTRACTOR: GRF ELECTRIC PHONE #: 503-829-4146
Inspection Request Scheduled For: Date: 4/28/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 005562 -01 5030234146 Y
Correction /Comments /Instructions:
A / 1K,.k P- iv - Ko MP
' vtiiri ivy I q 3 A--pc_ rK , f.
C ) v
PASS V PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL VALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
o O
Inspector: Date: �� Phone #: (503) 718-
CST\ OF TIGARD
PERMIT
PERMIT #: ELC2005 -00283
1� DEVELOPMENT SERVICES DATE ISSUED: 4/27/2005
cif II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103AB -04700
SITE ADDRESS: 11411 SW SHROPE CT ZONING: R -4.5
SUBDIVISION: WALNUT GLEN LOT : 005 JURISDICTION: TIG
Project Description: 2 branch circuits. AC and outlet
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: 1 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:
ROE, TRAVIS & AMY GRF ELECTRIC
11411 SW SHROPE CT 15460 SE PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 442 -1472 Phone: 503 - 829 -4146
FEES Reg #: LIC 76751
Description Date Amount SUP 3
ELE 3 -48-48 4C
[ELPRMT] ELC Permit 4/27/2005 $53.50
[TAX] 8% State Surcharge 4/27/2005 $4.28 REQUIRED ITEMS AND REPORTS
Total $57.78
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 ''0-
1- 33 -2344.
Issued By: /` c ,�w , � Permittee Signature: 4' i _
� )
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.