Permit C ITY O I TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 - 00326
° COMMUNITY DEVELOPMENT DATE ISSUED: 6/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 125DD -08500
SITE ADDRESS: 09720 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 LOT : 093 JURISDICTION: TIG
PROJECT: COUNTRYMAN
Project Description: Installing (2) branch circuits for A/C.
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:
DERAL & KARLENE COUNTRYMAN GRF ELECTRIC
9720 SW VENTURA CT 15460 S PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 245 -9225 Contact #: PRI 503 - 829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 6/11/2008 $53.50 LIC 76751
[TAX] 12% State Surchar 6/11 /2008 $6.42 SUP 1655S
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 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 By� — > Permittee Signature: � QQ / ccj 21 1
`' 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.
.itI 09 08 10:01a GRFELECTRIC 5038295747 p.1
RECEIVED
�. tit I1P l e.l ' ,Itil t) �� �` X' ��•
Elec_ Permit Application ■: •
JUN 0 9 2008 {{teemed
City of Tigard De� . - 7 7 ' � i PermitlQn.• - Ck)3dfv •
III i
13125 SW Ralf Blvd., Tigard,OR 97223,„,„„,, F TIGARD :
ARD p`° Ke"°" ou1Mew Pexassr % ,1
• Plwog: 503439.4171. Fax 5Q3.598.19O r B Sts Pstoi
i ic. U Inspection Line: 5113.639.4175 BUILDING DIVISIO 1• M� , 121 See rote2 f ronaatian
Internet www.tigwd-or.gov PLAN REVIEW Pleats Arch all that app ( An,t 1 sets of W whttai s checked Intl raw ):
[]New construction �TYPE Of WORK
❑ Service es, feeder 400 amps, Or ,aore CI O Om over •lor+�•
❑ Demolition i
in dditian/alteretiarVreplaeemcnt when the available Asti weevil ❑ MA""" and b00rj""ds.
E Other: GORY Of CONSTRUCTION nee ds i6,000 amps at 1 S 0 votes or 0 Fl wino It buildings.
CATEGORY mow pound, or exceeds 14,000 0 Commaeisl-are sFriculnaal
building m,ps forall otherimullinions. buildings
C] 2- family dwelling ❑ Commercial/industrial I:) AccessOrY g 0 PiR p+�mp. 0 Inudlanon of 75 KVA or
M builder ❑Other: 0 Einergency wren. lugs separately noised worm. Multi - family ❑ ',Milian deco motor load o -t-7 - • "1 -3••.
JOB SITE INFORMATION AND LOCATION D f 0 "A', "E
/ 1 . 1 0011? n< rnore- occupancy.
ehita part
lob no.: lob site address: 9 -7 Z 0 S t.L...) Ale Yf I N f!i 0 Si. or more re„dcn 0 nal units. 0 . reed v e c tam than
❑ Hasluc faoin ks. SF waits voltago name Ai.
City/State/ZIP: tc
• AA' Z.A. Z.A. a • ❑ Hamrdoislocatives. 600
❑ Soria sr !radar 600 amps n tnom.
SuiWbldg./aDt no.: ' Project name: Vt *4 . A i FLEE SCITEDIJL>E
3 Dn.. am , Fes Taunt 1 • '
Cross street/directions to job Site; New rratdeadd single- or multi- family dwelling unit.
Includes attached garage. 4
1,000 sq. ft or lcrx lasts
Subdivisitm: Lot no.: Ea. add 500 so ft or ponton 45.10 1
energy, t
Limited eneresidennal 75.00 2
Tax map/parcel no,: (w,t>, r c,, c ftl
DESCRIPTION Of WORK O J,imiiod snag, multi - family 75.Ap 2
'- f} � l 7 f � 1' r i residcn or feeders above sq. �)
l� i✓' /.L. { Services or feeders Installation alteration, aadJor relocation 2
200 amps or less 80.30
201 amps to 106.85 2
ID ! CI PROPERTY OWN)rA` 160 60 2 ;
pp �� 401 amps to 640 amps Name: L 1e- 1 e e !iU U 0 - J Jr'? Lr n 601 amps to 1 amps 240.60 _ 2
Address; rt, _ Over 1,000 amps or •alts
454.65 2
Temporary services or (Went installation, alteration. a sdlor
r elocation
Z � G6.83 1
Ciryrsl�terz>� (/�(�r cl 2001 or less
Phone: ( )
sp rit„. -- " et Z ZS I Fax: ( ) 201 am to400 amps 100. 2
J` j installation is being m ade on property that 1 own which is not 133 2
Owner instagattoa. This mater! B 40l amps to 599 ramps
intcaded for sale, lease. rent, or exchange, according to ORS 447, 449, 670. and 701. %reach circuits - new alteration or extension, `,cr panel
Date: A. Fee for branch circuits with
Cl Ow signature: above service or feeder fee, 6.65 2
APPLICANT I CI CONTACT PERSON above branch circuit
Business n4trte,
waho]u service or feeder fin:,
H. Fee for branch circuits
f 46.85 '-�
Contact name: fit branch circuit l + te • 2
Each add'lbraneh el7Cltrt 1 6,65 _ 1 )2
Address; MInellaneors (service or feeder no included)
Each manufaCNred or modular 90.90 2
CitYlSSatcrl iP: dwellin :. service and /or feeder
Phone: ( ) I Fax: ' ( ) Reconnect only 66.85 2
or irrigation circle
5].40 2
E ?limp
or outline lighting 53.40 2
CONTRACTOR Signal sir uit(t)orltmited-
Business name: 6 ra_. F e, c a C energy panel alrerithoo or Tom` Page 2 2
Address: �, '(� [fj P { y titbutsinn. Describe �F Each additional Ins • tine over allowable is an or the above
Ci�/StatelZl 4 r • 0 7 • 2.-- Per inspection 62.50
Phone' (M} fP: 7 ) K a-9 - . Investigation per hour (t hr min) 62.50
� 9 lndu ruial plant per hour 73.75
CC9 Lic.: �p 'J� Electrical tie.' 3 ..I C__, � Suprv, Lie.: i A 5 j ELECTRICAL PERMIT FEES
cared: .-, Subtotal:1 c i r'�
Print dame,
Supra, Electrician sigtlatuIe, required:
`~ r 0 6, Plan rev (ZS %Of Pamir fee): a
,, r Date: 0 f Stec surcharge (12%. of permit fee):
W Y I i /4 nn �W1 e `t fff e( Z
TOTAL PERMIT FE' t
Authorized signatutc:
This permit application expires Ira gerra,eu ant • ►u:nad :an 110
Print name: Date: days attCr ittutbets accspvA at cenriere-
• Hunter of inspections atluwod per permit.
1,ta • ill,aalrC.titAaLGPeau Mtm.lOe
nuts OS Ua•adtSTII IANCOMIWEO
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 00326
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/11/20013
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 7/11/2008 TIME: 7:00AM PAGE: 32
SITE ADDRESS: 09720 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 093 TYPE OF USE:
PROJECT NAME: COUNTRYMAN
•
DESCRIPTION: Installing (2) branch circuits for NC.
OWNER: COUNTRYMAN, DERAL & KARLENE PHONE #: 503 -245 -9225
CONTRACTOR: GRF ELECTRIC PHONE #: 503-829-4146
Inspection Request Scheduled For: Date: 7/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072489-01 503-829-4146 d
Corrections /Comments /Instructions:
7/7-4 A (4c
PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: — - Date:
7 I t aft Phone #: (503) 718 - Z--
-- - 7.
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC20013- 00326
13125 SW Hall Blvd., Tigard, OR 97223 ` - DATE ISSUED: 61/112008
Phone: (503) 639 -4171 :P
Inspection Requests (24 Hrs.): (503) 639 -4175 : -' I
INSPECTION WORKSHEET FOR DATE: 6112/2008 I TIME: 7:02AM PAGE: 50
SITE ADDRESS: 09720 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 093 TYPE OF USE:
PROJECT NAME: COUNTRYMAN
DESCRIPTION: Installing (2) branch circuity for NC.
OWNER: COUNTRYMAN, (FERAL & KARLENE PHONE #: 503245 -9225
CONTRACTOR: GRF ELECTRIC PHONE #: 603 - 02941116
Inspection Request Scheduled For: Date: 6/1712008 Pour Time:
Code # Inspection Description Confirm # Contact # Messes -
199 Electrical final 07126401 503-829-4146 Y 9,,
Corrections /Comments /Instructions:
A' (
... ) -- ;4& I/ C-4--- . r ,e D'i —6 i-t/77r
P —5 -' • . 71. 14 ;
/
y L..f., . e-9/4 7 0
A. ,
„The e lectric al i
nsiall
a n it-his sh all 40 c on detects no
� AI Q
r clays pe r � R g de with }� 20
8 - 2 ' - 0030
❑ - ASS ❑ PAR ' L APPROVVA ❑ CANCEL El NO ACCESS
r4 FAIL 'ILL FOR :'''S j-' 10 II ADDITION L FEE ASSESSED
Inspector: � �I . 4� Dater i 7. Phone # (503) 71