Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2009 -00050
COMMUNITY DEVELOPMENT DATE ISSUED: 2/3/2009
T! G RD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 108AB -01201
SITE ADDRESS: SW NO ADDRESS ZONING: R -7
SUBDIVISION: BRENTWOOD ESTATES LOT : JURISDICTION: TIG
PROJECT: BRENTWOOD ESTATES
Project Description: (1) 200 amp panel.
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:
SUN RIDGE BUILDERS INC NORTHSTAR ELECTRICAL CONTRACTORS
14912 SW SUMMERVIEW DR 19450 SW CIPOLE RD SUITE 107
TIGARD, OR 97224 TUALATIN, OR 97062
Phone: Contact #: PRI 503- 612 -0840
FAX 503 - 612 -0891
FEES
Description Date Amount Reg #: ELE 34 -359C
[ELPRMT] ELC Permit 2/3/2009 $80.30 LIC 90454
[TAX] 12% State Surchar 2/3/2009 $9.64 SUP 661S
Total $89.94 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 - 0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1. 800.3
Issued By: .. ) L 1),.a .. 91 )' Permittee Signature: \
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
F g Q C. _ - r it r,
J 1:33 ,1t' r ��
Electrical Permit Applicati EcEivED miimin= .
City of Tigard V Received
Date /By: o �y
' 1 13125 SW Hall Blvd., Tigard, OR 97223 3 • - ,( ` . -'" Permit No.: ��C2�04 4,00 SO
1 C g Plan Review
Phone: 503.639.4171 Fax: 503.598.I�bEB 3 2009 Dato /By: Other Permit: Ett aR00$ "-�l` /
Tf GAUD Inspection Line: 503.639.4175 Dnte Rendy /By: turn 65 See Page 2 for
Internet: www.tignrd- or.gov
CITY OF TIGA No tified /Method' l� Supplemental Information
_ _ .- ..... -
txl of RIDING DIVISION _ PLAN r aV1tN!, t :,..,. : �_
liens, check nil ;bat apply (;ohm it 1 sots of ut
plans w/ites checked below);
New construction E:1 Addition /alteration /replacement ❑ Service or faecal -loll limns or more ❑Building over three alrn'ie,
A Demolition ❑Other: sclera the nvnilablc intill current ❑ Merinos and boatymds
" exceeds 10 ,000 amps at 150 volts or Q Floating buildings
r
�: r': ,4.,.
; r: •: l OA: 'P�GQR �' , :QI 7 , CONSTRUCTION � • • ..
i A 1- and 2- thMily dwelling ❑ Commercial /industrial ❑ Accessory building
6 6
iess lo arouutl, or exceeds 14,000 ❑ Commercial -use ayficultural
coups for all other installations, buildinlys.
❑ Multi-family ❑ Master builder ❑ Other: 1're pump, ❑ Instnllntion of 75 KVA or
r [] Emergency system. larger separately derived system. • 3013 S1rE :�NrOR11•1 #10N AND LOCATION ❑Addition of new momr load of ❑ ' A" ` E" I- 2' "'IJ'
Job no.: U Job site address: o IOOHP of more,
�__ �� �� ❑ Six or more residential unite. In Recreational vehicle pinks
City /Sts ZIP: cif" ❑ I-Iculth•onre facilities. ❑Supply voltage fbr more than
�/ ID I Hazardous locations. 600 volts nominal.
1
Suite/bldg. /apt, no.: Project Wain Y dip(/' ? �f r„,
e,'v ce or feeder 600 amps or mare.
J r r ,✓f FER•SCHTDi.
Cross street/directions to. job site; l /, \ / /..41 /71 11 1 A nisi,•�nnoo � _ _ --- . � I Qty. I Pee. 1 " Tomt i •
- 7/ JVVV is _ fl ' L New d a ttac i n e attached e. multi = fancily dwelling Unit.
�l / �, / J , f r !J'� Includs attand arae.
Subdivision; Lot no.: 1,000 sq. or less (45.15 4
-- Ea. add] 500 sq. 1t or portimt 33.40 1 1
Tax map /parcel no.: /4 - • a • Limited cner --
% gy,.residential
ESCRIPTION 1%' WO (with above sq. ft.) 75.00 2
• �� ! c //1� ` , •
I � � //J yyy ere _ (// _ )esul Limited energy, multi- family
entinl (with above sat. rt.) 75.00 - 2 .
. Services-or feeders installntion act ration, and /o e: cc. tion
..( I '
20U tntpii or less ' , 80.30 I..2 ,
r
n P PFRRY NE R . _,:, ; . ❑ , . 2(11 nnipsto400a amps 106.85 . . ?._2. - `
Na 'u, f � w� 0 � _40I stn � p .�..
:- 1psto G0 1 .- . - 160.60. ...... ........ , 2.
. --- . bbl, amps•to I ; 000 amps .. •.. ..1111 241.).60.' 2— • i ) Address: Over 1,000 amps or volts • in ` 454.65 - • 2
• City /State /ZIP: Temporary services or feeders installation, alteration, and /or ..
• relocation •
Phone: ( ) Fax: ( ) 200 amps or less 66.85 I
Owner installation: This Installation is being made on property that 1 own which is not 201 imps to 400 amps 100,30 2
J" intended for sale, least, rcnt, or exchange, according to ORS 447, 449. 670, and 701. 401 amps to 599 amps 133.75 2
13rnurh circuits - ncw, alteration, or extension, per pnncl
Owner s ignature: Date:
1 A. Fa for branch c u'
: Ei .. APPLICANT; , " ❑, CONTACT above service of feeder fee, 6.65 2
each branch circuit
Business name: • B. Fee for branch circuits
L antact name: Cu shout service or feeder fee, of st branch circ 40.S.5 i 7
rn uit
V� I
Address: each add] branch circuit 6.65 I 2
miscellaneous (service or feeder not included) I
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, Serv and /or feeder j J
Phone: ( ) Fax: : ( ) Reconnect only I 66.85 2
E-mail: Pump or irrigation circle I 53.40 2
NartltSterE GUNTRACTOR Sign or outline lighting )3,40 2
` Signal circuit(s) or limited -
v Business name
lectrical Contractors energy panel, alteration, or
Address: • . . 19450 SW Cipole Rd, #10.7 . , . . .. extension. Describe: . Page 2 , 2
Tualatin. OR 97062
r City /State /ZIP: ; •••(503) 612 -0840 Fax.(503) 612-0891 .. .... ........ .. .. Ltc #34-359C CCB #90454 Metro #1911 �raclt addltlou t1. Itts�teetion over allowable in any o ItI. above' -- -- f' i inspt.t.tion •• ‘ 1. '
1nvl,�Ii .t tion per Matt 1 lir min 62.50
�'' CCB 1. lo.: I Elcctrioal'Lie.; . tprv. a � /� Industrial plant pct bout 73.75 I.. —
0 / / .. - >r1,r,CER1C;AL;'PFR1ti11T PEGS'
Suprv: Electrician signature, required: .. • •
_ -- l - Subtotal µ •
Print name: �/ , Date,
• / '7 / , Pion review (25 %of permit fee); Einr
L7r�Pt �J ` / _ State surcharge (12% of permit tee): °F r In
Authorized signature: _ TOTAL PERMIT FEE: �ij
1 hi, permit a ppini, a xpires if n permit is not obtnin ,(J' 1 1141 81W
Print name. Date: ficat after It hat bean OCCepted n5 complete.
° Mother of ins_peclious allowed per permit.
•lbuildinglPenninlELC •PermitApp.doc 05/23/06 440.46157(1 1l05/C01'Vll'EB
CITY OF TIGARD
BUILDING DIVISION
PERMIT #: 11c.2009.00(V,0
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/312009
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/19/2009 TIME: 7:01AM PAGE: 30
SITE ADDRESS: SW NO ADDRESS CLASS OF WORK:
SUBDIVISION: F3RENTWOOD ESTATES LOT #: TYPE OF USE:
PROJECT NAME: F3RENTWOOD ESTATES
DESCRIPTION: (1) 200 amp panel.
OWNER: SUN RIDGE BUILDERS INC, PHONE #:
CONTRACTOR: NORTHSTAR ELECTRICAL CONTRACTORS PHONE #: 503-612-0840
Inspection Request Scheduled For: Date: 2/18/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
105 tindmgroundIslal) cover 080622-01 603-612-0840
I c i F I N A L
Corrections/Comments/Instructions:
oa, te\oN R.o NO9
,
t Cr, N Q 310 0 1
PASS PARTIAL APPROVAL LIIJ CANCEL El NO ACCESS
FAIL Ei CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: NOB 1-g Date: 2-11 Phone #: (503) 718- 21.1917