Permit • CITY OF TIGARD ELECTRICAL PERMIT
1 Iii . a PERMIT #: ELC2008 - 00440
COMMUNITY DEVELOPMENT DATE ISSUED: 7/31/2008
TI GARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S111BC -01000
SITE ADDRESS: 10270 SW VIEW TER ZONING: R - 3.5
SUBDIVISION: GREENBRIER LOT : 008 JURISDICTION: TIG
PROJECT: BAUMAN
Project Description: (2) branch circuits to reconnect furnace and air conditioner.
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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:
WAYNE BAUMAN TRI COUNTY TEMP CONTROL INC
10270 SW VIEW TERRACE 13150 S CLACKAMAS RIVER DR
TIGARD, OR 97223 OREGON CITY, OR 97045
Phone: 503 - 639 -2491 Contact #: PRI 503 - 557 - 2220
FAX 503 - 557 -0919
FEES
Description Date Amount Reg #: ELE 527LHR
[TAX] 12% State 7/31/2008 $6 42 LIC 72623
[ELPRMT] ELC Permit 7/31/2008 $53.50
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 -. mor- • an 180 days ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center
Those rul s are set fort i • • R • 52- 001 -0010 through OAR 952 -001 -0100 You may obtain copi - : - -se rules or direct questions to OUNC at
503.246 .699 or 1 800 ••
Issued : ! Jr %,_ tf Permittee Sig . ure: , _�1 76�-'��
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:
C • NTRACTOR INSTALLATION ONLY
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SIGNATURE OF SUPR. ELEC'N: AIMS" _ __,;;!� �/ / . 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.
'"w
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,, JUL -31 -2008 08:09A FROM: - TO:5E1359E11960 P.1
Electrical Permit Application I (iii 01.1.1(.1. 1 .SI f1 \1'1 ' ∎,. • . 1 .,..
City of Tigard Received 7 $ r enn e t V a.. Cr I.G .?� er� — GYJ
DateB : ,
II
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
` ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B : other Peanut
t t Inspection Line: 503.639.4175 Date Ready /Ry 121 See Page 2 fnr
- - ier ?�ttu:
- Internet: www.tigard - or.gov Notified/Method. Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ® Addition/alteration /replacement Please check all that apply (submit 1 sets of plans w /items checked below) I I
❑ Demolition ❑ Other: ❑ Service or feeder 400 amps or more ❑ Building over three stories
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
® 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
` ION ` ❑ Addition of new motor load of
Job no • I Job site address: 1 0130 6W `Y 1'N ❑ "A "E ", 'I -2 ", "1 -3 ",
TV , W�.CJ 10011P or more. occupancy.
� � � ❑ more residential units. ❑ Supp to vehicle parks.
City/State /ZIP: Tigard, OR ❑ He HealtIt h - 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:
Description I Q17- _ . i Fee. r Total I •
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. R. or less 145.15 4
Ea. add'! 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq. It.)
nree# "�,� n ^ ,(LCL . O nd ^ t Limited energy, multi-family It
- - furnace co r Co rfi J �►C residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
• 200 amps or less 80.30 2
!'"k PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: J� f/J `l n >� fl 401 amps to 600 amps 160.60 2
� 601 amps to 1,000 amps 240.60 2
J
Address: 1- Over 1,000 amps or volts 454.65 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: l )) fjN 24a I Fax: ( ) 200 amps or less 66.85 l
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 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signatu e: Date:
A. Fee for branch circuits with
APPLICANT ❑CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: Same as Contractor B Fee for branch circuits
without service or feeder fee,
Contact name: Diane Mason first branch circuit 46.85 2
Address: Each add'l branch circuit ' 6.65 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: Tri County Temp Control energy era! panel, er or limited- o
e panel, alteration, or
Address: 13150 S. Clackamas River Drive extension. Describe: Page 2 2
City/State /ZIP: Oregon City, 97045 Each additional Inspection over allowable In any of the above
Per inspection 62 50
Phone: (503) 557.2220 / Fax: (503) 557.0919 Investigation per hour (1 hr min) 62.50 _
CCB Lic.: 72623 JfAq'!fo Electrical Lic.: 527LHR Suprv. Lie.: 2567LEB Industrial plant per hour 73 75
7/ r / / ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: ' ' r� �c /•s. Subtotal.
Print name: Dave Salholm Date: 11311 Plan review (25% of permit fee)
State surcharge (12% of permit fee):
Authorized signature: at v , - ;I:. ' �_�LLL a4(4)1LJ TOTAL PERMIT FEE. 5
1811 ,• (f ,,q This permit application expires if a permit is not obtaine
Print name: Diane Mason Date: within
days after It has been accepted as complete.
• Number of inspections allowed per permit.
I V3uddma\Permiu\CLC•PeenitApp doe 0SY23/06 440.4615T(f I /OS /COM/WM
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: FLC2008-00440
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/31/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ° _..
INSPECTION WORKSHEET FOR DATE 8/12/2008 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 10270 SW VIEW TER CLASS OF WORK:
SUBDIVISION: GREE:NBRIER LOT #: 008 TYPE OF USE:
PROJECT NAME: BAUMAN
DESCRIPTION: (2) branch circuits to reconnect furnace and air conditioner.
OWNER: BAUMAN, WAYNE PHONE #: x,03- 639 -2491
CONTRACTOR: TRI COUNTY TEMP CONTROL INC PHONE #: 503.557.2220
Inspection Request Scheduled For: Date B/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
1% Electrical final 074061 -02 503 -557 -2220 V i &/°?-.
Corrections/Comments/Instructions:
i
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ C ' L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
L
Inspector: �� i D ate: _ [1 1Z o D Phone # (503 718 - 2 Y'VO