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Permit
CITY OF TIGARD ELECTRICAL PERMIT pril PERMIT #: ELC2007 -00127 COMMUNITY DEVELOPMENT DATE ISSUED: 2/28/2007 .TIGARD • 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 102CC - 04600 SITE ADDRESS: 13645 SW STEVEN CT ZONING: R -4.5 SUBDIVISION: BEREA LOT : 007 JURISDICTION: TIG PROJECT: GIBSON Project Description: (3) branch circuits for furnace, GFI & exterior light. Job #5141. 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: 2 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: SCOTT & LORI GIBSON HILLSBORO ELECTRIC 13645 SW STEVENS CT 21185 NW EVERGREEN PKWY #110 TIGARD, OR 97223 HILLSBORO, OR 97124 Phone: 503 - 670 -0175 Contact #: PRI 503 - 439 -9666 FAX 503 - 601 -3680 FEES Description Date Amount Reg #: ELE 34 -4399C [ELPRMT] ELC Permit 2/28/2007 $60.15 LIC 134481 [TAX] 8% State Surcharge 2/28/2007 $4.81 SUP 4941S Total $64.96 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: 0 �_ Permittee Signature: �.Py 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. 02- 28 -'07 10:55 FROM- Hillsboro Electric 503 -601 -3680 T -675 P002/002 F -800 Met rical hermit A , _lication I ot; OI tic l:. i i; (:)•1,\ City of Tigard Received .1 / P ermit No.; 13125 SW Hall Blvd„ Tigard, OR 9722 ' ' A s �' f a . Date/13 y = / 1 ii W • Phone: 503.639.4171 Fax: 503.598.1960 i;,,, I . ; ` Date y Date/By: Other Pernik: Inspection Line; 503.639.4175 cj r l , () _ 'j I' Date Ready /By: lu ls: 6s See Page 2 for w Internet; ww.ci.tigard.or.us f E� 20 j Notified/Method: Supplemental Information fi . . • ••• .. ._ :.. °:- .:.: .. ; I ANR>V ,.. ❑ New construction . ifl f►,tte , >�gp t Please check all that apply: ❑ Demolition ❑ �ther; . N Cl'ir. . ❑Service over 225 amps, comm'1 ['Hazardous location , ; : ,, . ,, . , , amps p 6 g over 10 ce over 320 am rating Bulldn 10,000 sq. ft _ OOs, :.; .:: ;; : :QF CONS'LRIJCHON: : : .: of 1 - and 2 - family dwellings 4 or more new residential 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure ['Building over three stories DPeeders, 400 amps or more ❑ Multi family 0 Master builder ❑Other; - persons structures or .:.. •:•- �:, ".::::.,,.:.....: .,� _ load over 99 pars ['Manufacn,red structu ., :. ;..:•::don'::$ . . ^,r:,QCATI .. ... .........::. >.,,.,:::::.,:..:,> ..,... .. ,........,..,�►,,,.�52�;:�8�:. ......... _ .QIV:. ; „ 0E8rcssAlEAD118 Plan RV park Job no.: 91 1 Job site address: 1 � ) �,�i� t G [Wealth -care facility ['Other: �� Submit 2 sets of plans with any of the above. City /State/ZIP'Ti / v� , The above are not applicable to temporary construction service. Suite/bldg. /apt, no.: v Project name t 1 - .... . *> .'.r A1l1: i = ;' :;:::,... . .. . . i �' /'" , ` occriptioo I Illy, I Fee. I Total 1•• Cross street/directions to job site: New residential single- or multifamily dwelling unit. Includes attached garage. 1,000 sq. ft. or Inns 145,15 I 4 Subdivision: Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1 TBX map /parcel no.: Limited energy, residential 75.00 2 .;,..:......: energy, 00 2 • ' `•' ;•.: ° - ; Each manufactured or modular II • • dwelling. service and/or feeder 90.90 2 . I • /4 ‘ - i•1� ■ ` / Services or feeders installation, alteration, and/or relocation 4 4 A 0 +1.1 t- 200 amps or less 80.30 2 - ,:: ,:..:•.r..,.. I' g O� RTI ©: amps to 400 amps . 106.85 2 r : ... 401 amps to 600 amps 160.60 2 ^ Name. b A t ( 6. 1 04ii) t /1 601 amps to 1,000 amps 240,60 2 Address: inn yj /1✓— / ivz I V V r� v Y Over I,000 amps or volts 454.65 2 a r N (/r2/ V� Reconnect only 66.85 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or Phone: () I Fax: ( ) relocation 200 amps or less 66.85 1 Owner installation: This installation is being made on property that 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: e • :.:, :.:��: ,..,, t •.,�::. o r Branch circuits— } . .4c ,: ., >� >te,�rr.,.:,:.:1 ;; ! Fee for bran ; , :4 h c rcuits w h a or extension, per panel • ,....._.. . .., . .L :I . .... ....:................._ �........ • 1 :.. • • , . F7 . ... . ... .... .... • p$_ ..,... ..,.... . . . , ...-.._.. .. .:,: : � - .: � �: . 1V1'AiG°i`.. R�CliN ' i s <<: service or feeder fee, each Business name: A S, branch circuit 6.65 2 Contact name: "' 1 � ' • B. Pee for branch circuits without service or feeder fee, �L_ Address: first branch circuit ' 46,85 �'K' 2 Each add'l branch circuit 6.65 1 4% 2 City/State/ZIP: Miscellaneous (service or feeder not included) Phone: Pump or irrigation circle 53.40 2 ( ) 1?ax. ( ) Sign or outline lighting 53.40 2 E -mail: Signal circuit(s) or limited- . ....:: ,.:,,:.:,.<:::: GO .: ; r„"I;�f1�;. , .... energy panel, alteration, or extension. Describe: Page 2 2 Business name: Lisleb►o f3r�i U Address �� 1 r 1 , t *Ito Each additional inspection over allowable in any of the above U �� [ P inspection 62.50 City/State /ZIP: � � Investigation per hour (1 hr min) 62.50 Phone: ' 9i,t4te I P an; (j Ub) ' i Q D Industrial plant per hour _ 73.75 .......... , coat Lic.:, 1 Electrical Lic.::.4 I Suprv. Lic,: .1 ( 7 :: LtiCTRlC fi)�;': ! YtM REES�:;: ;.5;::;:;:":: - Subtotal l.iV Suprv. Electrician signature, required: �� Plan review (25% of permit fee) Print name: \ /I)-7t I� Date: '� „I D� State surcharge (8 "/a of permit fe y � TOTAL PERMIT PEE 1P4M Q Authorized signature: This Pat•mit application expires if a permit is not obtained within 180 days after it has been accepted as comptete Print name: I Date: • Fee methodology set by Tri- County Building 1aduStry Service Board •• Number of inspections per permit allowed. iA$uildioggennh LC- PumirApp.doc 12/03 440461 57(10/02/COM/ma+s CITY OF TIGARD - BUILDING DIVISION PERMIT #: ELC2007 -00127 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/28/2007 Phone: (503) 639 -4171 AI, �i Inspection Requests (24 Hrs.): (503) 639 -4175 � _ -. INSPECTION WORKSHEET FOR DATE: 3/29/2007 TIME: 7:00AM PAGE: 48 SITE ADDRESS: 13645 SW STEVEN CT CLASS OF WORK: SUBDIVISION: BEREA LOT #: 007 TYPE OF USE: PROJECT NAME: GIBSON DESCRIPTION: (3) branch circuits for furnace, GFI & exterior light. Job #5141. OWNER: GIBSON, SCOTT & LORI PHONE #: 503-670-0175 CONTRACTOR: HILLSBORO ELECTRIC PHONE #: 5034339666 Inspection Request Scheduled For: Date: 3/29/2007 Pour Time: Code # Inspection Description on!' Contact # Message 199 Electrical final 045663 -01 503-538-2953 Y Corrections /Comments /Instructions: , p�/y� t U 1 tf T . 1 61,1 LAB Lc S 118 cANi Go (Z, 1 O HA C W o(Ll( ia; 6 c,.. li V A C 4 • a� • i 1 As 111 PARTIAL APPROVAL ❑CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES.ASSESSED Inspector: G N) ()16 LE Date: ?J' . 01 Phone #: (503) 718 - 1‘