Permit pr CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00172
COMMUNITY DEVELOPMENT DATE ISSUED: 3/21/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 134 DD -01200
SITE ADDRESS: 11675 SW TIEDEMAN AVE ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: VILLASENOR
Project Description: (2) Services with 10 branch circuits.
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: 2 W /SERVICE OR FEEDER: 10 PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: IN PLANT:
601 - 1000 amp: PLAN REVIEW SECTION
1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
JOSE VILLASENOR GREENWAY ELECTRIC COMPANY
11675 SW TIEDEMAN 9460 SW TIGARD STE. 104
TIGARD, OR 97223 TIGARD, OR 97223
Phone: Contact #: PRI 503 - 620 -6020
FAX 503- 620 -6124
FEES
Description Date Amount Reg #: ELE 34 -617C
(ELPRMT] ELC Permit 3/21/2007 $227.10 LIC 153421
[TAX] 8% State Surcharge 3/21/2007 $18.17 SUP 5025S
Total $245.27 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 Narfication 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,QUNC at 503.246.6699 or 1.800.332.2344.
•
Issued By: Zat Permittee Signature: „ (�
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.
- ;,
Electrical Permit Application FOR OFFICE usr: ONLY
City of Tigard Received Permit No.
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi.
Phone: 503.639.4171 Fax: 503.598.191 2 1 � 't' - ` DateB : Other Permit:
Inspection Line: 503.639.4175 AR _ �OO • L4. �•_ I Date Ready/By: 7uris: ® Page 2 for
Internet: www.ci.tigard.or.us CITY OF TIGARD Notified/Method: Supplemental Information
BOi®IYtSION PLAN REVIEW
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ['Service over 225 amps, comm'I ❑Hazardous location
['Service over 320 amps — rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
® 1- and 2- family dwelling im Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑ Multi- family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
['Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: 307026 -1 Job site address: 11675 Tiedeman ❑Health -care facility ['Other:
Submit 2 sets of plans with any of the above.
City/State/ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: 11675 Tiedeman
FEE* SCHEDULE
Description I Qty. I Fee. I Total
Cross street/directions to job site: Tigard & Tiedeman New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
Extend existing circuit to X Mas tree display via cord drops and add circuit for fire dwelling, service and/or feeder 90.90 2
places Services or feeders installation, alteration, and/or relocation
200 amps or less ) 80.30 J LO,‘,; 2
❑ PROPERTY OWNER 201 amps to 400 amps 106.85 2
❑ TENANT 401 amps to 600 amps 160.60 2
Name: Jose Villasenor 601 amps to 1,000 amps 240.60 2
Address: 11675 Tiedeman Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/ State/ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 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: Date: Branch circuits — new, alteration, or extension, per panel
® APPLICANT I ❑ CONTACT PERSON A. Fee for branch circuits with •
service or feeder fee, each 6.65 St; 2
Business name: Greenway Electric branch circuit
B. Fee for branch circuits
Contact name: Jim Rooney without service or feeder fee, 46.85 2
each branch circuit
Address: 9460 Tigard St Suite 104 Each add'l branch circuit 6.65 2
City/ State/ZIP: Tigard Or Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503 - 620-6020) Fax: : (503-620 -6124) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
extension. Describe: Page 2 2
Business name: Greenway Electric
Each additional inspection over allowable in any of the above
Address: 9460 Tigard St Suite 104 Per inspection 62.50
City/ State/ZIP: Tigard Or Investigation per hour (I hr min) 62.50
Phone: (503 -620-6020) I Fax: (503 -620 -6124) Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES*
CCB Lic.: 153421 Electrical Lic.: 34 -617C Suprv. Lic.: 5025S Subtotal oZ a 7. / 0
Suprv. Electrician signature, required: a. L i Plan review (25% of permit fee)
Print name: ; S Mx.� / or� Q State surcharge (8% of permit fee) 8,
1/ Date: /21/07
TOTAL PERMIT FEE a v . 7
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007-00172
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 3/21/2007
Phone: (503) 639- 41710-It
Inspection Requests (24 Hrs.): (503) 639 -4175 `_ ..
INSPECTION WORKSHEET FOR DATE: 4/2/2007 TIME: 7:02AM PAGE: 4
SITE ADDRESS: 11675 SW TIEDEMAN AVE CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: VILLASENOR
DESCRIPTION: (2) Services with 10 branch circuits.
OWNER: VILLASENOR, JOSE PHONE #:
CONTRACTOR: GREENWAY ELECTRIC COMPANY M PHONE #: 503
Inspection Request Scheduled For: Date: 4/2/2007 Pour Time:
Code # Inspection Description •onfirm ° Contact # Message
199 Electrical final 045849 -01 503 - 539 -5447 Y
Corrections /Comments /Instructions: ph Q(1_-
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n -ASS ❑ PARTIAL APPROVAL ❑ CANCEL NO i ❑ NO ACCESS
❑ FAIL
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L ECTION ❑ ADDITIONAL FEES ASSESSED
4 Inspector G 1 V Og L v Date: 4- Phone #: (503) 718- 1-1.14o
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City of Tigard II
13125 SW Hall Blvd. •
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Tigard, OR 97223 i ..
Phone: 503 -639 -4171
T I GARD
FAx TRANSMITTAL
Date March 22, 2007
Number of pages including cover sheet 2
To: Tom Goodrich From: Albert Shields
Co: PGE Co: City of Tigard
Fax # : 503 - 672 - 5555 Fax # : 503 - 624
/ CC� Nobe_ Ha. Watkins Ph #: 503 -718 -2426
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SUBJECT: SERVICE RECONNECT - 11675 SW TIEDEMAN
MESSAGE:
Tom, thanks for your and PGE's cooperation in pulling the meter from the above property
per Gary Nobel's request of 2/14/07.
The purpose of this note is to let you know that, pursuant to our order, the property owner
has hired a licensed electrical contractor, Greenway Electric, who has taken out a permit to
properly install the electrical service to the property and correct the multiple electrical code
violations that I had cited the property owner for.
I performed an electrical service inspection this morning and awarded a "Pass" on the
inspection. A copy of that inspection report is attached. We are satisfied that all inadequacies
with the service have been corrected and that the property is now q»alified to have electrical
service restored.
Restoration of service is needed before the electrical contractor can complete checking out the
circuits and outlets and complete his repairs and having power restored will also be needed by
the licensed plumbing contractor who has been hired to do extensive work, essentially re-
plumbing the building.
Accordingly, this requests our and PGE's further cooperation in restoring service at your
earliest convenience. Pl- le call me a 03 718 - 2426 if you have any questions.
Albert Shields
Residential Electric ,j - •% Codes orcement Officer
i ?ENGIFAX.DOT
CITY OF TIGARD
BUILDING DIVISION PERMIT r "L.D '7
13125 SW Hall Blvd., Tigard, OR 97223 e� DATE ISSUED: CO i ' '�Z
Phone: (503) 639 - 4171 ,, 11 I A J
Inspection Requests (24 Hrs.): (503) 639 -4175 s !�- ^'� .. 3 ZO O
INSPECTION WORKSHEET FOR DATE: ZZ D 'TIME: PAGE:
SITE ADDRESS: // 4 7,4 `5 '✓ / / E.7..1-04-17 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION: V OWNER: 0 5 A4) PHONE #:
CONTRACTOR: _.0�i� /Q PHONE #: j90
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Me age
s E2✓L 1 - C,c5V4 �
Corrections /Comments /Instruction . ( 74 5290-e)
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/ PASS PARTIAL APPROVAL ❑ CANCEL El NO ACCESS
AIL 1// A L , F• ' ION ADDITIONAL FEES ASSESSED l ir
Inspector: - DateYA Phone #: (503) 71
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