Permit �.A
r tp .
�I 1 Y OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00333
COMMUNITY DEVELOPMENT DATE ISSUED: 5/16/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133AD-12500
SITE ADDRESS: 11334 SW SUMMER LAKE DR ZONING: R -7
SUBDIVISION: SUMMER LAKE LOT : 006 JURISDICTION: TIG
PROJECT: RAGER
Project Description: Add 50 amp circuits for sub panel in out building.
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: 1 W /SERVICE OR FEEDER: 1 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
BRAVO, JOSE AND TIMBERLINE ELECTRICAL CONTRACTORS
TODD, ANN TONETTE 4707 SW KELLY AVE
11334 SW SUMMER LAKE DRIVE PORTLAND, OR 97239
TIGARD, OR 97223
Phone: Contact #: PRI 503 - 459 - 4089
FAX 503 - 254 -4227
FEES
Description Date Amount Reg #: ELE 26 -121 IC
[ELPRMT] ELC Permit 5/16/2007 $86.80 LIC 160037
[TAX] 8% State Surcharge 5/16/2007 $6.94 SUP 4957S
Total $93.74 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 N i ifica on 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 t UN to • • .:.99 or 1.800.332.2344.
Issued �‘ /j, L _ ; , / / Permittee Signature: 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.
.: Permit Application FOR OFFICE USE ONLY
I. .. Received
City of Tigard CEW Date/By: 5/1S O Permit No.: j cc !,3
° 13125 SW Hall Blvd., Tigard; OR 2 E� Plan Review
' C Phone: 503.639.4171 Fax: 503 Date/By: Other Permit:
T I v A It D Inspection Line: 503.639.4175 MAY 1 6 2007 Date Ready/By: si El See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
CITY OF TIGAflD
TYPE OF ' , 0 ')41M3 DIVISION PLAN REVIEW
Please check all that apply (submit 2 sets of plans w /items checked below):
❑ New construction I Addition/alteration/replacement
❑ Service or fecdcr 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000'amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000' ❑ Commercial -use agricultural
® 1- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑.Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION ❑ Emergency system. larger separately derived system.
❑ Addition of new motor load of
( ❑ "A ", "E ", "I -2 ", "l -3 ",
Job no.: 10 2 i b Job site address: i 13 - � SIL Su t M(4 4 V (CLIU D ❑ Six or or more residential Recreational parks.
Six or more residential units. ❑Rrn vehicle arks.
City/State /ZIP: 'r`, f a V d I D ❑ 1 '7 2i- ❑ Health -care facilities. ❑ Supply voltage for more than
Hazardous locations. 600 volts nominal:
Suite/bldg. /apt. no.: Project name: J /a e ❑ Service or feeder 600 amps or more.
Cross street/directions to job site: Description FEE SCHEDULE
I Qty. I Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
kid LL Limited energy, multi - family 75.00 2
f� dd sb l'c1M IP C w UU ►4 J ;ti b pa bl e ( I. ti residential (with above sq. ft.)
Quf b U t (4 Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PRO
OWNER 0 TENANT 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City/State /ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or less ) 66:85 (p( . 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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit / 6.65 , (,5 2
Business name: B. Fee for branch circuits
Contact name:. without service or feeder fee, 46.85 2
first branch circuit
Address: Each add'I branch circuit c 6.65 /3.3D 2
Miscellaneous (service or feeder not included)
City/State /ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
((��� ( I / / I Signal circuit(s) or limited -
Business name: TIy�4//C v(144`
/ I Vu .€ gI p l L i 1 G � U 31 f " C... energy panel, alteration, or
Gx extension. Describe: Page 2 2
Address: 0 . 01 f
✓
City/State /ZIP: t S Q Each additional inspection over allowable in any of the above
L D w � O V - 7D3 Per inspection 62.50
Phone: (7 7 zi CC, 110, / Fax: (33 ) .2 '/ 2 Z 7 Investigation per hour (1 hr min) 62.50
CCB Lic.: /t, 0 1 Electrical L . .... _ //C Suprv.Lic.: (/ 5-7,g' Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: J Subtotal: C g‘ . gb
Print name: P � t LV t ,t r Date:. c-- 119- 07 Plan review (25% of permit fee):
L° State surcharge (8% of permit fee): G • 91
Authorized signature: TOTAL PERMIT FEE: 93 .
Print name: Date:
This permit application expires if a permit is not obtained within 180
• days after it has been accepted as complete.
• Number of inspections allowed per permit.
IA Building \Permits'ELC- PermitApp.doc 05/23 /06 440-461ST(II /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
;RESIDENTIAL WORK ONLY:
Fee. for all residential systems combined $75.00
Check Type of Work Involved:
O . Audio and Stereo Systems*
E . Burglar Alarm-
O Garage Door Opener*
❑. Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
• ..(SEE OAR 913- 2.cO -2
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
O . Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
E . Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective. Signaling
❑ ,,' Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\Building'Permits\ELC- PermitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5 ,,-/16/2()07
Phone: (503) 639 -4171 1 tl
Inspection Requests (24 Hrs.): (503) 639 -4175 'LL.
INSPECTION WORKSHEET FOR DATE: 1/22/2008 TIME: 7 :01AM PAGE: 67
SITE ADDRESS: 11334 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 000 TYPE OF USE:
PROJECT NAME: RAGER
DESCRIPTION: Add 50 amp circuits for sub panel in out building.
OWNER: BRAVO, JOSE AND, PHONE #:
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503459.4089
Inspection Request Scheduled For: Date: 1/22/2008 Pour Time:
Code # Inspection Description Co irm_ # Contact # Message
17 [=!ethical rougli•in 063594 -01 ,'\ 503- 807 -2407 Y
Corrections /Comments /Instructions: I e1\LL i 5�
‹rv,e KV (twe4 ,_ )
•
XPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: C9'' 0 6 b L' Date: t-1 Phone #: (503) 718- Z+'
CITY OF TIGARD
II
BUILDING DIVISION ` PERMIT #: ELC2007 -00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/1612007
Phone: (503) 639-4171 i rl
Inspection Requests (24 Hrs.): (503) 639 -4175 `'I I..
INSPECTION WORKSHEET FOR DATE: 6/1 /2007 TIME: 7:02AM PAGE: 51
SITE ADDRESS: 11334 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 006 TYPE OF USE:
PROJECT NAME: RAGER
DESCRIPTION: Add 50 amp circuits for sub panel in out building.
OWNER: BRAVO, JOSE AND, PHONE #:
CONTRACTOR: TIMBERLINE ELECTRICAL CONTRACTORS PHONE #: 503-459410139
Inspection Request Scheduled For: Date: 6/1/2007 Pour Time:
Code # Inspection Description - Confirm # Contact # Message
105 Underground/slab cover r 1 04 '
49383 -01 503 -807 -2407 N
Corrections /Comments /Instructions: 'j1koAJ
c,�c�li. RPC(EQ, (o3 6 6 018
I' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , n LE' Date: 6' I V'r Phone #: (503) 718 - ' ` i
CITY OF TIGARD ;
BUILDING DIVISION PERMIT #: ELC2007 -00333
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/16/2007
Phone: (503) 639 -4171 r idgg'�I�
Inspection Requests (24 Hrs.): (503) 639 -4175 - . .
INSPECTION WORKSHEET FOR DATE: 5/12/2008 TIME: 7:01AM PAGE: 37
SITE ADDRESS: 1133 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 006 TYPE OF USE:
PROJECT NAME: RAGLR
DESCRIPTION: Add 50 amp circuits for sub panel in out building.
OWNER: BRAVO, JOSE AND, PHONE #:
CONTRACTOR: TIMBERLINE ELFCI RICAL CONTRACTORS PHONE #: 503-459-4009
Inspection Request Scheduled For: Date: 5/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 069535 -01 .- 503 - 686 -0230 \ Y
Corrections/Comments/Instructions:
� PQov 10a (2sadviru P A(46iL 6021043 `f'► ao I I
Ne.i. 1 Z. l (RD , ,
63k ‘4 i - Z , L.',._ \N itt ml , 4 %AM IL ft GittskIC
k a S • Na A. tk.k cy (t o ,op w4c) 0, 2.62),
__a___W , Va.krait Qe SVitit.ikrc
6 (z.§..-v - mg scLi, i) ; N pixha.,
WIT Ilk °,3 Lfs- lq.via
U
❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ACALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6" N 66 -, G Date: OM ti) Phone #: (503) 718- V4 LA
CITY OF TIGARD : r.
BUILDING DIVISION PERMIT #: ELC2007- 00333
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 5/16/2007
Phone: (503) 639 -4171 r
Inspection Requests (24 Hrs.): (503) 639 -4175 � IL
INSPECTION WORKSHEET FOR DATE: 6/5/2008 TIME: 7:00AM PAGE: 61
SITE ADDRESS: 11334 SW SUMMER LAKE DR CLASS OF WORK:
SUBDIVISION: SUMMER LAKE LOT #: 006 TYPE OF USE:
PROJECT NAME: RAGER
DESCRIPTION: Add 50 amp circuits for sub panel in out building.
OWNER: BRAVO, JOSE AND, PHONE #:
CONTRACTOR: TIMBERLINE ELECTRICAL. CONTRACTORS PHONE #: 503-459-4009
Inspection Request Scheduled For: Date: 6/5/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 070704 -01 503. 6860230 N
Corrections /Comments /Instructions: 12. P ri ,
\,
4. N
\ _ ; i;
v � V
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ` N'661.--- Date: 6' O 0 _v Phone #: (503) 718- 1-341116