Permit + � L CITY OF TIGARD ELECTRICAL PERMIT
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° PERMIT #: ELC2007 -00611
COMMUNITY DEVELOPMENT DATE ISSUED: 8/30/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133AD-13900
SITE ADDRESS: 12701 SW SORREL DOCK CT ZONING: R -7
SUBDIVISION: SUMMER LAKE LOT : 020 JURISDICTION: TIG
PROJECT: FERNANDEZ
Project Description: (4) branch circuits for heat pump, furnace, GFI and bath fan.
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: 3 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:
FERNANDEZ, JUAN + MELANIE WEST SIDE ELECTRIC CO INC •
12701 SW SORREL DOCK CT 1834 SE 8TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 736 -0677
• PRI 503 - 231 -1548 •
FEES
Description Date Amount Reg #: ELE 26 -135c
[ELPRMT] ELC Permit 8/30/2007 $66.80 LIC 13306
[TAX] 8% State Surcharge 8/30/2007 $5.34 SUP 4654S
Total $72.14 REQUIRED ITEMS AND REPORTS
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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 952-001-0! = ough 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.
i 'Ar Issued By • /// jilt L - Permittee Signature: Si .
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.
Rug 29 07 04:33p West Side Electric Co. (5031736 -0677 p.
.altdairical Permit Application FOR OFFICE 11SE ONLY
City of Tigard IGa
- `` ' D f)u ldny: • • fI // �r _Penult No FL r ,� " ZJIJ(o(�
13l'l5 SW lull Fl lvd„'1 1 b ai J, OR 9722:1 \ qu Review
4 . "' Phone: 503,G,i9,4 I'/ l Fax: S0.i. >y (mbar Penult:
t.>ilwnr
YIGARD Inspection Lille: 503.639.4175 Dale Ready/By: - hair' RI Sec P:gi 2 fur
1utaLUel: www.tigard- or.guv I,1 Nwllicd/Med al: .., y Supplemental lnturrartioa
L
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TYPE OF WORKP»3 •�-}� 0 l _ _ - PLAN REVIEW
0 New construction Addi[iun/il T; ` Neese check an apply (suboat 2 sets of plan• w /ua•Lri chccYed below):
L.7.1 Demoliliutt ❑ (Thief: G `\`I`� 0Sct rice orfeeJ..r 400v,tg'surmere ❑Dulldingoverthree
,�,`1 c0
_ when: dli: available fault aurrcat ❑ Marimix and boatyards.
_ CA1'ECORY OF CONSRLIPO[ION � exceril;; 10,000 amps ai ISO Volta or (3 Floating hu;lJirign.
7f I and 2- lilllllly dwcllitlg ('.(Httt11e1'l:i$1/ln(1115I1'iu1 r l__I I Ica ii' ro nd, OrcAceeda 14,000 0 Conuniscial.Use agraculau
Cl -� Accessory building amps IiLrall miler iu:tati lions. btiilduag•..
L..1 Multi- Candy El Martel builder ❑ Oilier: fl Putc pump, 01rsaUaitiouof75KVAor
3011 11'►'); 1NFOItMA'I'JON AND LOCATION l -- ❑ C,urLgna:y :pion. larger separaely derived syateui.
Jul" Hu.: .. - -- q ❑ Addition anew rumor load or ❑ ^A ", "'Li", - l•2 ","1 .3"
u.: q II1 Job site address: L 2-'70( LOUHI. mare. uwvp:u,cy.
...... --- ,..7.)5•5 " .. .. -•— / �^' �_ ,!-�. ( L 0 Sim ,Lr rrurr. rasa:Ionia) Labia, ❑ Rocroatiounl vehicle parks.
Lily /State/LIP: r 0 licaldo- u ret:tcililiaa. 0Supply
_ 1 4r' Z 2,,? _ vulm Ire for more do.)
01I
Suite /bid' ✓L 1.110.: — - azwW GOO voltsuurrytttl.
6 P Project name: r 0Service ur feeder 000 amps or nlure.
• Crux, street/directions CO job site: K M FE SCHF.DU
v., .•. — �IrriL�liou L • '!'seal
New residential single- or mull- fa,uily dwelling will.
Includes attached garage.
Suhtlivi, ion: Y— - _ + l.of no.: 1,000 sti, Ii, or Ices 145.15 4
Tax map/parcel rcel no.: _ - -- D. add'I SUU. . It ur portioLl 33. 1
_..
Lim cacrgy, residential
DESCRIPTION 01: WORI -- -- I' iw;tl,ahnyn ti.) 75.00 2
1 / t � 4 L.itLti[Yl1 energy, mWti•G4nily
L r es Kt etl! l with above • n 75.00 2
St ryict's ur feedct•s lust:Ltlation, alteration, autWor relocation
_200 amps pt. less 80,30 2
�YItOPEwrY W
ONL;12 — i 201 aril s to 400 am 1 \ �
_ I ❑ 1'FNANT p I • 106.85
Name: 401 maps to 600 amps — 140,60 2
601 amps to 1,000 amass 240,60 2
Addt'ess - . —_ ��'( _ _ _ Over 1 . 000 antpsor volts __ 454.65 2
City /State/ /1P; • Temporary services or feeders iASt:tllatiun, altera and/or
relocation
Phone: O 59 O _ (, g lax: ( ) 200 amps or less 66,X5 1
Owner iustnlluuua; This intilallatiun is being made can properly that 1 own whit h is nor 20 amps t 400 amps 100.3 2
kneaded for sale, lease, rent, of exelluugc, accoiditlg to ORS 447, 449, 670. and 701. gulp aun to 599 maps 133,75 2
Owner signature: _ Dale: Branch circuits - new, alteration, or a Tension, per purl
_.._
A. Fcc lbr branch circuits with
❑ APPLICANT 1 CONTACT l')ERSUK above service or feeder 1'cu,
- . each branch circuit 6,05
Iluailtess name: __ B. Fcc for branch chew 1s •
without service or feed fee,
name: ';
4e.S5 L' 2
Contact
-- — • - - •. •- _ tint brunch circuit _ _
Address; linen m1(11 branch circuit 6.65 r q> 2
' — __z. - " " • -- Miseellnncuus (service or feeder nor laeluded)
City/State/ZIP: Each manufactured or modular
— — dwr.IliLty„ service end/or feeder 90.90 2
- — _ rtccuuucct _ 66.85 2
I -Mail: glenng@wesisidetelectric.com Poop or irrigation circle 53.40 2
CONTRACTOR • — i Sign or outline lighting 53,40 2
Business name: West Side Electric Co., Inc. Signal circuit(s) or hnLitul
- energy panel, alteration, or
Address: 1834 SE 8th Ave. extension. Describe: Page 2 2
City/State/ZIP: Portland, OR . 97214 _ I t•Ii a inspection over allowable• in any of the above
— - -' - Per inspection 62.50
Phone: (503) 231 Fax: (503) 736-0677 Investigation per hour (1 hr nun) 62 „50 �
CC13 Lic,; 13306 W I Electrical Lie.: 26 -135C. Stlprv. Lie,: 46545 Industrial plant per hour 7 3.75 -
Sugrv. Electrician tan signature. requirl. ll �'� / — _. - ELECTRICAL l'li(tM11' Imes `
... ., V' .1-, - ( swht X30
Print name: (taztdiili Roberts ti tle: 4r;2/ ro • _ Plan roview (25% Ofperauii fa : ) ;
1 State surchar (8% of permit fee): e - 3 ( Authorized Siglhttttre:
—.. _ - -•• -
!'_ I'OTAIPERMIT Ctiii: `7 Z. 1�
Print man W : Dan,. -
This pereuif pppltcotiva expired u p tMrm w it not obtained! l
w u 1 8 0
— — _ I days after it has bran accepted as eauiplewc.
• Number of h iepectiau allowed per pern
I . ouisis ot•? J( 4404013flil /u•,n'Ut+LWF1i
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00611
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2007
Phone: (503) 639 -4171 A
� Ins ection Re uests 24 Hrs.: 503 639 -4175 J. IL.
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INSPECTION WORKSHEET FOR DATE: 9/6/2001 TIME: 7:OOAM PAGE: 73
SITE ADDRESS: 12701 SW SORREL DOCK CT CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 020 TYPE OF USE:
PROJECT NAME: FERNANDEZ
DESCRIPTION: ( 4 ) branch circuits for heat pump, furnace, GFI and bath fan.
OWNER: FERNANDEZ, JUAN + MELANIE, PHONE #:
CONTRACTOR: WEST SIDE ELECTRIC CO INC PHONE #: 503'231 -1548
Inspection Request Scheduled For: Date: 9/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 055188 -01 503 -231 -1548 N
Corrections /Comments /Instructions:
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Ili PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL F'R INSPECTION ❑ ADDITIONAL FEES ASSESSED
.!; C &a�
Inspector: � � I Date: Phone #: (503) 718-