Permit .
•
;L.-- S
Building Division
G n P. D Request for Permit Action OCT 18 2006
�.i i X or
•
TO: CITY OF TIGARD � TiT rITM(
Permit System Administrator
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov
• FROM: V, Owner ❑ Applicant ❑ Contractor ❑ City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or individual) I Vv., Q 0. l u �.k k Pvbp.� —L LL
•VO I D Mailing Address: O � �/C `� 1 4 b 6 I
�JJJ Q Cho /0;Z-06
Phone No.: SO 3S- t SL\
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
0 CANCEL PERMIT APPLICATION.
N REFUND PERMIT FEES (attach receipt, if available).
El INVOICE FOR FEES DUE (attach case fee schedule and explain below).
El REMOVE CONTRACTOR FROM PERMIT (do not cancel permit).
Permit #: L.LC. 6 - Y�/ 3 (-1
Site Address or Parcel #: rW � � ( l rs- k
Project Name: `■e--•CArv--I
Subdivision Name: Lot #:
EXPLANATION: ,b /T /o/05 & 2de, Atilt' /2 S EE
aoac - DD /93
Signature: owe Date: 16 I t
• Print Name: I
Refund Policy
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
c) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
d) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 1 -2 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to S s Admin: Date, / ` - , rek Rte to Bl.: Admin: Date /i 4 670 . B . tou
•
Refund Processed: Date /0 e to By '' Invoice Processed: Date By
• Permit Canceled: Date j0 .06 By ..%.• Parcel Tag Added: Date By
Receipt #/$ -50 0 _ Date 2s• /614, Method ( -4,„ Amount $
1:\ Building \ Forms \RegPermitAction. oc Re/v 05/24/06
4 CITY OF TIGARD - ELECTRICAL PERMIT
PERMIT #: ELC2006 -00478
DEVELOPMENT SERVICES DATE ISSUED: 8/25/2006
''•III 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S136DC - 03800
SITE ADDRESS: 07080 SW CLINTON ST ZONING: MUE
SUBDIVISION: ISAACS SUBDIVISION LOT : 005 JURISDICTION: TIG
Project Description: Reconnect only
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: 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: 1 SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC:
Owner: Contractor: n
CHARLES TAYLOR /�
5285 SW MEADOWS RD #369
LAKE OSWEGO, OR 97035
Phone: 503 - 635 -1513 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 8/25/2006 $66.85
[TAX] 8% State Surcharge 8/25/2006 $5.35
Total $72.20 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 th 0 days ATTENTIO • Or- .on law requires you to follow rules adopted by the Oregon Utility Notifica '.n Center. Those rules are set
forth in R 952 - 001 -0010 thro • OA :5 '- 001 -0100. You may obtain copies of these rules or direct questions tp UNC at 503 -246 -6699 or
1 -800 32 -2344.
�, �:
Issu By: / ,/ ` Permittee Signature: ic
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.
Electrical Permit Application .. vol( ()FFICI USE OWN I X
City of Tigard jai D _/ Permit No.: , 7 •
71
13125 SW Hall Blvd., Tigard, OR 97223 plea Review
' C Phone: 503.639.4171 Fax: 503.598.1960 Date/B . Other Pemut:
1' I GA R i Inspection Line: 503.639.4175 Date Ready/By. ruri ' /Y B See Page 2 for
Internet: www.tigard - or.gov Notified/Method Supplemental Information
TYPE OF WORK PLAN REVIEW
❑ New construction ❑ Addition /alteration/replacement Please check all that apply (submit is sets of plans w /items checked below):
❑ Servi or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
less to ground, or exceeds 14,000 ❑ Commercial - use agricultural
❑ 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
❑ Addition of system. "A", "E", "1 derived 1 ", system.
JOB SITE INFORMATION AND LOCATION
❑ Addition of new motor load of ❑ "A", "E", "1 -2 ", "I -3 ",
Job no.: Job site address: 7040 S',f GL / ITV 1001-113 Six or or more. occupancy.
❑ Six or more residential units. ❑ Recreational vehide parks.
City / State/ZIP: ' / 61)-i3 , ( O g q 7 .2.2 3 ❑ Health -care facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: I Project name: 'YLO 4 ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total I •
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
Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
. ---- F - )€- 0_0 Q:1-- Limited energy, multi - family 75.00 2
N 1 residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
❑ PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: (k Thei. — s - p e 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: 5,2 f5 ''/ / �/ �. 0 f AO * 3•'6 5 Over 1,000 amps or volts 454.65 2
City/Stale/ZIP: Gf3 �/ (?`-7s0 0 p 9 70 37 Temporary services or feeders installation, alteration, and/or
Phone: (Oh 6 3 S — ( S/ 3 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
❑ APPLICANT I ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Contact name: first branch circuit
Address: Each add'I branch circuit - 6.65 2
Miscellaneous (service or feeder not included)
City/ State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) - Fax: : ( ) Reconnect only 1 66.85 2
E -mail: Pump or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 2
Signal circuit(s) or limited -
Business name: energy panel, alteration, or
Address: extension. Describe: Page 2 2
City/State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (I hr min) 62.50
CCB Lic.: Electrical Lic.: I Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
�� ��
Suprv. Electrician signature, required: Subtotal:
,�� Plan review (25% of permit fee):
Print name: .- Date:
� //, State surcharge (8% of permit fee): 5. 3 5
Authorized signature 4 TOTAL PERMIT FEE: 7
This permit
Print name: • D ate: p n application expires if a permit is not obtained within 180
p 0 / 2 LC/��/1 A d 7.2. �,0 days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ BuildingTermita \ELC- PennitApp.doc 05/23/06 440.4615T(I1 /05 /COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all residential systems combined $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
I COMMERCIAL WORK ONLY
Fee for each commercial $75.00
system
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems •
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
1:\ Building \Pamits\ELC- PamitApp.doc 0323/06
CITY OF TIGARD O ELECTRICAL PERMIT
PERMIT #: ELC2006 -00478
.. ,
�p DEVELOPMENT SERVICES D "'� DATE ISSUED: 8/25/2006
''=- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S136DC-03800
SITE ADDRESS: 07080 SW CLINTON ST ZONING: MUE
SUBDIVISION: ISAACS SUBDIVISION LOT: 005 JURISDICTION: TIG
Project Description: Reconnect only
RESIDENTIAL UNIT T? P 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: 44, o da oi p: SIGNAL/PANEL:
MANF HM/ SVC/ FDR: 601 +a U 5' ''00 - .his: MINOR LABEL (10):
SERVICE /FEEDER B CIRC t11 S DD'L INSPECTIONS
0 - 200 amp: W /SERVI RR OR FEED =I' : R INSPECTION:
201 - 400 amp: 1st W/O r RVC OR F 0 : PER HOUR:
401 - 600 amp: EA ADD'L LRNCH Cr C: IN PLANT:
601 - 1000 amp: i?__ P REVIE ECTION
1000+ amp /volt: > =4 ° ` NITS: 600 VOLT NOMINAL:
Reconnect only: 1 C /FDR >= 225 AMPS: SS AREA/SPEC OCC:
Owner: \ Contractor: 7\ /
CHARLES TAYLOR
/
5285 SW MEADOWS RD #369 .
•
LAKE OSWEGO, OR 97035 III
Phone: 503 - 635 - 1513 Cont.' . , . , 1;
:•
FEES ,* .,,.
Description Date Amount Reg #: S
[ELPRMT] ELC Permit 8/25/2006 $66.85
[TAX] 8% State Surcharge 8/25/2006 $5.35 . 0
Total $72.20 REQUIRED ITEMS AND REPORTS 0
MJ
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 �t rr180 days: "ATTENTIO • Or on law requires you to follow rules adopted by the Oregon Utility Notifica '. Center. Those rules are set
p
forth in R 952 - 001 -0010 thro OA 5 - 001 -0100. You may obtain copies of these rules or direct questions t•pUNC at 503 - 246 -6699 or
1 -800- 32 -2344.
Issu By: fi. CA % Permittee Signature:
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: E , /p —c0c/7g REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By I I ✓ Code Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading/footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls/anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing MEC - Mechanical Permit
810 MFG- Structure set -up
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final _
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final 322 Shower pan
999 Sprinkler final 330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill _ 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I:\Building\Inspection Cards\Forms\AOP - InspCard- Blank.doc 12/09/2005
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006-0047t3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/25/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/28/2006 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 07080 SW CLINTON ST CLASS OF WORK:
'SUBDIVISION: ISAACS SUBDIVISION LOT #: 005 TYPE OF USE:
PROJECT NAME: TAYLOR
DESCRIPTION: Reconnect only
OWNER: TAYLOR, CHARLES PHONE #: 503 -635. 1513
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 8/28/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 035638 -01 503 - 799.0232 N
Corrections /Comments/ Instructions:
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❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FA FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: + N Date: % Z 01 0 Phone #: (503) 718- 2