Permit n CITY OF TIGARD ELECTRICAL PERMIT
3. ,, COMMUNITY DEVELOPMENT Permit #: ELC2013 -00132
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/25/2013
Parcel: 1 S135CA90113
Jurisdiction: Tigard
Site address: 11044 SW GREENBURG RD 113
Project: Thomas Subdivision: ASH CREEK PARK CONDO Lot: 113
Project Description: (1) 200 amps or less for service change
Contractor: GARNER ELECTRIC Owner: THOMAS, BOB & STEWART
2920 SE BROOKWOOD AVE A 11044 SW GREENBURG RD, #113
HILLSBORO, OR 97123 TIGARD, OR 97223
PHONE: 503 - 648 -4552 PHONE:
FAX: 503 - 642 -7925
FEES
Quantity Description Date Amount
1 ea Services or Feeders - 200 02/25/2013 $100.70
Specifics:, amps or less
1 ea 12% State Surcharge - 02/25/2013 $12.08
Type of Use: SF Electrical
Class of Work: ALT
Type of Const:
Occupancy Grp:
Total $112.78
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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 the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952- 001 -0010 through OA 2 -- 000 -0 90. You m ! L t L 3 obtaiinn a yy of the rules or direct questions to OUNC by calling 503232.19877 or 1800.332.234 l Issued By: Vr } ( J Permittee Signature: Did 4Pi80' _(C it7 776)
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' Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Electrical Permit Application RECEIVE i FOR OFFICE USE ONLY
City of Tigard oat�% a As-I/ 3 PemritNo.: a0/3 pp/ 3 .) —
I ' 13125 SW Hall Blvd., Tigard, OR 97223 FEB 2 5 20 13 -
C : Phone: 503.718.2439 Fax: 503.598.1960 Other hermit:
TIr:nRto Inspection Line: 503.639.4175 CITY OF TIG A ' I Date Ready/By: LIMA' 0 Seo Page2for
Internet: www.tigard- er,gov • otlflcd/Methnd: mental information
..___RI ill niN
(� DNISI 1
❑ New construction Addition /alteration /replacement Please chock ail that apply (submit 2 Ret of r ur w/irems checked below):
❑ Service or theder 400 amps or more Q Building over three stories,
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
'•:'•':; '
, .,.,;li''o',�: ',i ,';1.,�.., ,, `�� I. ;�i'i;i''" cxcecds tU,000 amps at ISO volts or 0 buildings.
: �
'F `;i ` ,, C;x'. i W'�w ii ;;• ,:; ; ,iW "' '; ! , ..l.l e s
JUaVlii•: ;ii ttllill; iI • p, ..... , yi . , ;,: ;' ; jli' il: „r61.. t' ,.i
� less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
/��'- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps lbrall other installations. buildings.
0 Multi - family 0 Master builder ❑ . O Fire pump Ina ellntion of 75 KVA or
,, ,::: r; �,p �, lrl ;; ❑ Emergency system. larger separately derived system.
te.
;.:, ,,.. i ,; t14. 3 N ..! Vi fr h kA' llv >f Other: .
❑
'y. II��I ' . Addilicnof nbtlnrloud nr ❑" "F, ","1-2", i
Job no.: Job site address: I i b 14 SW lr, , . ' a r p _i I or more. ctr
�l ❑ Six x o or r more residential units. ❑ R Recreationtioii
al veltiule parks.
City/Stare/ZIP; ter. 0 2- 9 7_ ❑ Heslth-cnre facilities, ❑ Supply voltn a for morn than
In Hazardous locations. 600 volts nominal.
Suitc/bldg. /apt, no.: Project name: ❑ Service or Raeder boo :mops or more.
job si te: FGE SC b'tlt,E •,
j D I Q rx I
Cross street/directions to Fee. 1 Tutu! I •
New residential single- or multi - family dwelling unit.
includes attached garage -
Subdivision: Lot no.: 1,000 sq, R. or less 168.54 4
Eu, add'I 500 sq. ft. or portion 33,92 I
Tax map /parcel no..
;::•-;:
I "! h.,, rre;iErlt;�'l�l!,t,t,Lll: fl:!l ; i I:tli %'s; 1'r;� .,I (with above sq. 75.00 2
Limited energy, residential
,r• -,I,i l.l I , ,., I r )Ir ,,,I>�� ;E�l�:`;V1'OhC�i ' r� is , ; � : ; ; ; R.
,�,,til ,• . 1 1 u n,. ,r„I, .., dlr,•I r�: �u','s' .:' ....,, ..., , r„ •,r ,.. ,,
Limited energy, multi - family
75.00 2
a , _.&L.e ■ .. residential with above
t scrvico or feeders Installation, alteration, and /or relocation
200 tr...' , l
amps or less IQO 70 2
I r;!i;:j18;li!1'i ' , (,il !a ( : , ::'i d : 1: ;S1:l ) ! ,1 201 s[ amps , 1,.: !. t( . 1 11 ,I .
l ,..,.. ,. :
:I,'i. pi. , ; t . ;' l..FAh1T :
i :,. . . .... . .. ..; i!`" 20 amp to 400 a mp. 133,56 2
Name: ' b 4 5 )rQ,1,J�) + 401 amps to 600 amps 200.34 2
-� �r�tT 1 _ 601 amps to 1,000 amps 301.04 2
Address: _Over 1,000 amps or volts _ 552,26 2
City/State/ZIP: Temporary services or feeders Installation, alteration, and /or
relocation
Phone: ( ) l Fax: ( ) 200 amps or less 59,36 I
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 125.n8 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 16$.54 2
Branch circuits- new, alteration, or extension. per panel
Owner signature: Date: A. Fee Ibr branch circuits with
i l', 'r'` iii •tV1�'l.0c,P, `•' ,!,..i.::!.::';' ,, : a ovc scrvicc or feeder fee,
�'ri ii ;'. {;: 'ji . I�i, , :d�'' .fl>ItP'1'<t'a.,:E>'I�OI!I,' 7 • each branch circuit 2
Business name: R. Fee For branch circuits without
• service or feeder fee, first
56.1R 2
Contact name: branch circuit
Each add'I branch circuit 7,42 2
Address: Miscellaneous (service or feeder not included) _
City /State /ZIP: Each manufactured or modular 67.84 2
I dwelling, service and/or feeder
Phone: ( ) I Fax :: ( ) Reconnect only 67.84 2
iii Pump or irrigation circle 67.84 2
E-mail:
,,. ..,.I , ,: .: , `:I;l;, ,�, Sign or outline lighting .84
'i'
,���::'1 �'�.l, 11';' :�.li!: �.i:! ..1i1 :::�.�:�i 1 •. I:'1 �: � tntj 2
"',,... , .�r.. .. ` , ,.:,,,,.1.,,,,;,;11.. , �,., , .. „ , , .. ..,:, -:p ., ... ... � , . � �. i,)a t�� , ,: Signal "', . ' . ' , .' . " . •'� " '; ; . . : � ;,'• :II Cirouit(a) or limited -enarg Y
Business name: Garner Electric panel, alteration, or extension. Page 2 _ 2
Each additional inspection over allowable in any of the abov
Address: 2920 SE iBroolcwood Ave. #A Additional inspection (I hr min) 66.25/ hr
- City /State /VP: Hillsboro, OR 97123 Investigation (t hr min) 66.25 / -
- Industrial plant (l hr min) 78,18/ hr
Phone: (503) 648 Fax: . 03) ' 2 - 7925 Inspections for which ne fee is
- Speci lically listed ('In hr min) ')0.0 hr
COB Lie.: 121159 Electrical Lic.: 3'. 05C . up. Lie.: 3 707 -S :.; ::'. ;.El 1 C I PER1V�l(C „, it $v.'. . —
Suprv. Electrician signature, required: V
� '' Subtotal: Subtotal: 1 si, ,, l P // 3 P la n review (25% of permit fee):
Print name: Chuck Gamer Date: 7 Z2 /, State surcharge (12% of permit tbe):
r/ 'TOTAL PERMIT FEE: (1a_ 7s/
Authorised signature: This permit application expires ira permit Is not obtained within 180
Print name: days after It has Peen accepted as complete.
Date: Number or Inspections allowed per permit.
I:\ aulldlnelPerm ;li\FLC- PnmitApp.doc 07/01 /1a 440.46 1 571 1 1 /05 /t:OM /wF..R
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11044 SW GREENBURG RD 113, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
02/26/2013 00:00
ELC2013-00132
FAIL
No access 1:00pm
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11044 SW GREENBURG RD 113, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
02/28/2013 00:00
ELC2013-00132
Scheduled
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11044 SW GREENBURG RD 113, TIGARD, OR,
97223
Residential - Electrical
199 Electrical final
02/28/2013 00:00
ELC2013-00132
PASS - No C of O
Violation Summary:
Inspector Contractor