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Permit
'CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2007 -00230 COMMUNITY DEVELOPMENT DATE ISSUED: 4/11/2007 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104AD -02700 SITE ADDRESS: 12915 SW WALNUT ST ZONING: R -4.5 SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: HANSEN Project Description: Replace service panel and alter (12) branch circuits for remodel. 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: 1 W /SERVICE OR FEEDER: . y2' 1 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: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: ED HANSEN NORTH LAKE CONTRACTORS 12915 SW WALNUT 12900 NW LOVEJOY CT TIGARD, OR 97223 PORTLAND, OR 97229 Phone: 503 - 579 -1950 Contact #: PRI 503 - 709 -0985 FAX 503 - 641 -3168 FEES Description Date Amount Reg #: ELE C13 [ELPRMT] ELC Permit 4/11/2007 $160.10 LIC 154178 [TAX] 8% State Surcharge 4/11/2007 $12.80 SUP 48915 Total $172.90 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 . NTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 1 -0010 through R 95 01 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issue By: jG Permittee Signature: X 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: jPNTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: e „ i' lit tLf/i; 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. E1ecti caL ermit:Application _ ,. F OFFICE USE ONLY • '1 Received q� City of Tigard Date/B 47 Permit No 24.6,,, — � • q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' C : Phone: 503 639 4171 Fax 503.598 1960 Date/By Other Permit TI G A R D Inspection Line. 503.639 4175 Date Ready /By Tuns ® See Page 2 for Internet: www.tigard - gov Notified/Method ...--7 l ar Supplemental Information ' . TYPE OF WORK ` - " PLAN REVIEW '. - Please check all that apply (submit 2 sets of plans w /items checked below) ❑New construction ❑ Addition /alteration/replacement ❑ Service or feeder 400 amps or more ❑ Building over three stones '❑ Demolition ii Other: where the available fault current ❑ Mannas 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 ❑Emergency system larger separately derived system JOB SITE INFORMATION AND. LOCATION , ❑ Addition of new motor load of ❑ "A ", "E ", "I -2 ", "I -3 ", Job no.: Job site address: / 2 / S L.J LiJui 64-1/ s1-- 100HP or more. occupancy ❑ Six or more residential units ❑ Recreational vehicle parks City/State/ZIP: W ,_. © c 7 22 3 ❑ Health -care facilities ❑ Supply voltage for more than S ❑ Hazardous locations 600 volts nominal Suite/bldg. /apt. no.: Project name: /4 ❑ Service or feeder 600 amps or more FEE SCHEDULE . Cross street/directions to job site: Description I Qty. I Fee. I Total 1 • 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 ` D ESCRIP11ON-_ OF WORK - (with above sq ft.) ' Limited energy, multi - family 75 00 2 residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less / 80'30 g0%31 2 • ❑; PROPERTY OWNER • ❑, TENANT 201 amps to 400 amps 106 85 2 Name: f L 1.-e4--. G 401 amps to 600 amps 160 60 2 / , 601 amps to 1,000 amps 240 60 2 `Address: / 2' / ' S t) /.t/.04,4 5�, Over 1,000 amps or volts 454 65 2 - City/State /ZIP: / / w,.X e." "'? ? ZZ 3 Temporary services or feeders installation, alteration, and/or relocation , Phone: (60.3 57 % /95 L . Fax: ( ) 200 amps or less 66 85 1 Owner installation: This installation is being made on property that 1 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 Owner signature: Date: Branch circuits — new, alteration, or extension, per, panel A Fee for branch circuits with ❑• APPLICANT ' ❑ CONTACT PERSON above service or feeder fee, each branch circuit 6 l 6 65 2 Business name: B' Fee for branch circuits without service or feeder fee, Contact name:. 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 ^171 /� 71 �. b e s I Liz- energy panel, or Business name: or No (� l t"t 1..44-14 � C.—a!J f r�'*�1 " Cl..C� energy panel, alteration, or Address: l 290D M� tom ' cr extension Describe: Page 2 2 City/State /ZIP: p ,.. � f' + a_ 97 Z2c Each additional inspection over allowable in any of.the above Per inspection 62.50 Phone: 7 F ( $� Fax: ) f� Investigation per hour (I hr mm) 62 50 CCB Lic.: is y i -78 Electrical Lic.: C ( 7 6 Suprv. Lic.: 40 n ....S Industrial plant per hour 73.75 • i (a / i s f 4 0 ELECTRICAL PERMIT' FEES; • Suprv. Electric signature, required: ( � � 0 7 Subtotal /60 /C.. � LV l ( 1 1 a S . Date: c f Ct 07 Plan review (25% of permit fee) Print name: O ' State surcharge (8% of permit-fee) /a • 8`0 Authorized signature: TOTAL PERMIT FEE. ! 7 ,2� 9 This permit application expires if a permit is not obtained.within•1S0 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit I \Building\Permits\ELC- PermitApp doc 05/23/06 4400.4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard . Jr .. r, 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- 260 -260) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ 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 :\Budding\Permits\ELC- PermitApp doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: F1.C2007- 00230 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/ 1 112007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1/31/2008 TIME: 7:00AM PAGE: 45 SITE ADDRESS: 12915 SW WALNUT ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: HANSEN DESCRIPTION: Replace service panel and alter (12) branch circuits for remodel. 8/08/2037 ADD: (5) branch circuits. OWNER: HANSEN, EL) PHONE #: 503.579.1950 CONTRACTOR: NORTH LAKE CONTRACTORS PHONE #: 503.709 - 098,5 Inspection Request Scheduled For: Date: 1/31/2008 Pour Time: Code # Inspection Description Confirm Contact # Message 199 Electrical final 064221-0 503 780.63113 Y Corrections /Comments /Instructions: 3 0 m1 v ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: � ry Vv Date: V "en Phone #: (503) 718- A) • CITY OF TIGARD BUILDING DIVISION - PERMIT #: ELC2007- 00230 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2007 Phone: (503) 639 - 4171 :Veit Inspection Requests (24 Hrs.): (503) 639 -4175 !+� ''__ INSPECTION WORKSHEET FOR DATE: 819/2007 TIME: 7:00AM PAGE: 59 SITE ADDRESS: 12915 SW WALNUT ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: HANSEN DESCRIPTION: Replace service panel and alter (12) branch circuits for remodel. 8/08/2007 ADD: (5) branch circuits. OWNER: HANSEN, ED PHONE #: 503 - 579 -1950 CONTRACTOR: NORTH LAKE CONTRACTORS PHONE #: 503 Inspection Request Scheduled For: Date: 8/9/2007 Pour Time: Code # Inspection Description irm Contact # Message 120 Electrical rough -in 053667 -02 503 - 579-1950 Corrections /Comments /Instructions: X PASS El PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: N 081 Date: 1 6 ( Phone #: (503) 718- 1144- f ' CITY OF TIGARD BUILDING DIVISION +'' • -�' PERMIT #: ELC2007 -00230 13125 SW Hall Blvd., Tigard, OR 97223 , DATE ISSUED: 4/11/2007 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639 -4175 L. • INSPECTION WORKSHEET FOR DATE: 4/12/2007 TIME: 7:0011M PAGE: 50 SITE ADDRESS: 12915 SW WALNUT ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: HANSEN DESCRIPTION: Replace service panel and alter (12) branch circuits for remodel. OWNER: HANSEN, ED PHONE #: 503 - 579 -1950 CONTRACTOR: NORTH LAKE CONTRACTORS PHONE #: 503-709-0985 Inspection Request Scheduled For: Date: 4/1212007 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 Electrical rough -in 046365-01 503- 780.6383 Y - )2\A -=- V ) )5 ° 1 Corrections /Comments /Instructions: ?0...13\f tia9N)UNIL. (Lit.- CA L_5 fe A c.c0 Pmt, .Ac '2 2 c 1-,v 6 t Z 12RA* fIbwiNi EE Si 1.)1C., b H IZ � CY* ❑ PASS i PARTIAL APPROVAL ❑ CANCEL • ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED • Inspector: ' tlV 63 L1r Date: 4 ( Q Phone #: (503) 718-1114t0