Permit CITY OF TIGARD ' , ---- •
PERMIT
BUILDING SERVICES DIVISION
I .: "`"{ irf1 13125 SW Hall Blvd., Tigard, OR 97223 00
=- - K 503- 633 -4171 www.tigard - or.gov PERMIT #:1-1.44, , . , J,r.
DATE ISSUED: 3-f _ ..__ ___ ._.__.,
SITE ADDRESS: _1) -.1&' 51,4)_____\) - i NSAV E- PARCEL #:
BLDG /STE #: ZONING:
SUBDIVISION: LOT: JURISDICTION: •
This is an interim permit issued during computer system maintenance.
Construction work and inspections may proceed under this permit number.
The actual permit will be issued and mailed to the applicant within one week of the date issued above.
PROJECT DESCRIPTION CI) & { Ct 'Cac ►'TS .'cG t€. --h. r L _... •
`:::: RESIDENTIAL - - • • • : TEMPSRVC /FEEDERS- -: . `MISCELLANEOUS- .
1000 SF OR LESS: 0 - 200 amp: _ _ _ PUMP /IRRIGATION: —
EACH ADD'L 500 SF: 201 - 400 amp: _ _ _ SIGN/OUTLINE 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: _____ _ _ 1 W/O SRVC OR FDR: PER HOUR: _ _
401 - 600 amp: ____- __ _ EA ADD'L BRANCH CIRC: , IN PLANT:
601 -1000 amp: _
.. PLAN REVIEW SECTION
� _ A __ - . � -
1000+ amp /volt: >= 4 RES UNITS: > 600 VOLT NOMINAL:
Reconnect only: SVC /FDR >= 225 amps: �— _ CLASS AREA/SPEC OCC: _
.OWNER ,. • FEES -
Name: e.- --- ---.__ Permit Fee $ iO.ZG' ... f
Address: LZ- 1(25__._. ° . � TN /4 S Plan Review Fee $ _.. __. - .--- .._.._ - - - - -. 0
a
Llty /State/ Zip: - ... t ._�L • State Surcharge (8%) ---- __._.__._.. - -- 9 ( ) s
Phone: N/ A Other Fee: — - - $ — — t
.... CONTRACTOR
Other Fee: $ 1
Total Fee:: $ Q •. 4
Name: __LiL�. � &Z1 --__a_ <... - -_
Address: : O. D_x.__ ,A_3.a. _ "� -._.
City /State /Zip: _.`T1 k - _ C R - -- 12. L._.--..
Phone: _ _ 5
CCB Lic #: _ $ p _q _ _ .._.__ g Y. .O . Z _... _..._._.__ -
Ele.Ct. Lic. #: 34 - 7_ /_ 0
Supr. Lic. /#: _---[ 5 ... - - -- -- ?-'j_.__..
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. Al
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 -0080. You may obtain copies of these rules or direct questions to OUNC by calling 503 -246 -1987 or
::: S i6�Gr.��C � �./ ` °'' Permittee Signature: ("7-7 4/.9 ��`�; r rr��- c -.-��i
OWNER INSTALLATION ONLY . . -
The installation is being made on property I own which is not intended for sale, lease, or rant.
OWNER'S SIGNATURE: DATE:
..- CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELECTRICIAN: DATE:
LICENSE NO.:
Call 503 - 639 -4175 by 7:00 AM for an inspection that business day.
Note: If you cannot schedule an inspection while the system is down, please call 503 -718 -2433 for assistance.
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 :Building\ Forms \ManualPermitFor ns\ManualELCpermit.doc 03/06/06
CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00167
DEVELOPMENT SERVICES DATE ISSUED: 3/14/2006
=- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 1026C -08000
SITE ADDRESS: 12765 SW WATKINS AVE ZONING: R -4.5
SUBDIVISION: THOMPSON MLP 1999 - 007 LOT : 001 JURISDICTION: TIG
Project Description: 7 branch circuits for • hen remodel.
C.2�Oa(.., -- 1 00 3 7
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: 1 PER HOUR:
401 - 600 amp: EA ADD'L BRNCH CIRC: 6 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:
SARA & GEO KARL WILLAMETTE ELECTRIC INC
12765 SW WATKINS PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: 503 - 522 -5733 Contact #: PRI 503 - 624 -3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 -283C
[ELPRMT] ELC Permit 4/3/2006 $86.75 LIC 75059
[TAX] 8% State Surcharge 4/3/2006 $6.94 SUP 19655
Total $93.69 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: I 1/ Permittee Signature: (flit a
_ �
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.
2006 8• HP LASERJET 3200 p . 2
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al Permit • pp ,Mcatio 1)1 FoR Orris usi ONLY -:1: ,
City Of Tigard MAR 13 2006 Date /By 5 - I� - Ott � g Permit No L 7 ,e
l 3 l 2 5 SW Hall Blvd., Tigard, OR 97223 Plan Review �QJ (a-7 Phone: 503.639.4171 Fax: 50 Q 0 �` t f� DateJBy Oder Permit: T
inspection Line: 503.639.4175 � � 0 1 - ' I IO -t 1 i _ „„ Date ReadyiBy: Jur4T La See Page 2 for •
Internet: www ci �gard or us . ,a .T10: NotifterIMethud " J l4 Supplemental Information
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❑ New construction ® Addition /alteration/replacement Please check all that apply:
❑ Other ❑Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition ❑Service over 320 amps - rating ❑ Buildng Dyer 10,000 sq. ft:, •
: t' � , ,3t • � i ce ' i t ` a l i u gre V , .n) ° 1 t ` I • 3x0. :;�"r' , `4V . 1 i
A t- of l• and 2- fasrtily dwellings 4 or more new residential
1 ;aitItittik � (n
,. �, � N ah14,0 Z. 6$: R }ta hrcitz kcel,,3. s. ... ,,
. .. t4 r.m a. _ .0
gL1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ ll77"" Multi ❑ Master builder ❑ Other ❑Occupant load over 99 persons ❑Manufactured structures or
. tom'_,.. 5
,.0,1, 1 ,� � : ic '� 4a VA k r�' '_ iifiTi 'l� ? 3<4 ❑figress.tightingp1an RV park
['Other: ❑Health care facility other:
1 ob no.: ' 4.5 Job site address: J27 � � �`o �0e Submit 2 sets of plans with any of the above.
City/State /ZIP: -' j � The above are not applicable to temporary construction service.
S uite/b1dg. /apt. no 1 Project name: S It hr. C K rat k 7 1 Description Qty. Fee. Total •'
Cross street /directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'] 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2 1
W r-V ;qtr -r r k rn at : 1 [z Y ' =�T' i:ii �';�g�'d a); 1 l� l
1 : t �kilaii. A . ;Y� ` x� . i d =t: t,.'- � ri-1 ba,,,. h�ual @., _. 1 ra.„'i . ��.s Each manufactured or modular
41 dwelling, service and /or feeder 90.90 f 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2 1
r t � � t ur , f 1 rlcp r f , - z } ire7+ 201 amps to 400 amps ] 06.85 2
litY1i • - "" • ' 1 � to l �,{#_i4 :'`r ,^ ; . -' 4.41- g z . a') , l mu,„gw � t.. ,, 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
C.,.... Reconnect only 66.85 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 arrq,s 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 600 an 133.75 2
Owner signature Date: Branch circuits - new, alteration, or extension, per panel
,o z s , r v 1 , t� y er I pa +r ii I itf +• s trt. y' r " i ,s ti er. A. Fee for branch circuits with
t t a , i 'r ._t.'a� _ + 1 1 .1. . "'.: :,' ..,nAti�;0' A ±. , :. ... rki.- Y k " a i,, A 31�: . ' 9in
� L..,,=., �. service or feeder fee, each
6.55 2
Business name:
branch circuit
B. Fee for branch circuits
Contact naive: without service or feeder fee, / 46.85 6
, 2
each branch circuit (/ �_
Address: Each add'l branch circuit 14 1 6.65 :f 7 2
City/State/ZJP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( )
Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) er limited-
4 ;. , + ,a '�.l r} it = 7' tam ` y :. i l'Ap i , 41 L A �l • • energy panel, alteration, or
,.'.G�, ii .t. ., ,/, ao:iL. u:o. L.�dt Nx.f 'rt,t i ..k,:.. .t..1= -eiai .,ti _...e., . - ,�Si, ... _ ir'r
extension. Describe: Page 2 2
Business name: t , I t 4- x f,. r r. I , - 0 tit: iw e._
Each additional inspection over allowable in any of the above
Address: p C . . ,� C'_� 0 o f
Per inspection 62.5
City/State /ZIP: T c (} 9 1 Investigation per hour (l hr nun) 62.50
1 Industrial plant per hour 73.75
Phone: (SC: „) 6 z ik 34, 4 Fax' (5v3) tp .at -- vi 3 q kxr} c 11 r t 3 `�' s( s t :h
5r.uii_1 �d .'fi�i 1 t „E2r1.
CCB Lic.: 7-- » 3 ei Electrical Lic.: S it_ 25 C Suprv. Lic.: tc,5 6 S- C Subtotal F6. 1..S
Suprv. Electrician signature, required: . d Plan review (25% of permit fee
State surcharge (8% of permit fee) 1. .9 7
Print name: Date: ..( 6
j r _ q
I) Authorized ,..- t . _ TOTAL PERMIT FEE Gp G '�� 1
Authorized signature: This permit application expires if a permit is not obtained within 150
} days after it has been accepted as complete
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
••• Number of inspections per permit allowed
i -' Building \PcrrnitsWELC- PennitApP.doc 12.413 440.4615T(10/O2ICOM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200& -00167
13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 3/14/2006
Phone: (503) 639 -4171 't
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/21/2006 TIME: . 7:07AM PAGE: 31:,
SITE ADDRESS: 12765 SW WATKINS AVE CLASS OF WORK:
SUBDIVISION: THOMPSON PARTITION LOT #: 00 TYPE OF USE:
PROJECT NAME: KRAI-
DESCRIPTION: 7 branch circuits for garage conversion remodel
OWNER: KARL, SARA & GEORGE PHONE #: 503.522 -5733
CONTRACTOR: WILLAMETTE ELECTRIC INC PHONE #: 503
Inspection Request Scheduled For: Date: 6/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 032049 503-522-5733 N -
Corrections /Comments /Instructions:
`211200:
199 Electrical final 03204901 503 - 522.5733 N
• . d e ir th ", , ,
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
•
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6ffi Date: ‘"27 O Phone #: (503) 718 - Z-67
CITY OF TIGARD
BUILDING DIVISION ,. _ PERMIT #: 00O 0- 1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 00
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: / � � ( � � CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
' CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 -a7 -c) Pour Tim: . 4 • , / ,
Code # Inspection D cription Confirm # Contact # Message
/ Z o 1i�Q c 57.3
Corrections /,Comments /Instruc ions:
D
•
•
N K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: v t2 N L Date: 3 L d6 Phone #: (503) 718 -29
CITY OFJIGARD ��-
BUILDING DIVISION PERMIT #: 2oOC
13125 SW Hall Blvd., Tigard, OR 97223 1!' DATE ISSUED: OQI&
Phone: (503) 639 -4171,, 11
Inspection Requests (24 Hrs.): (503) 639 -4175 :. _—_- °7 ' I..
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SI SUBDIVISION: E ADDRESS:
/ 11 (O S W �- t.J LOT 1+ CL CLASS OF
OF O RE:
PROJECT NAME: /_
DESCRIPTION: 672 2, / /& /
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: ` j -,,2 (I-O � Pour Time:
Code # Inspection Description Confirm # Contact # Message
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Corrections /Comments /Instructions: ,
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❑ ,PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
[AIL ACALL OR INSPECTION ❑ ADDITIONAL FEES ASSESSED
L VO Inspector: Dat Phone #: (503) 718- /