Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00516
COMMUNITY DEVELOPMENT DATE ISSUED: 9/5/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 134DC -00500
SITE ADDRESS: 11476 SW TWIN PARK PL ZONING: R -4.5
SUBDIVISION: TIGARD PARK LOT : JURISDICTION: TIG
PROJECT: ALATTAR
Project Description: (2) branch circuits. For new a/c & reconnect for furnace conversion.
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:
ADNAN ALATTAR OWNER
11476 SW TWIN PARK PL
TIGARD, OR 97223
Phone: 503 - 521 -1320 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 9/5/2008 $53.50
[TAX] 12% State Surchar 9/5/2008 $6.42
Total $59.92 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 1: I _ = - _TTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 95 .01 -0010 throu• • O • - •2- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.24 or 1.800.332.2344.
/
I/ Permittee Signature: /� / � 7/
Issued :y: 4 / , �� g ,
OWNER INSTALLATION ONLY
The installation is being made on property I own which i - -ot intended for sal: - - se, or rent.
OWNER'S SIGNATURE: d / DATE: 5e 5 2 0434
ONTRACTOR 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.
Elettrical Permit App FOR OFFICE USE ONLY
City of Tigard R 'A Dat e e/B e y 5 e p Permit No EG (. #9 �Q7S /
il 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C ! Phone. 503 639 4171 Fax: 503 598 1960 Date/By Other Permit
T I G A R U Inspection Line. 503 639 4175 Date Ready/By ® See Page 2 for
Internet www tigard - or.gov Notifed/Method Q Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans whtems checked below)
❑ Service or feeder 400 amps or inure ❑ 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
❑ I- 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 denved system
❑Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ",
Job no.: Job site address: ,1 / r Q , � ii
i `'� IOOHP or more occupancy
/ � O < / W lki 1 rC. 1 I-�^ Six or more residential units. ❑ Recreational vehicle parks
City/State /ZIP: ` '�' P- �' 2 2 ❑ Health-care facilities. ❑ Supply voltage for more than
7 ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: U I Project name: ❑ Service or feeder 600 amps or more
FEE SCHEDULE
Cross street/directions to job site:
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
Ea. add'I 500 sq ft. or portion 33 40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WO (with above sq 11)
Limited energy, multi- family 75.00 2
( f Q / , t -• �Q �(,,) / / c . • k- 4eAtiAle residential (with above sq ii )
U� _ / Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106 85 2
Name: Ad v,,... Ar 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: ( ' L f 7-6' s I j ) y�H P�r p 1C c_._ Over 1,000 amps or volts 454.65 2
' City/State /ZIP: �� ` C a / e Z 3 Temporary services or feeders installation, alteration, and/or
vT ` / relocation
hone: (5O3 ) 52_ / (3 2 a I Fax: ( ) 200 amps or less 66.85 1
tier installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
'mended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701.
Owner signature:
❑ APPLICANT I 401 amps to 599 amps 133.75 2
Branch circuits — new, alteration, or extension, per panel
Date: A Fee for branch circuits with
0 PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B Fee for branch circuits
without service or feeder fee, //
Contact name: first branch circuit 46.85 (p• 2
Address: Each add] branch circuit f 6.65 4 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
Business name: Signal circuit(s) or limited -
D EZ__-' energy pan alreetion, or
Address: 60/° 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 mm) 62 50
CCB Lie.: Electrical Lie.: Suprv. Lie.: Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: 5 . 5O
Print name: Date:
Plan review (25% of permit fee). -61--
State surcharge (12% of permit fee). 6), 1 17• -
Authorized signature: TOTAL PERMIT FEE. •9. 9 2-
This permit application expires If a permit Is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
1 \Buildmg\Permits\ELC- PermitApp doe 05/23/06 440-4615T(11 /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:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
•
system
•
(SEE OAR 918- 309 -0000)
Check Type of Work Involved:
❑ Audio and Stereo Systems 1
• ❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ -HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
- •Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Building\Permits\ELC- PermitApp doc 03/23/06
CITY OF TIGARD . . •.
BUILDING DIVISION PERMIT #: ELC2008 UQ516
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/572008
Phone: (503) 639 -4171 I11
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_'
INSPECTION WORKSHEET FOR DATE: 10/7/2008 TIME: 7 :00AM PAGE: 11
SITE ADDRESS: CLASS OF WORK:
11476 SW TWIN PARK PL
SUBDIVISION: TIGARD PARK LOT #: TYPE OF USE:
PROJECT NAME: Al AT fAR
DESCRIPTION: (2) branch circuits. For new a/c & reconnect for furnace conversion.
OWNER: ALATTAR, ADNAN PHONE #: 503.52.1 - 1320
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/7/2008 Pour Time:
e # ns ec scription Confirm # Contact # Message
1 1145 G at ni g it circuit 076389 -01 5038039751 N
Corrections /Comments /Instructions: (�
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G- c_ k - ' r ci,L kr 41c UNIT.
A PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G- N 6 8 LP" Date: 1011 CI Phone #: (503) 718- l y,
CITY OF TIGARD • , r- 5r
11 u A
BUILDING DIVISION t, �b \b' PERMIT PERMIT #: EL.C2008.00516
13125 SW Hall Blvd., Tigard, OR 97223 / 1 p l DATE ISSUED: 9/' /20t)Bs
Phone: (503) 639 -4171 f
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I ��
INSPECTION WORKSHEET FOR DATE: .10/712008 TIME: 7:00AM PAGE: 30
I
SITE ADDRESS: 11476 SW TWIN PARK PI_ CLASS OF WORK:
SUBDIVISION: TICARD PARK LOT #: TYPE OF USE:
PROJECT NAME: ALATTAR
DESCRIPTION: (2) branch circuits. For new a/c & reconnect for furnace conversion.
OWNER: ALATTAR, ADNAN PHONE #• 503571 -1320
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
14 5 NC or heating unit circuit 076195-03 503-803-9751 N (O )-P r1 &till Pl
Corrections/Comments/Instructions:
UAA0
6 9/1/ 4 6 t 9A itkeLef ®l?
60144411 ° //(-
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I A (A)1A4 .. 44 ' . _ A `i. A . 1 4.AL.■ ALL .
a II TO 'Z P
❑ PASS !4 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL V tALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
l
Inspector: Y Date: t 7/ Phone #: (503) 718 -