Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00237
COMMUNITY DEVELOPMENT DATE ISSUED: 4/16/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DA -07200
SITE ADDRESS: 11450 SW WINTER LAKE DR PARK ZONING: R - 4.5
SUBDIVISION: SUMMER LAKE PARK LOT : OOA JURISDICTION: TIG
PROJECT: SUMMERLAKE PARK
Project Description: Replace main breaker. Job No. 99065 -108
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:
TIGARD, CITY OF OREGON ELECTRIC GROUP
13125 SW HALL 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 - 95C
[ELPRMT] ELC Permit 4/16/2007 $80.30 LIC 203
[TAX] 8% State Surcharge 4/16/2007 $6.45 SUP 4460S
Total $86.75 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 wilLbe done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
su : -nded for more -n 188 - -ys. ATTENTION: Oregon law requires you to follow rules adopted by t = Oregon Utility Notification Center.
hose rules are set forth OA 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain co.•- o these rules or direct questions to OUNC at
503.246.6699 or 1.800.11.2
Issued By: / � � ( j 1 r Permittee Signature: i /110 / ���
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:
• TRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: t % , „' /�A ` 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.
APR -12 -2007 09:14AM FROM -OR ELECTRIC SVC 5035352763 T -366 P.001 /002 F -471
' eL L rlcal rermut I ' 1� p ;;gyp
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p li►It lc'I :I;I :cl�t.1
City of Tigard 4 � U L
J a.._ Received
13125 SW Bell Blvd., Tigard, OR 97223 Date/By, 9 42 D7 - 4L( Permit Na :�-1"4-d0i7.. 37
Phone: 503.639.4171 Fax: 503.598.196 4:1V1:: Pt um Rev'
Imperil= Line: 503.639.4175 APR 12 2 i '`���'i is • Other Permit:
Internet www.Cl.ti Date Ready /By 1..•: ® See Paget for
gvdor t Notified/Method:
.�.
Stepplemcauu information
❑ New construction ►,13
i ' .4 piamrig? Please check all that a PLAN REVIEW
ID Demolition PPS
❑ Other: ['Service over 225 amps, comm'I ❑Haznrdous location
CATEGORY OF CONSTRUCTION . • • ❑ Service over 320atttps -trans ❑Bulldng over 10,000sq R,
1:3 1 - and 2 - famil dwcllin of 1- and 2- family dwellings 4 or more new residential
Y g ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑ Multi - family ❑ Master builder 0 Other: OBuilding over three stories ❑Feeders, 400 amps or more
El Occupant load over 99 persons ❑Manufactured st or
JOB SITE INFORMATION AND LOCATION
❑Egress/lighting plan 1W park
Job no.: 99065108 Job site address: / /'/549 et k) / ,Q kh —D,e_' ❑Health facility ❑Other
Submit 2 sets of plans with any of the above.
City/State/ZIP: TIGARD, OR 97223 The above are not applicable to to construction nst uction service.
Suite/bldg. /apt no.: Project name: SI MMERLAKE PARK - FEE" SCHEDULE
Cross sarWdirections to job site: n`°c""` Qtr. [_ Ted ••.
New residential single. or multi- family dwelling unit.
Includes attached garage.
1.000 sq. fl. or less j 145.15 4
Subdivision Lot no.: Fa add'I 500 sq. A or portion 33.40 I
Tax map /parcel no.: Limited energy. residential 75.00 2
DESCRIPTION OF WORK Limited energy, non-residential 75.00 2
REPLACE MAIN BREAKER Each manufactured or modular
dwcllinservice and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
❑ PROPERTY OWNER 200 amps or less 1 80.30 $0 . 2
. ❑ TENANT amps to 400 amps 106.85 2
Name: CITY OF TIGARD 40 amps amps 160,60 2
601 amps to 1,000 amps 240.60 2
Address: 13125 SW HALL BLVD ^ Over 1,000 amps or volts 454.65 2
City / State/ZIP: TIGARD, OR 97223 Reconnect only 66.85 2
Temporary services or feeders installation, alteration, and/or
Phone: (971)230 -8943 I Fax: ( ) relocation
Owner installation: This installation is bein made on ro 200 amps or less 66.85 1
intended for sale, lease, g P Pty that 1 own which is not 201 amps to 400 amps 100.30 rent, or exchange, according to ORS 447,449, 670, and 701.
401 amps to 600 amps 1 33.75 2 2
Owner signature: , Date: Branch circuits - new, alteration, or extension, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A Fee for branch circuits wiry
Business name: OREGON ELECTRIC CONSTRUCTION Bch er fee, each 6.65 2
Contact name: RICA LADD B. Fee for branch circuiui ss
without service or feeder fee, x6.85 2
Address: each branch circuit
Each add'I branch circuit 6.65 2
Ciry /State/ZIP: Miscellaneous (service or feeder_n_ of included)
Phone: (503) 849_2754 I Fax :: ( ) Pump or irrigation circle 53.40 2
E - mail: Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
CONTRACTOR energy panel, altemdon, or
Business name: Oregon Electric Group =tension. Describe: page 2 2
Address: 1010 SE 11th Ave Each additional inspection over allowable in any of the above
City / Statc/ZIP: Portland, OR 97214 Per inspection 62.50
Investigation per hour (1 hr mm) 62.50
Phone: (503) 234 -9900 1 Fax: (503) 535 -2763 IndusaPal plant per hour 73.75
CCB Lic.: 203 , . I ElectricaLLia : 26 S • rv. Lic.: 4460S ELECTRICAL PERMIT Ff; ES•
Subtotal $O.3 p
Suprv, Electrician signature, reequired: _46.1.„. — P lan review 25% of
Print n Li 1 ( permit fee)
amt: g pm fee)
a,, ;1 / , � ✓ jE Date: Mill fo .1.15
State surchare (8% of erit
Authorizeed signature: ' -" vex" W041// �r TOTAL PERMIT FEE g ,�,C
Tbi permit appatatlon a xpires if a permit is not obtained within 180
Print name. J� ,, ;. days after It ems been accepted ar complete
1� 1(�,r 2. ! 4 4 �•/ Date: 04/12/07 Bo
• PeemchodologysetbyTi •Coemtyt3uinede
ln>Strysarvie ard
•• N of in spections per perm allowed
iAlicilduac \PnmicAELC- PermitAps.dce 12103 44046ISrtlO'O]JCOMrnE3
CITY F TI AR Ce4404-
O G D
BUILDING DIVISION PERMIT #: ELC2007 -00237
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/16/2007
Phone: (503) 639 -4171 �^+yli�l
Inspection Requests (24 Hrs.): (503) 639 -4175 ^_
INSPECTION WORKSHEET FOR DATE: 4/17/2007 TIME: 7:01AM PAGE: 19
SITE ADDRESS: 11450 SW WINTER LAKE DR PARK CLASS OF WORK:
SUBDIVISION: SUMMER LAKE PARK LOT #: 00A TYPE OF USE:
PROJECT NAME: SUMMERLAKE PARK
DESCRIPTION: Replace main breaker. Job No. 99065-108
OWNER: TIGARD, CITY OF, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503-234-9900
Inspection Request Scheduled For: Date: 4/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 046627 -01 503 - 849 -2754 N
Corrections /Comments /Instructions:
•
:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G'' (' oe Date: 41 I 01 Phone #: (503) 718- 111