Permit • ( CITY O F TIGARD ELECTRICAL PERMIT
iit PERMIT #: ELC2006 - 00486
�I�� DEVELOPMENT SERVICES DATE ISSUED: 8/30/2006
�` 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S103DA -06200
SITE ADDRESS: 13490 SW WATKINS AVE ZONING: R -3.5
SUBDIVISION: FANTASY HILL LOT : 015 JURISDICTION: TIG
Project Description: 200amp service and (3) branch circuits.
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: 3 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:
LARRY SNELL OWNER
13490 SW WATKINS AVE.
TIGARD, OR 97223
Phone: 503 - 624 -0452 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 8/30/2006 $100.25
[TAX] 8% State Surcharge 8/30/2006 $8.02
Total $108.27 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: (23. Permittee Signature:61,--1-.7
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.
Electr App ioQ � l�ca 1 c>1i cl i;l lci USE ()NIA'
C ity of Tigard � C D • OW
y '; Penult No .1 C - , nom -Da (in,
.V 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review
0 Other Pemu
. r , �/LST .. op t
'� Phone 5 03.639.4171 Fax: . Date/ . aoOlo 1
'f _ G n �t D Inspection Line: 503.639 ke y �o o� Date Ready/By Ir_ E5 See Page 2 for
. Internet: www.tigard- or.gov Notified/Method Supplemental Information
'i 3
g l ) E IL OV � -1 , PLAN REVIEW
❑ New construction dltlO tl� a lfCrS 0 iii P13 h' ien > E Please check all that apply (submit 2 sets of plans w /items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ D emolition
❑ 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 ❑ Commeraal -use agricultural
Viand 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"
0 Emergency system larger separately derived system
❑Addition of new motor load of ❑ "A ", "E' , "I -2 ", "I -3 ",
Job no.: Job site address: / 3 7 961 S �{/ �(/� / J 100HP or occupancy
/ / lit S /1t /./e El Six or more residential units. ❑ Recreaaonat vehicle parks
❑ Health-care rat es ❑ Supply voltage for more than
City/State/ZIP: / / / a, r ❑Hazardous locations 600 volts nominal
Suite/bldg./apt. no.: roject name: � W ❑ Service or feeder 600 amps or more.
p FEE SCHEDULE
Cross street/directions to job site: Fa, ,, �/ f a r / , 0 S 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.)
_ Limited energy, multi - family 75.00 2
/— /C G 5 e Y (/ / G G d X -t' 7 residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
/ t' C.E(, --. 200 amps or less / 80.30 2
PROPERTY OWNER I" • ❑ TENANT 201 amps to 400 amps 106.85 2
Name: 4 A , v v p - S vi c l 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: / 3 , /'® 5 & / G"a. 7/- / /,l 5 li p
/Q Over 1,000 amps or volts 454.65 2
City/State/ZIP: 7' / - s a , y G C I? , 9 t/ 2 ;s3 Temporary services or feeders installation, alteration, and/or
relocation
Phone: (j d 3) 6 d y! 0 qS p 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 447, 449, 670, and 701. ,,/ 401 amps to 599 amps 133.75 2
Owner signature Date: e- !�6 A. Fee for circuits – new, alteration, or extension, per panel
A. Fee for branch circuits with
APPLICANT I ` ' ❑ CONTACT PERSON above service or feeder fee, QG
each branch circuit 3 6.65 / ! /,' 2
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'I 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
Signal circuit(s) or limited -
Business name: yt c r energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax:( )
Investigation per hour (I hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
' ELECTRICAL PERMIT FEES • -
Suprv. Electrician signature, required: Subtotal: ina ,l
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): g. O —
Authorized signature: TOTAL PERMIT FEE:
Print name: Date • This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
• Number of inspections allowed per permit. I D Q
I \Building\Pmnits\ELC- PermitApp doe 05/13/06 440-4615T(1I /05 /COM/WEB O.
0 �1 4
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:
El Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
El Heating, Ventilation and Air Conditioning System*
El Vacuum Systems*
El Other:
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR. 918- 260 -260)
Check Type of Work Involved:
El Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
O HVAC
El Instrumentation
❑ Intercom and Paging Systems
El Landscape Irrigation Control*
❑ Medical
El Nurse Calls
El Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I \Building\Pmnits\ELC- PamitApp dot 0323/06
.
CITY OF TIGARD r
BUILDING DIVISION PERMIT #: ELC2006 -00486
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/30/2006
Phone: (503) 639 -4171 Zl
Inspection Requests (24 Hrs.): (503) 639 -4175 ..:'„ ^ 11 __
INSPECTION WORKSHEET FOR DATE: 9/6/2006 TIME: 7:06AM PAGE: 30
SITE ADDRESS: 13490 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: FANTASY HILL LOT #: 015 TYPE OF USE:
PROJECT NAME: SNELL
` DESCRIPTION: 200amp service and (3) branch circuit:. •
OWNER: SNELL, LARRY PHONE #: 503.624 -0452
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/6/2006 Pour Time:
Code # lospec • Description Confirm # Contact # Message
Q 199 Electrical final 036084 -01 503. 624•-0452 N
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3 PAS ❑ PARTIAL APPROVAL ❑ CANCEL , ❑ NO ACCESS
. ' ►/ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: N � Date: I 'I) 'a Phone #: (503) 718- 2.�'i 6 _