Permit n CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT ISSUED: E 1/2008 00381
DATE ISSUED: 7/1/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 14AD -04300
SITE ADDRESS: 09046 SW WAVERLY DR ZONING: R -
SUBDIVISION: WAVERLY ESTATES LOT : 042 JURISDICTION: TIG
PROJECT: DEBENEDETTI
Project Description: Installing (2) branch circuits for A/C and Furnace.
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:
DUANE & MISCHELL DEBENEDETTI BEAR ELECTRIC
9046 SW WAVERLY DR P 0 BOX 389
TIGARD, OR 97224 DONALD, OR 97020
Phone: 503 - 639 -8989 Contact #: PRI 503 - 678 -1355
FAX 503 - 678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
[ELPRMT] ELC Permit 7/1/2008 $53.50 LIC 20919
[TAX] 12% State Surchar 7/1/2008 $6.42 SUP 4902S
Total $59.92 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws All
work will be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days ATTENTION. Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 thr• . • h OAR 952- 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1 800.332.2344.
Issued By , /7 / Permittee Signature: P �, r' ���p✓
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: ' DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
0'-01/2008 TUE 12:02 FAX 5036781108 Bear Electric.Inc. 0001 /002
/ '
Electrical Permit A .: ' , vol! at E,® FOR OFFICE CSE ONLY ,
City of Tigard 1 Received / or � � Permit No.: b
„ .440b I$ l
, ' 13125 SW Hall Blvd., Tigard, OF, 7223. 2�(y.� Plan Review Q �[
Phone. 503.639.4171 Fax: 5 f 960 DatdBy Other Permit. l.JO - 6
T I G A R D Inspection Line 503.639.4175 J� Q� (; Date ReadyBy �a VI See Page 2 for
Internet. www.tigard-or.g OF TIGARD Notifted7Method: ' - G/' Supplemental Information
1
❑ New construction A on/alteration /replacement „ Please check all that apply (submit ( sc6 of plans w!items checked below)
❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Demolition ❑ Other' where the available fault current ❑ Marinas and boatyards. '
. + ` i ' " '� ' �i�' fEG� .t�3t�02L;iGiDJ'$S��
�iCaIO1V- . ? exceeds 10.000 amps at 150 volts or 0 Floating buildings
less to ground. or exceeds 14.000 ❑ Commercial -usc agricultural
21 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 StFE INFOR°IDIikr[O*t ii 'LOCAIflO'N r ' ❑ Emergency system larger separately derived system
. .... . . s ... ; .... ,• -.. •, , =' ` ❑ Addi of new motor load of ❑ "A ". "E "I 2 3
M I-1P or more occupancy.
Job no - ' Job site address Lo w4 Wiv K--11 R Dr ❑ Six or more residential amts ❑ p arks.
Recreational vehicle
City /State/ZIP , O'2 Q\ 1 2Z� ❑ H ealth -care facilities ❑Supply voltage for more than
T o ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name' `D .i. ti1/4) li p tri ❑ Service or feeder 600 amps or more.
7 "' ::: #."GHEbUJis
Cross street /directions to job site: Description I Qty.
( _. Fee. l � Total . ( • .
New residential single- or multi - family dwelling unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea add'I 500 sq. ft. or portion 33.40 1
r. Limited energy, residential 75.00 2
- }j ' : °ky "�'' v. O - .e£w•:, ` 5.`. c i`•=i< 'ft: (with above sq. 0.) .
-� ` _.. ., ' � %:y..._ r� °.� .. >. � - : >. - �na�!h��t.:..i a"� �...� rc_... ?yo � Li?i: <�'3 c �. .
Limited energy, multi - family
75.00 2
Rep \c ,,c Q \f0 S Icy S ce e.■« >�\-. L331 2c ../ residential (with above sq ft.)
Services or feeders installation and/or relocation
`
1� \` Cs-h AIL 'u �l -' - 200 amps or less 80.30 2
. :C.-1 P I20PEf My OWNER ' . : ,,, :, • , ' , . D _ ', T 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) 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 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
w , A. Fee for branch circuits with
. , Ai gi .I n- Od _ . _ - j`�tr '« � C{
l .4 e •-:-::,=',-.._.,,,, above service or feeder fee,
r : > + `�' "4 each branch circuit 6.65 2
Business name: B. Fee for branch circuits
without service or feeder fee, �j
Contact name: first branch circuit \ 46 - f k Ot 6,-)
Address: Each add'I branch circuit i 6.65 ( 04_05 2
Miscellaneous (service or feeder not included)
City /St ate /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
Cty1V I_?1 i0 .' % Sign oro utline lighting 53.40 2
(�� � ^ Signal circuit(s) or limited -
Business name:
k K ai C �\C � 1 J , .r energy panel, alteration, or
Address. B Box 3g extension Descnbe: Page 2 2
City /State/ZIP: Dzycyl1 Ck OR, ( '-10.20 Each additional inspection over allowable in any of the above
1 / I Per inspection 62.50
Phone ( ` � ), l n) Fax: ( 3 1 k(i�
Investi per hour (I hr min) 62.50
CCB Lie.: 20C1 pi Electrical Lie.: L- I (n C Sup Lie: q ¶Q\ Industrial plant per hour 73 75
aitOKAL. I'ERMIT,.kEE8
Suprv. Electrician signature, required: - /"11114 Subtotal:
�i. .�1�.� 63,5n
� Platt review (25% of permit fee)
Printname���1n� , , ►�,. � Date. -i VU o
State suttharge (12 /o of permit fee)
Authorized signature: TOTAL PERMIT FEE' 5q 5C) 7 • : '
This permit application expires if a permit is not obtained nithin 180
Print name. Date: days after it has been accepted as complete.
• Number of inspections allowed per permit
1 awldmg Peones lilt • Pern App dn. 052 440.5015w I 05 CUM WEB
CITY OF TIGARD
BUILDING DIVI PERMIT #: ELC200B- 00381
13125 SW Hall Blvd., Tigard, OR 97223 ' NO DATE ISSUED: 7/1/2008
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639-4175
r.
INSPECTION WORKSHEET FOR DATE: 7/3/2 TIME: 7:00AM PAGE: 34
tO2W -► i, �Z / >✓a U 1-5/
SITE ADDRESS: 09046 SW WAVERLY DR CLASS OF WORK:
SUBDIVISION: WAVERLY ESTATES LOT #: U42 TYPE OF USE:
PROJECT NAME: DEBENEDETTI
DESCRIPTION: Installing (2) branch circuits for NC and Furnace.
OWNER: DEBENEDETTI, DUANE & MISCHELL PHONE #: 503-639-8989
CONTRACTOR: E3EAR ELECTRIC PHONE #: 603-678-1355
Inspection Request Scheduled For: Date: 7/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072149 503 - 453.4822 001
Corrections /Comments /Instr tions:
- .4_ A4 / 1 10 4- r
•
0 . rA PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL •1' CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector Date: Phone #: (503) _ -�`�
Ins ? 6
P ( ) 718-