Permit CITY OF TIGARD ELECTRICAL PERMIT
1,4 g ' COMMUNITY DEVELOPMENT PERMIT #: ELC2008
DATE ISSUED: 9/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 AA -04200
SITE ADDRESS: 14420 SW 86TH AVE ZONING: R - 4.5
SUBDIVISION: GREENSWARD PARK LOT : 032 JURISDICTION: TIG
PROJECT: LUNDH
Project Description: Installing (2) branch circuits.
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: SIGNAUPANEL:
MANF HM/ SVCI 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: 1 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:
ERIK & ROSALIE LUNDH HILLSBORO ELECTRIC
14420 SW 86TH 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: 503 - 538 - 2953 Contact #: PRI 503 - 439 -9666
FAX 503 - 601 -3680
FEES
Description Date Amount Reg #: ELE 34 -499C
[ELPRMT] ELC Permit 9/11/2008 $53.50 LIC 134481
[TAX] 12% State Surchar 9/11/2008 $6.42 SUP 4941S
Total $59.92 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
I
Issued By: P ermittee Signature: ��r - Y$ U�
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.
09- 10 -'08 16:28 FROM- Hillsboro Electric 503 - 601 -3680 T -958 P002/002 F -862
WWeet c_aal Permit Apt Application O " '7� rk'' ";ax sera s „ ;rig ct ^il , w �T ,T�lq "'4 "1:M ti .
n { �y¢ •� w �� I [)�<t,i till 1u tit plAI � Y �� v V r
"s' .�•7t a i s ' � '�1,. -r: .'t+ $1 4 1'&P - .:.:7� ! '...., d t� i. l ar•id ) W ra .,.,9 k E 6 V i ,, �
Arf r1� . , City of Tigard Received
f. 13125 SW Atli Blvd., Tigard O { p wig `t No.: �' v r � / � lan Review ®'1; c-,
?" :, Phone: 503. 639.4171 Fax: 5039: '17\i'3 • Date/g : Other Fermin —
ti{ 1 f r Inspection Line: 503.639.4175 r - - a Z1
i
_� 9 Note ed/M6
-
: B1 see Page i for
u °ri'. d rc yi Internet: www.tigard-or.gov / � Notified/method: Supplemental Information
TYPE OF WO', Q • `' '- PLAN REVIEW
0 New construction • Addition/alte ;I:. , 11'"1 'I h
, A Please check all that apply (submit g sots of plans w /ieuns coked below):
❑ Demolition ❑ ��'` ❑ Service or feeder 400 awpa or more ❑ Building over three stories,
Other: Where the available fault current 0 Marinas and boatyards.
CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
Id 1 - and 2 dwelling less to ground. or exceeds 14.000 0 Commercial -use agricultural
y g ❑ Commercial/industrial ❑ Accessory building a f all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump,
❑ Installation of 75 KVA or
.I013 SITE INFORMATION AND LOCATION ❑ B° ' 1eY system, larger separately derived system.
❑ Addition of new motor load of ❑ "A ", "E", "1-2". "1 -3 ",
Job no.: / 2,(e Job site address: i �t , 1oo11P or more, occupancy,
❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ' / 1
....,Health-carc tbcilikes. ❑ Supply voltage for more than
..33�� [ Hazardous locations. 600 volts bon:inal.
Suite/bldg. /apt. no.: . Project name: FPI 13 s vice or feeder 600 amps or more.
Cross street/directions to jab site: FEE SCHEDULE
d nncrip ■ Q ty. Nee. Total •
New residential single- or multi - dimity dwd iug unit.
Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft, or less 145.15 4
Tax map /parcel no.: Bs. add'I 500 sq. ft. or portion 33.40 t
DESCRIPTION OF WORK Limited energy, residential
75.00 2
(with above sq. ft.) _
, y Limited energy, multi - family
/L residential (with above sq. ft.) 75.00 2
Services or feeders Installation, alteration relocatio
200 amps or loss 80.30 2
❑ PROPERTY OWNER ❑ TENANT — • 201 amps to 400 amps _ 106.85 . 2
Name: 401 amps to 600 amps 160.60 2
Address:
— -- 601 amps to 1,000 amps 240.60 2
Over 1,000 amps or volts 454.65 2
City /State/Z1p: Temporary serviceal or feeders in alteration, and/or
relocation _
Phone: ( ) Pax: ( ) 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 maps to 599 amps 133.75 2
Owner signature: Date: Branch ciecult – new, alteration or c z tens ion, per pa nel
❑ APPLICANT _ A. Fee for branch circuits with
❑ CONTACT PERSON above service or feeder fix,
6.65 2
'—" each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fix, 1 46.85 2
first branch circuit
Address: Each add'I branch circuit , _ 6.65 6! . 2
Miscellaneous siervice or feeder not Included)
City/State/ZIP: • Each manufactured or modular
cllin s 2
dw
Phonc: ( ) Fax:: ( ) Recom� only and/or feeder
E-mail: Pump 66.85 2
Pump or irrigation circle 53.40 2
CONTRACTOR Sig or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
HILL BORO FLE R . energy panel, alteration, or
Address: 21185 NW EVERGREEN PKWY #110 extension. Describe; Page 2 2
City /Statc/ZIP: RI LLSBORO , OR 97124 Each addition ins et ion over allowable in any of the above
Per inspection 62.50
Ph ' (5 0 3 439-9666 I Fax: ( 5 O 3 ) 601-3680 Investigation per hour (1 hr min) 62.50
CCB Lic.: 134481 Electrical Lic.: 34-499 , • Suprv Lie.: 4941 S Industrial plant per hour 7175
Suprv. Electrician signature, required: / ELECTRICAL PERMIT' 17EES i –
Print name: JOEY VITACC s Date: I rU /( Plan review (25% ofpemtit fee
�+U State surcharge (12 %ofpermit fee): r •
Authorized signature: TOTAL PI3RMIT FEE � . ! 2
Print name: Date: This permit application expires if a permit is not obta 180
days after it has been accepted es complete.
r:\Build ngU+cRniulwr r
• Nruahor of inspections allowed per permit.
PeimitApp.doc OS/23/a6 440- 4615T(11/05,C0M/WEB
CITY OF TIGARD ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT : ELC2008 -00529
" •,a ���` DATE ISSUED: 9/11/2008
TIGARD' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 111 AA -04200
SITE ADDRESS: 14420 SW 86TH AVE ZONING: R -4.5
SUBDIVISION: GREENSWARD PARK LOT : 032 JURISDICTION: TIG
PROJECT: LUNDH
Project Description: Installing (2) branch circuits.
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: 1 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:
ERIK & ROSALIE LUNDH HILLSBORO ELECTRIC
14420 SW 86TH 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: 503 - 538 -2953 Contact #: PRI 503 - 439 -9666 •
FAX 503 - 601 -3680
FEES
Description. Date Amount Reg #: ELE 34 - 499C
[ELPRMT] ELC Permit 9/11/2008 $53.50 LIC 134481
[TAX] 12% State Surchar 9/11/2008 $6.42 SUP 4941 S
Total $59.92 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: �� -� Permiftee Signature: � `����G.�
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: Ea- oL,.. ) c ) )1 REQUIRED ON GREEN INSPECTION CARD.
1 Code I Inspection Description • I PASS Date I By ✓ • Code I 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 x 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 X 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
810 MFG- Structure set -up MEC - Mechanical Permit
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
995 Misc. inspection:
315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
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 \Forms \InspCard- AOP- Blank.doc 02/02/07