Permit ill --, G'TY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00399
COMMUNITY DEVELOPMENT DATE ISSUED: 6/12/2007
TIGARD 1 31 25 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103BA -00200
WE ADDRESS: 11525 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: LOT : JURISDICTION: TIG
PROJECT: SCROGGINS
Project Description: (3) branch circuits for furnace replacement & new a /c. Job No. 13012
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: 2 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:
LYNN SCROGGINS COHO ELECTRIC INC
11525 SW WALNUT AVENUE PO BOX 40
TIGARD, OR 97223 WILSONVILLE, OR 97070
Phone: 503 - 750 -1528 Contact #: PRI 503 - 582 -9774
FAX 503 - 582 -9840
FEES
Description Date Amount Reg #: ELE 3 -575C
[ELPRMT] ELC Permit 6/12/2007 $60.15 LIC 157169
[TAX] 8% State Surcharge 6/12/2007 $4.82 SUP 1781S
Total $64.97 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center.
Those es are set fo • e ' R 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain copie • these rules or direct questions to OUNC at
503. 6.6699 or 1.800..:2.2 . A .
Iss ed By: ' / i1 ` � I Permittee SignaturMit - • f f�� `
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:
∎ , . CTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: •_._ �allPr � /Iir 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.
L' ,
FROM :COHO ELECtRIC FAX NO. :5035829840 Jun. 12 2007 06 :16AM P2
Electrical Permit A u ►.% E 1E FOR OFFICE USE ONLY
City of Tigard Received /,, l , Permit No.:
13125 SW Hall Blvd., Tigard, OR 97223jij 1 2 2007 Plat eview ® O • r " �� •�
Phone. 503.639.4171 Fax 503.598 1960 '"rr` .1 '' 1'1 0 :, Dato/by. Otter Permit:
inspection Line: 503.639.4175 C1T � � •) A il -
, : •„ • _ Date Ready/By. ! GS Sec Page 1 for
Internet: www.ci.tignrd.or.us BU's Y 1V1SIO Ni
otfi -__
OI�OD / tQt Supplemental
�f rl1F I'!" ∎ il�yRrll t .' U 9f! ir l, ;r 1 1 i1 8 . ,, - , i< v ,, i i`'rlf� h� ' , ! � 'I y ' �� ' ',Lte �f'd'yi tu 9,. ' 'a': ,, . n . , f -', n . I"
1� !'n ��! t! 1� .., ■ll nl � l i , 61 1 (tie ,!h I b llt5 1014 i t ��� i y f h i t fi 1 it !` q ' .. C' , i t t : {,,• ( - • II rgat Ui , 1, y tt,1 i l Ilk HO, 1, r ?�, . (,,. I , ,,li L 1 ^l� ��� s( 1; .f,i0e1; 0 n,,,l ` 1 -! s1+ •.
❑ Ncw construction :1 Addition /alteration /replacement Please check all thin apply'
['Service over 225 amps, comtn'I ['Hazardous location
El Demolition 171 Other:
p ° �,i3f!1tf if' i'h;4`IYFII i�ry, t v hr�' ^r�' yytr a�s „,,„ {j� f+ .i, 't, ,,3; ❑Servicenvor320amps- rating ❑Butldngover10,000sq.fl,
uk(1 A:• :h Y ai1k�li,:41,r, i in,a; l (;+, 3tl, ' r , ,;•,., , it,P,I ;id.! ;i ,t i t ^ 3, I. , ” 3r L a. "yR � u '' U a ,. <f'L� of 1 and 2•farruly dwellings 4 or more new residential
1: 1- and 2- fartuly dwelling ❑ Commercial/industrial 0 Accessory building ['System over 600 volts nominal units in one svucotre
❑Building over three stories :Weeders, 400 amps or more
❑ Multi-family ❑Master builder ❑ Other:
Ej1 a l i L '},{ :E 1 ' Y *tI
� �ljl'4. {i'. t �t ) _ �Fl r,, i t� t ; a y ,, i Ivt� 2 ; ,.. , ' UI'�I x } .
41 nc 1 ��44�1 ! - � '- "i 1 iJ'll 'i r "' 'S. ❑Occupant load over 99 persons ❑Manufactured structures or
S
tl. / aJ�:' ��' jl nti,LilLus,Si1' i ¢, .,
r 1
� il1 1, I E0 , 41. ,, ,'iki1tauimpl'a ; I r.LA;4:r t u: 6 hz, klr LLL.I � i lr. ❑Bgfess/liphting RV park
Job no. Job site address: f Health -care facility ['Other
--- -- 1 � � e� r • • - Submit l sets of plans with any of the above,
City / State/ZIP: --C-1 r , , a () -Q C i a3 The above arc not applicable to temporary construction service.
SUltl /bldg. /apt.IIO.. Project name: e�p,� 1 �� . r ai �' l yrgl�.,. ,j }{!.t ?,li� r. ".. '�,12,, '
li,'lEJ ,,'r ?+.,1' ,
,.
CdO et. D,Litrlpttun Qty. Pee. Total
Cross a treet/dircctions to job site: New residential st -or multi- family dwelling unit.
— - - Includes attached garage,
1,000 sq. ft. or Ice 145.15 4
Subdivision: - I Lot no.. R -`— Ea add'I 500 sq. ft or portion - - 33.40 1
Tax map/parcel no.:
Limited energy, residential 75,00 2
GZ I A 1 °I' ", + ar�i ±., . ^ - , iy ri.1d �� m'w u ; r ;a J + , ;id' {, i B'ih �.�t1 {''t t energy, non-residential -- - 75.00 2
` 1 `�,,, {11Fi f1 y, +, S1!p S O I n�l,l,:��� d 1 riu i !n d A ` 1 r i U I t4 '11tI Iy 41 r IVi�6�41r I', ,1 �� Et ch manu ----- ul
a, iSul a �,i, ills u.0 rill l.l;,li1.,.,.t., .l.11l I,a341r,tua rtiv,.,- at.� LI• N 11,;1! „t i.,..u,.7f .tl.+: fiA, ∎Nr ��� , , .�� l i 1' ,1 ;Ill or mo
p dwelling, service and /or' feeder_ _• 90.90 I 2
it 0 -. 4..... Ise 'e-t ..' 2_, `I ��� t lL-- L3a/1e Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
V( ^ t I 79 [ lici t I� f +r'} ,OCV 1 , ' + :�, + , lU ii t i t , 11;1 i ,! i. rnif \ ;tI + X,. I !f l�y{ ( I' ! 2t11 ampv to 400 amps I106,85 2
N, -,,i. ''' , 1 n E° 3 f .}� ,11 a ' lt�l d+, + fi , ) ( �i. I I I 1 I��((� rv'l�g brut ,i iii �,,I ��(�J, I .,_.
JL. {.0 t ,, dm 6 ,n;l 1,. . ft do,. t„n. { t,. r t i:Il�li i ' , ,,. ,, .'a: well +n li g 1,, I'IA: �rl ,I, I ' 40l amps to 600 amps 160.60 - 2
Name: C'
5 601 amps to 1,000 amps _ 240.60 2_
Address. — a - `�1 i _ \ Yv -~ Over 1,000 amps or volts 454 65 2
---:\.' .0.,r- Reconnect only 66.85 2
City / State/ZIP: d (�'" a3 Temporary services or feeders Installation, alteration, and/or
relocation
Phone: ( ) ', b + 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
f
L 75 Y ( 7 7 n1 A l F', y 1 '� :0 ei ' I, r :,:'1.,,A r J7FhfI �{ " � o I itI , 1L'im .0 ^4 ,
V 1 l l u 5 y'f . + + e � -
Nkukti.4;, * ,„, t rx � ;,,t t l }., • ... sh. L I � . � , „ l;, Si ' t . �m11„ IIIII ,16i l ' ,niii w h ,,, ' mo irL A,seviceorfeed feeder fee, each
service or feeder f ee, each 6.65 2
Business name:
branch circuit
' " 13, Foo for branch circuits
Contact name: without service or feeder fee,
Address: " each branch circuit 1 46.85 y/ CbC� - 2
a
Each add'i branch circuit o, 6.65 I' (.3 2
City /State /ZIP: Miscellaneous (service or feeder not included) _
Phone: T Pump or irrigation circle 53.40 2
( ) Fax: : ( ) Sign or outline lighting 53 40 2
E-mail:
!, r I O+ , l 7 V N, y + r�y n ( Q +t n mu' Signal circuit(s) or limited -
CIYf+Alibi.l,i (`aiiiii ii nt,�+ll2,�', } P f!n L!Jh d;V�, nJ. +$ l�:,i �Ul ?i?lifrMlll cif, `i aIl1lf nit: l ;.Wri nri;lli encr8Y panel. alteration, or
P extension. Describe: Page 2 2
Business name: eQ • ke_ :la
Address: C e ?ctsA it�� Each additional Inspection over allowable in any or the above
1 -- --..•" Per inspection w 62 50
ti
City /State/ZIP: ', \ -,,j':,'\.rt 61t.,, c i; ''''2t ' V _ Investigation per hour (1 hr nut) 62.50
Phone: (5 ) . u, _ �—'1 — I LI Fax ( ) '� ` (-- 3 Industrial plant • rhour 73 75
l , i { i f F , 3 C 1 1 h J i , i . ,, gi + + e " ' ,
CCB Lic.: _ r•io,;rlNril;Nf, �, +, !L1111 rfal.l +c, }iiit, `r�,r fl t,dPJ,;'a }. 5 }!;1 A 1vv I:
\E,11( Electrical .: ` • ' Suprv. Lie.: , Y 5S T` Subtotal - �Q,
Suprv. Electrician signature, required: .;. , ' Plan review (25% of permit fcc) -
,J 1 State surcharge (8% of permit fee) '4 , •$
Print name: cc.4 t , i y Date: �..1 a_ (2 , - ,
TOTAL PERMIT PEE bt,4 • CI `i
Authorized signature: PM i,„, t• !
i, Thla permit appUcadon expires If n perrhjt tt not obtained within 1s0
da after It has been necepted es complete
Print name: l' `ktD Ali Date �1 _ �• i • Noe methodology set by Tri-(:ounty Building Industry S°rvtce nnard
�1— t- r« Number of inspections per perniit ullewed,
t:\BuilelnatPe, LtAffi.C•Parnutnpp 12/03 440.4(13T(10 /031COM/WBB
CITY OF TIGARD .
L
BUILDING DIVISION PERMIT #: ELC2007 -00399
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/17J2007
Phone: (503) 639 -4171 �'�
Inspection Requests (24 Hrs.): (503) 639 -4175 I I..
INSPECTION WORKSHEET FOR DATE: 6/13/2007 TIME: 7:01AM PAGE: 82
SITE ADDRESS: 11525 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: SCROGGINS
DESCRIPTION: (3) branch circuits for furnace replacement & new a/c. Job No. 13012
OWNER: SCROGGINS, LYNN PHONE #: 503 - 750.1528
CONTRACTOR: COHO ELECTRIC INC PHONE #: 503 -582 -9774
Inspection Request Scheduled For: Date: 6/13/2007 Pour Time:
Code # Inspection Description _Confirm # Contact # Message
199 Electrical final 050111 -01 \ 503- 582 -9774 N
}
Corrections /Comments /Instructions: '-,___,_________/
® PkoN w0R-t NO1 ANc ' IN -
No el-- S
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•
�y G" W 1 a 3iIt',
I;. PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
T: , - 'CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, Inspector,: . Nbg Lt"
- Date:' 6 I 1 3t 01 Phone #: (503) 718- 12-44k)