Permit C ITY OF TIGARD ELECTRICAL PERMIT
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PERMIT #: ELC2007 -00298
° COMMUNITY DEVELOPMENT
D ATE ISSUED: 5/2/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 109DB -04300
SITE ADDRESS: 13063 SW SUMMIT RIDGE ST ZONING: R -7
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT : 122 JURISDICTION: TIG
PROJECT: DUONG
Project Description: Branch circuits (2) for a/c 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:
LEON DUONG GRF ELECTRIC
13050 SW SUMMIT RIDGE CT 15460 S PARADISE LN
TIGARD, 97 97224 . MULINO, OR 97042
Phone: 503 - 860 -7440 Contact #: PRI 503- 829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 5/2/2007 $53.50 LIC 76751
[TAX] 8% State Surcharge 5/2/2007 $4.28 SUP 1655S
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued ; /j , l L i ' / ' // Permittee Signature: 3 60phrodiern
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
May 02 07 10:46a GRF Electric 5038295747 p.1
1 i
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FJ E ONLY US ectrical Permit Application Received FOR OFFICE E
Date/By: Permit No.: ELL?_(, )R — Gam$
City of Tigard Planning Approval Sign
Date/By: Sign
No.:
-s' 13125 - SW Hall.Blvd Plan Review Other ,
Tigard, Oregon 97223 R " A Date/By: PermitNo.: t IEGZ.CD+" -00239
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post- Review • Land Use
i 7c;�t to ,, I ; e Date/By: Case No.:
Internet www_ci.ligard onus MAY - 2 `, e• �l Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 638176 IGAR Name/Method: Supplemental Information.
BUILDING DIVISION
:: : 5 'TYPE OF 'WORK ','': ;,';.: '` :"- :..•', ; ' a, I';f.!;;:I, . N PLA REVIEW (Please c1iee all""that apply) "
.�;,. , :
• New construction ❑ Demolition ❑ Service over 2 ❑ Health-care facility
amps- ty
commercial ❑ Hazardous location
ddition/alteration/replacement ❑ Other: ❑ Service over 320 amps -rating of ❑ Building over 10.000 square feet.
;:.CATEGORY'OF';CONSTRUC 1ON " I & 2 family dwellings four or more residential units in
& 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts momma! one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
[] Accessory Building ❑ Multi- Family . • ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
0 Master Builder JD Other: ❑ Egress/lightilhg plan ❑ Other:
a
JOB: SITEIIYIFt )R1YigTI011Cand`,LOCATION Submit seta of plans with any of the above. The above are not applicable to temporary construction service. • Job site address: 1 ''g 0 (D "g Su)"
d) 5 L,, , yi h1.‘ ..... .. _ °•F'EE SQHEDt1LE "'` ,- , , :-4 4 1. ? ' z'
Suite #: j Bldg. /Apt. #: l,, . d Number of inspections per permit allowed
Project Name: r te e S/ L , Desu'iptioa Qty Fce (ea.) Total `
���� New residential- singte or multi - family per j
Cross street/Directions to JCS site: dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 I
Limited energy, residential 75.00 2
Subdivision: I Lot #: Limited energy, non residential 75.00 , ', 2
Tax map/parcel #: Each manufactured home or modular dwelling
/� serv and/or feeder 90.90 2
: S,',.. `-. :':i :..... :!!7:2 D CRIPT+ I0NrOF:WORK ... . ', s .'� . - . .
Services or feeders - installation,
alteration or relocation:
200 amps or less 80.30 2
. 'L . C b;' • G (. ei� 1 C- • /0“4. a. 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 , 2
_, ° _ 601 amps to 1000 amps 240.60 2
E9 TEIKANT . ;:+ i ., 454.65 2
�1' ' . ' W /►!' ' � - - Over 1000 amps or volts
Name: L O yl r), 19 je) et Reconnect only 66.85 2
Address: I Z D rp c t1 -J _Si A run it.A. Temporary services or feeders - installadon,
alteration, or relocation: 1
Cit /State/Zip: -, A,, A l� v e. 200 arnps or leas 166.85 2
Phone: Fax: ./ 201 amps to 400 amps
7 0 401 to 600 amps • 133.75 2
• Q?APYLIC T_°; .'n'': "'t • . S;t `s:;:.
=`[� .CONTACT :PERON`'.' Branch circuits - new, alteration, or
Name: extension per panel:
_. A. Fee for branch circuits with purchase of 6.65 2
Address: service or feeder foe, each branch circuit 1
City /State /Zip: B. Fee for branch circuits without purchase of tint 46.85 �V_ 2
branch service or feeder fee, t branch circuit
Phone: I Fax: Each additional bran circuit ( 6.65 6. ("1_ 2
Misc.(Service or feeder not included): 53.40 2
E -mail: � Esots PAP m i rtiRation circle
:'� ,... -- r - -- ar 'h: "i! *,.... . iOR'; &'t7 .y . (:'. ...� s. r 53.40
,; Each sign or omline lighting
Job No: Signal circuits) or a limited energy panel, 2
alteration, or extension Page 2
Business Name: 61--f E) ex.-4-y- r_ Description:
Address: 17 Pi), Y c l A ` l L1. • Each additional Inspection over the allowable in any of the above:
City /State./Zlp: MLA J t ,,; (2 .. ' ? C) L Per inspection per hour (min. I hour) 62.50
Phone: cp3 -- OA - `t i r Fax: 51)3 - 8� S ?&r-7 Investigation fee:
CCB Lic. #: 7 107 e Lic. #: 3- , e- 4 eV . 4 Od,er t qr,} '' ` :R;<:.. ; :'EleetiiCil:PeirrmiCireest,• . ;,:' ..
Supervising electrician - Subtotal $ c j, ' sO
signature required: w Plan Review (25% of Permit Fee) S
Print Name: w,"1 I uw. S 7 - L ic. #: ( j S
State Surcharge (8% of Permit Fee) S ti-. Z. Cr
TOTAL PERMIT FEE $ tj "7. 7 K
• ' Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days alter It.has been accepted as complete.
*Fee methodology set.by Tn - County Building Industry Service Board.
(Please print name)
is \Permit Fomss\ElepamitApp.doc 01/03 •
CITY TIGARD OF TI
O G .
BUILDING DIVISION fe / 3� PERMIT #: ELC 7- 00298
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 007 .
Phone: (503) 639 -4171 ..... s - - °
Inspection Requests (24 Hrs.): (503) 639 -4175 P'I ��
INSPECTION WORKSHEET FOR DATE: 5/9/2007 TIME: 7:00AM PAGE: 50
SITE ADDRESS: 13063 SW SUMMIT RIDGE ST CLASS OF WORK:
SUBDIVISION: SUMMIT RIDGE NO. 3 LOT #: 122 TYPE OF USE:
PROJECT NAME: DtJONG
DESCRIPTION: Branch circuits (2) for a/c and outlet.
OWNER: Dl1ONG, LEON PHONE #: 503 - 660.7440
CONTRACTOR: GRF ELECTRIC PHONE #: 503- B2941146
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Inspection Request Scheduled For: Date: 5/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 047928 -01 503 -557 -2220 Y
514, q t , 0 -71/Yo ft Corrections /Comments /Instructions:
7 1
/
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date /� /`" Phone #: (503) 718- '2 ��