Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00133
°. COMMUNITY DEVELOPMENT DATE ISSUED: 3/7/2008
TIGARD. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S103BC - 04300
SITE ADDRESS: 12380 SW WALNUT ST ZONING: R -4.5
SUBDIVISION: CURL ACRES LOT : 002 JURISDICTION: TIG
PROJECT: CHANDLER & NEWVILLE INC
Project Description: Reconnect power.
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor:
CHANDLER & NEWVILLE INC
311 N. MERIDIAN
NEWBERG, OR 97223
Phone: 503 - 830 - 4793 Contact #:
FEES
Description Date Amount Reg #:
IELPRMTj ELC Permit 3/7/2008 $66.85
[TAX] 12% State Surchar 3/7/2008 $8.02
Total $74.87 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 C at 503.246.6699 or 1 800 332.2344.
Issued By: •ermittee Signature:
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.
Electrical Permit Application t l 1:012 OFFICE USE ONLY
Iii City of Tigard ` Received
U j , Date/B ANEW= Permit No C (�i(J�"-C /U� 3
1,11, n 13125 SW Hall Blvd., Tigard, OR 9722 tt L� Plan Review
-::;-„,.
- Phone. 503.639.4171 Fax 503 598.19.1, o ' 1 ,. cjte t y Other Permit
f I G A R u Inspection Line. 503 639.4175 0 0 \u .4. adyBy ions gi See Page 2 for
Internet• www tigard- or.gov 2;` 11/4/ \ 1 " 'fled/Method Supplemental Information
TYPE OF WORK s k0 PLAN REVIEW
❑ New construction ❑ Ad ition/alteration/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 stones
❑ 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
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory build' g amps for all other installations buildings
❑ Multi - family ❑ Master builder ❑ Other: lA 9 i - e x ❑ 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 ", "1 -2 ", "1 -3 ",
Job no.: I Job site address: / 2 3 �' 'O - 1001-1P or more occupancy
10,4 / /j�l ifs J" 0 or more residential units 0 vehicle parks
/
Ci /State /ZIP: �� ❑ Health -care facilities. ❑ Supply voltage for more than
ty / / �� O / - /� ❑ Hazardous locations 600 volts nominal
Suite/bldg. /apt. no.: Project name: C� t/•fNdl iiY .- liwu 7 / 1 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 WORK (with above sq. ft.)
/ ( J /J A w Limited energy, multi-family
2 Pea le, / P G 1 t g e J 7`/).l Cr residential (with above sq ft ) 75.00 2
4 d �/� �—b r (y 'MOO d 7 $ Services or feeders installation, alteration, and/or relocation
�� 200 amps or less 80 30 2
Ly rxOPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: C 4„,,,, d e , t /� J r' 401 amps to 600 amps 160.60 2
' " -e W V t / 1 e '1 A L 601 amps to 1,000 amps 240 60 2
Address: 3 // N J � e / r d I , l ,/) Over 1,000 amps or volts I 454 65 I 2
City/State /ZIP: New b € / a g_ 9 - l 3 Z Temporary services or feeders installation, alteration, and/or
relocation
Phone: (S'3) g' 30 — 47 q 3 I Fax: ( ,93) S w-6 / / I 200 amps or less 66.85 I
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, leas ent, or ea ge, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: ��— Date: Branch circuits — new, alteration, or extension, per panel
A. Fee for branch circuits with
agAPPLICANT I 0 CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: la pi t� r-210^-1./9t1
first branch circuit 46 85 2
Address: 3 / / ,{( !^') .e ,/ 1 '0[1,4 ei Each add'l branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City/State /ZIP:/ �w 4 , o (- q 7 / 3 2 Each manufactured or modular
/ ° / dwelling, service and/or feeder 90.90 2
Phone: (.�3) P e 3 0 - 4.' 3 Fax: : ( Sa3) .) t -b /1 J Reconnect only r 66.85 GC %-3- 2
E -mail: f G 0 a j p. L4 0 e . / ✓`-'.G,�S� , A/ e 7 Pump or irrigation circle ( 53 40 0l 2
CONTRACTOR Sign or outline lighting 53 40 2
■ Signal circuit(s) or limited -
Business name: L)1; ]� r.,.4 .4 I n L G t" $- T J U L'4 -0- , A ‘ ® 'e.51 ( \9 ✓ l energy panel, alteratiot or
Address: 3 o /1/, ' e,..4 - e 4 ,....1(// r extension. Describe: Page 2 2 .
City/State /ZIP: GOO , Ore I 7 /14.-O Each additional inspection over allowable in any of the above
Per inspection 62 50
Phone: (Si) ) 1 30 — Fax: ( )
Investigation per hour (1 hr min) 62 50
CCB Lie.: / 733 I Electrica .: I Suprv. Lic.: Industrial plant per hour 73 75
ELECTRICAL PERMIT FEES
Suprv. Electric'.. signature, required: Subtotal (p (,,5 —
Print n • • `e: Plan review (25% of permit fee):
State surcharge (12% of permit fee): F. C
Aut a rized signatur \ TOTAL PERMIT FEE: 8 -
A
This permit application expires if a permit is not obtained within 140
Print name: Date:
days after it has been accepted as complete.
• Number of inspections allowed per permit
I \Building\Permits\ELC- PermitApp doe 05/23/06 440- 4615T(1 I /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
p Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
p 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 \Bmldmg\Permits\ELC- PermttApp doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B -00 X33
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/712.008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/10/2008 TIME: 7:00AM PAGE:
SITE ADDRESS: 12380 SW WALNUT ST CLASS OF WORK:
SUBDIVISION: CURL. ACRES LOT #: 002 TYPE OF USE:
PROJECT NAME: CHANDLER & NEWVILLE INC
DESCRIPTION: Reconnect power.
OWNER: CHANDLER & NEWVILLE INC., PHONE #: 503 -1330 -4793
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3/10/2008 Pour Time:
Code # Inspection Description Confirm # ntact # Message
1'15 Electrical service 066410-01 503-830-4793 \ Y
Corrections /Comments /Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL C ALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: & t € L.E Date: WC' IA Phone #: (503) 718- L,'f k