Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00021
COMMUNITY DEVELOPMENT DATE ISSUED: 1/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112CA-06500
SITE ADDRESS: 15218 SW THURSTON LN ZONING: R -
SUBDIVISION: ASHFORD OAKS LOT : 019 JURISDICTION: TIG
Project Description: Electrical alteration
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: 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:
PAUL & SNARLY WANDELL OWNER
15218 SW THURSTON LN
TIGARD, OR 97224
Phone: 503 - 670 -8309 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 1/10/2007 $46.85
[TAX] 8% State Surcharge 1/10/2007 $3.75
Total $50.60 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 ' • - •one cordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
mo . than 180 days. A • ENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Cent- Those rules are set forth in
0 R 952 - 001 -0010 throug O • ' 9 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at . • <• ::699 or 1.800.332.2344.
•
Is ued By: / A � Permittee Signature:
?WNER INSTALLATION ONLY
The installation is being made on propert o - ' •- is not i� ded .' sale, lease, or rent.
OWNER'S SIGNATURE: DATE: 0WC 7
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.
Elec1*ical Permit Application soli owlet Hsi.: oNl.Y
City of Tigard Received e Ma �; ,..01%.1111M11
0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 • Date/B : Other Permit:
'r l G A R D Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Fiffn Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition /altcration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Service or feeder 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
O 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 - "l - ",
Job no.: Job site address: 15218 SW Thurston Ln. 100HP or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: Tigard, OR 97224 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Off of SW 79 Durham & Bonita Description 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
Tax map /parcel no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75 00 2
I added two electrical outlets to a walk -in closet that we finished residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
® PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: Paul & Sharly Wandell 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 15218 SW Thurston Ln. Over 1,000 amps or volts 454.65 2
City/State /ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (503)670 -8309 Fax: ( ) 200 amps or less 66.85 I
Owner installation: This instal on is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, r Za o o ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 _ 2
Branch circuits — new, alteration, or extension, per panel
Owner signature :)1 - �C.. Date: il A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
¢
Contact name: without service or feeder fee, / 46.85 y /,O 5 r 2
first branch circuit
Address: Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (I hr min) 62.50
CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73.75 _
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: y� • b
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): 3. 7 5
Authorized signature: TOTAL PERMIT FEE: 0 . 66
This permit application expires if a permit is not obtained within 180
P rint name: I Date: _ _�_ :. -- �_ -- - -__ -• -- -__ -�
r f ,
CITY OF TIGARD..
BUILDING DIVISION PERMIT #: ELC2007 -00021
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2007
Phone: (503) 639 -4171 tit 1.
Inspection Requests (24 Hrs.): (503) 639 -4175 L.
INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7 :03AM PAGE: 24
SITE ADDRESS: 15218 SW THURSTON LN CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS LOT #: 019 TYPE OF USE:
PROJECT NAME: WANDF_LL
DESCRIPTION: Electrical alteration
OWNER: WANDELL, PAUL & SWIRLY PHONE #: 503- 670 -8309
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa•e
199 Electrical final 012008 -01 503-793 -6478 OP
Corrections /Comments /Instructions: Z',1C ftr
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
F AIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: (�lf'1 P Date: / / / 6 )1 Phone #: (503) 718- Z-6 /
CITY OF TIGAR.Q... L '
BUILDING DIVISION L i 9 1 PERMIT #: ELC2007-00021
13125 SW Hall Blvd., Tigard, OR 9722 DATE ISSUED: 1/1012007
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 _..' IL.
INSPECTION WORKSHEET FOR DATE: 1/17/2007 TIME: 7 :00AM PAGE: 26
SITE ADDRESS: 15218 SW THURSTON LN CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS LOT #: 019 TYPE OF USE:
PROJECT NAME: WANDELL
DESCRIPTION: Electrical alteration
OWNER: WANDELL, PAUL & SHARLY PHONE #: 503 - 670.8300
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 042183-01 503 - 793!6478 Y , 1'
- IvI' , i_
Corrections/Comments! Instructions:
J
�/V
V
...,.
,■ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / // 7 /j7 Phone #: (503) 718 V.510