Permit ELECTRICAL PERMIT •
CITY OF TIGARD
PERMIT #: ELC2007 -00250
COMMUNITY( DEVELOPMENT
DATE ISSUED: 4/18/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S1 10 BA -05400
SITE ADDRESS: 11825 SW WILDWOOD ST ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT : 011 JURISDICTION: TIG
PROJECT: WIEDER
Project Description: Panel change.
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: 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:
CAMERON; DONNA MARIE + BOONES FERRY ELECTRIC INC
WIEDER, DENNIS C PO BOX 628
11825 SW WILDWOOD ST WILSONVILLE, OR 97070
TIGARD, OR 97224
Phone: Contact #: PRI 503 - 682 -4936
FAX 503 - 682 -7946
FEES
Description Date Amount Reg #: ELE 3 -223C
[ELPRMT] ELC Permit 4/18/2007 $80.30 LIC 88482
[TAX] 8% State Surcharge 4/18/2007 $6.42 SUP 4918S
Total $86,72 REQUIRED ITEMS AND REPORTS
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This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100 You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: -/, , , d i e /i - // Permittee Signature: dtt, i e,/'c a /kin
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i -, ►ejpr 18. 2007•I 9:54A BO _ S FERRY ELECTRIC No. 7418 P. 1
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j
11Ca __ FOR ()FI'IC:F USE c)N9,v
:.- = ` V ''' 1 City of Tigard = i� r .
r
a 13125 SW Hall Blvd., T+. and X 97223
OR permit No.: Gl� ��MM / ^ �IZ$�
,tii Plan Review
71
Phon ®, 503.6394171 Fax; 503 598.1960 � Date/B , oat. Permit:
T I C; AR t inspection Line: 503.639.4175 1-F( S 2007 Date Ready/By: r rte:
www.tigard- or.gov
Notified/Method:
u S See Supplemental for
Internet
ty l Supplemental'cre 'cremation
C m GI 3� -j" '� J Y
�11 .v' } t . i_ r ... ..:r ' S. : l e... _r 1 s {' � f s k [ < �3 <:i 3 �-•
' f ` S4n l ��r, ! ' r_ • j r•.:1. i .. > -P.. ; , [ . [ IF i s 5. 4 a � O t i Tr Jj .3r. 1` , .l a, EE:. i ~
dditio F1 :�' 3 r , `. . - - • - •- • - • : r .,'. _ ,,: �., ..
❑New construction
man Tr (r(A Please cheek all that apply (submit 2 sets of plans whtenis checked below):
❑ Demolition ❑Other ❑ Service or feeder 400am or more s. c ❑ Building over three stories.
s,
''� ��!!',�� r 1 fFft;! .3.3!x,. Pq�1C � H L �il , Y� 3','a) } q �p�j�tl Ii�� SYt, is t� s `, ' [ ` � � ix � •, whore the availnbla fault current 13 Maness and boatyards,
PI' _,.-..., _ r - _ , ; ? ' r _ t exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
and 2 family dwelling ❑ Commercial/.industrial l eas to grou oraxcee 14000
❑ Accessory building ❑ C ommercia l -use agneulturel •
❑ Multi -family amps for all other installations,
y ❑ Master builder ❑ Other: p p Installation
g } `r r w jr r u t , r -, ,, ❑ F ir e urn ❑ Irtslallatl0o of 75 KVA or
' n' _a 9 }Y }t;711�1 `II. : i t l 11 i�lfl`1? 1,i+f 111 11 r r<fI , y [,. f 'r ;t. f.. ❑Emergem. ter
} lt ._.. ..,, { v1 3
larger separately derived system
30b n0 - _., ❑ Addition of ncysysle new motor load of ❑ °A ", "E", •� 1 -2", "1 - +',
j 250, Jo b site address: i t 8 � `` t OpHP or,noro
.54.0 i d W 00 d Recre l ❑ Si x or Moro resi dential units. ❑ Regeatien al vehicle parrs.
City /$LBtC /zIP;
■
O ,, 4 0‹ ❑ liealib.care facilities. El Supply voltage for Mora than
Suite/bldg /apt. n0.; ❑ Hazardous locations 600 volts nominal. .
Project name: e., Ci` ❑Service or feeder 600 amps or more
Cross street/directions tb job site; ' °;'
^ _ -�
_31.__,1 S , ', a S,l IT ,'.` ii il �.*'.�{.,r,`1 C ;p f .,l -
L1 3 �.
., OIY• Few Tbml
New residential Single- or multi - family dwelling unit.
Subdivision:
includes attached garage.
I Lot no.: 1.000 sq. ft. or less, 145,15
Tax map /parcel no Ea add'i 4
t [ 500 sq. ft. or portion 33.40 1
f } t f ': Y fir' , .} r;.. F , "at,, iJ,ri,ti` l ell; �' e I Fn %fV;;? `� t r� F • t Limited energy, residential - .
m +1 } y?,,( , ± (wills above sq. R) 75.00 2
�°tvr�� C y, g Limited energy, multi - family 75.00
- _ residential (with above sq. t1.) 2
+T '� Scr vices or feeders installation and/or relocation
i4. i t �E�?q ^ fl I' - f,ll'_ r '�F i - r „3} S 1 }fi ` Lry:} ifl �';aNM J:� F1' r 7'c ' 20 a s t o 400 amps 106.85
Name: 2
401 amps to 600 maps (60.60 _ 2
dress: 60( amps to 1,000 amps 240.60 2
Over 1,000 amps or voila 454.65 2
City/State/Z1P: Temporary services or feeders installation, alteration, and /or "
Phone: ( ) - relocation
Fax; ( ) . 200 amps or less • 66.85
Owner installation: This installation is being made on property that I own which is not . 201 to 400 amps 100.30 1
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 a s 2
"aP 133,75 2
2s{ Ow 44 ller signature: Date: Branch circuits - new, alteration , or extension, Cr panel
` f I fv 11 l IFi }....'�'�' rr it .1 „� ,J f i i 1 > ' c i TE'1 ^ i 3 A. Pee for branch circuits with
.
�- 1E <�.1: _ - -r eri I i}' 3 r '1l}.fa 't �t` " `r' i � t
�iif'F4 55; ` " 3 g , Q
...... 1�..- .,..3- .0,.rs.. , l , _,n�3 a� ,- t.4.,.L.� k..- ',i.. above service or feeder fee,
Business name: each branch circuit 6.65 2
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit 4 6.85 2
Address: Each addl brunch circuit
6.65 2
City/State/ZIP: - Miscellaneous (service or feeder not included)
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Each manufactured or modular 1
Phone: ( ) I Fax: ; ( ) • dwelling, service and/or feeder 90.90 2
E-mail: Reconnect only ' -
66.85 2
a{ ii ; fit 1 Ir i n >. T �-F:.� Pump or irrigation circle 53.40 2
4 ..,_ d"::�. i 1•_t F ..,_IZ� i t f lY,.�„J-,
}., 7,-, -1 Sri z.:. r � rj: .1• Sign 53.40
Business name; Boones Perry Electric INC _ 'l.ign or outline lighting 2
Signal circuit(s) Or limited -
-
Address: P.O. Box 628 energy panel, alteration, or
extension. Describe: Page 2 2
City/State/ZIP: Wilsonville OR 97070 Each additional inspection over allowable in any of the above
• Phone: (503) 682-4936 I Fax: (503) 682 -7946 Per inspection 62.50
CCB Lie.; 88482 - Investigation per hour (1 hr min) 62.50
Electrical Lic.; 3 - 223C I Suprv. Lie.: 4 tea Industrial plant per hour
73.75
Supry Electrician signature, required: '+ l�F' 'i?a L & �(l RW te } t� 1 ` i ti t }� 1 T
Int name: t]
' Subtotal: Q , 6
s� i , c e • a Jn ' I Date: t -- / 6- - _
Plan review (25 °/Q of permit fee):
Authorized signature: State surcharge (8% of permit Erse)-
TOTAL PERMIT PEE: g' 6. 7 ,z
Print name: I Date. This permit application expires if permit is not obtained within 180
days after it has been accepted as complete.
i:tllu[Idr!•glPerm11a1Et C- Permitepp.dec 05/23/06 • Number of nwpections allowed per permit
410- 4615T(1 I /05/COM/Wa
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CITY OF TIGARD
BUILDING DIVISION - " PERMIT #: ELC2007 -00250
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/18/2007
Phone: (503) 639 -4171 /an jp' III (
Inspection Requests (24 Hrs.): (503) 639 -4175 Al
INSPECTION WORKSHEET FOR DATE:' 4/20/2007 ' TIME: 7:00AM PAGE: 77
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SITE ADDRESS: 11825 SW WiLDWOOD ST �hr r CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 011 TYPE OF USE:
PROJECT NAME: WIEDER
DESCRIPTION: Panel change.
OWNER: CAMERON, DONNA MARIE +, PHONE #:
CONTRACTOR: - BOONES FERRY ELECTRIC INC PHONE #: 503 -682 -4936
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Inspection Request Scheduled For: Date: 4/20/2007 Pour Time:
Code # Inspection Description Confirm # � Contact # Message
199 Electrical final 046856 -01 503-682-4936 N
Corrections /Comments /Instructions:
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V'
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PASS ❑ PARTIAL APPROVAL ❑ CANCEL El ACCESS
❑ FA ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .V. - Date: Phone #: (503) 718- 2itik