Permit CITY OF TIGARae ELECTRICAL PERMIT
PERMIT #: ELC2007 -00405
COMMUNITY DEVELOPMENT
DATE ISSUED: 6/14/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133DD-07000
SITE ADDRESS: 12664 SW WINTER LAKE DR ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT : 109 JURISDICTION: TIG
PROJECT: CHRISTENSEN
Project Description: Service change and (2) branch circuits for a/c and service outlet.
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: 2 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:
SCOTT & AMY CHRISTENSEN SOHLER ELECTRICAL CONSTRUCTION
12664 SW WINTERLAKE 41131 SW BURGARSKY RD
TIGARD, OR 97223 GASTON, OR 97119
Phone: 503 - 524 - 0658 Contact #: PRI 971 - 832 - 0807
FAX 503- 214 -6246
FEES
Description Date Amount Reg #: ELE C 121
[ELPRMT] ELC Permit 6/14/2007 $93.60 LIC 167949
[TAX] 8% State Surcharge 6/14/2007 $7.49 SUP 594S
Total $101.09 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 , f , / / P e r m i t t e e Signature: , IIfp - o r
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.
/ REC EI JED
.•.•a. J. .,* Wag. r5411Plaaz.att N IL 4 iii, / � L t�
FOR OFFICE USE-ONLY - :.
City of Tigard CITY OF nuit - 't rat I fi /�t 0 S ..it Ha.: ,...
13125 SW Hall Blvd.. Tigard, OR 97223 BUILDING DI VI a :� _ : . .,> P I D R � =• "•s—
Phone: 503.639.4171 Fax: 503598,1960 : Other FurniC
�
Inspection Linc 503.639.4175 • i111.:‘ Date Reidy
/By: wwev.ei.tigard,or.us 6 See Page 2 Car
I
_ N et : J L Supplemental Information
• _-. • :_ sX'Hro:OF'.WORk:;:..: - , -::-..'. ELAN REVIEW -
D New construction yj Addition/altaration/replacemrat Please check all that apply:
D Demolition Cl Other: DSa vies over 225
.. amps, corrura'1 DNazardous location
CATF.GQB]E'OF' y • : - ? QSavice over 320 am over =rips — rating DBuildng ov 10.000 sq.
.� farruly dwelling CQi!PSr 2 - '1'RU CZTU N • :. :: :_• ' _ : - - of 1- and 2- family dwellings 4 or more new residcnri:
8 ❑ Commercial mdmRrial D Accessory building DSystem over 600 volts nominal units in one structure
D Multi-family 0 Master builder D Other: DButldmg over three stories DFcedtrs, 400 amps or m
JOB SITE 'INT: A7!ID`LOCAilTO1V ' - DOallpant load over 99 persons DManufacturod structures
. L • • DEBss/lighling plan RV park
Job no.: I Job site addresw j� (� y < - - - 0}1.11h-ca. facility DO1LT:
_ w �/ 1 N .r F fr kE! 0}1.11h-ca. Submit 2 sets of plans with any of the above.
City/State/21P:
I / ix:Pr IP J -7;013 The above are not applicable to temporary construenon service.
SuitelbldgJapl. no.: Project oannc = � ° • ° : 4 • ::
: .\ c , FEEL SC�iEDUf.E
I G �� r. f; ea .w/ 5 Q7 F I Total
Cross street/directions to job site: New residential single or multi- family dwelling unit.
Includes attached garage.
1.000 sq. It or less 145.15
Subdivision: ) Lot no.: Ea. add', 500 sq. R or portion 33.40
Tax map/patul no. Limited =MY. residential 75.00
:. DES[�2> IAN` - 0F WORK` ''_ :, :` .",: =: = ' Limited energy, non - residential 75.00
' - • Each =nufacnued or modular
5 %. R V ] C N (: /.� /� N/ G � / C t dwelling. service and/or feeder 90
ff
• , S < 2 V / C r Services or feeders installation, alteration, and/or relocation
Ch t i . — 1 e. - I 200 amps or less r 80.30
- UPE :OWNER. ' ... - - ' `- .• ... 201 amps to 400 amps 106.85 I �, ? / I
Name: ' Sc :1 C r--, }-. 5 ; .. i 401 amps to 600 arms 160.60
Adress: 601 amps to I A00 amps 240.60 - I
A d ssi:erz�: 1,2 L y n S 1 /1/ ) � e, L•H kl_ i< I l
� Over 1.000 aortas or volts 454.65 I
-r I e i4,t D , aloe
Phone (5 S) 5 t/ •_ 0 / 5- I Fax: ( ) T services or feeders installation, altcn8oq and/or
Ic relocation
Owner installation: This installation is being made on property that I own which is not 200 In or less
400 00 66.85
intended for sale, lease, vent, or exchange, according to ORS 447 449, 670, and 701_ 4 01 stops m amps ' 10030
! Owner signature �►� 401 amps to 600 amps 133.75 1
(� Branch circuits— new, alteration, or extension, per panel
. - •� ::"f1 APPI;IICA1+iT _ ,: - •. , ::: • _'I? : ; _ •' _ : •UIVTA(G'i" *F:R50Dti'� =- A. Fee for branch circuits with
=wee vior or feeder fee, each
Business name: S G { i F S_7 r ' r erh I N S -I-„ branch circuit pL 6.65 13 . 7 t)
Contact Dame: —� � B. Fee for branch circuits
n n without service or feeder fee.
A� ill (( �,� p /f / each branch circuit 46.85
S l� . r rs -.rr k 1 Z- p Each add9 branch Mr' cult _ 6.65
City/State/ZIP- Crr.. S 4-- nI U j / 9 7 1 fc 1VBsadsnmlcs
/ / (service or feeder not included)
Pboaa ( 97/) 3.� — O P, G 7 f Fax:: (563 Pump or irrigation circle I 53.40 1
EE-mail: _ �� I y Sign to outline lighting 53.40
Signal circuit(s) or limited-
-• • - - • . . . . - :CUN=RACtoR •,:,;.. ' • __ / .1- energy panel, alteration, or
Business name: Cd I, Ica Eie Jr, l+.p L-•
, I o r✓ S -., exlrnsitm_ Describe: Page 2
Ad d r ess: Each additional inspection over allowa in any of the above
City/State/2TP:
Per i inspection I 62.50
Investigation per hour (t hr mite/ 62.50
Phone ( ) Fax: ( ) Industrial plant per hour 73.75
Li -- CCB Lie.: / 6 7 9y 9 - - 81 cal LiC4 c /:2 I j Supry: Lic.: 57 _5
` EL$GTRICAL E1trarr FEES°
Subtotal 1 z, 6.
Sttprv. Electrician signature, teguired: j i f : -- Plan review (25% of permit fee)
Print name N JJ l i-p yl e c-- Date: State surcharge (8% of permit fee)
Authorized S7gQ.IpifC: I L �M TOTAL PERMIT FEE / Q ( r (3 9
•
This permit application expires if a permit is not obtained within 180
Print name: All (► Date: aRer It has heels accepted as complete
• Fee medoadedomt set by Tri Building Indesoy Sernee Board
1BelldiQgiPeaziME C- PcnnitA .dac 17103 •� Number of inspections per permit attestor[
6•11...4. err „ w•sar...•nurz
T BLOT- S86 -EOS -tapyog aof' di,E =EO LO bT unr
f 1 '
CITY OF TIGARD . • •
BUILDING DIVISION • PERMIT #: ELC2007 -00405
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14 /2007
Phone: (503) 639 -4171 �
Inspection Requests (24 Hrs.): (503) 639 - 4175 , ' F'I �..
INSPECTION WORKSHEET FOR DATE: 6/26/2007 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 12664 SW WINTER LAKE DR CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 3 LOT #: 109 TYPE OF USE:
PROJECT NAME: CHRISTENSEN
DESCRIPTION: Service change and (2) branch circuits for a/c and service outlet.
te4tio`6TANs
OWNER: CI-IRISTENSEN, S & AMY PHONE #: 503 - 5240658
CONTRACTOR: SOHLER ELECTRICAL CONSTRUCTION PHONE #: 971 - 832 - 0807
Inspection Request Scheduled For: Date: 6/26/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 05092401 503. 985.0131 N
Corrections/Comments/Instructions:
C N- rt t -r i A4 So r J
45 PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: GY ` vv oe Date: 6'210 'G1 Phone #: (503) 718 - S' tik)