Permit _- ,,,1V ��� ®� �'���® ELECTRICAL PERMIT
i li '' ' -' COMMUNITY DEVELOPMENT PERMIT #: ELC2007 -00433
..
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/25/2007
PARCEL: 25111 DB -09100
SITE ADDRESS: 15510 SW OAKTREE LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.10 LOT : 552 JURISDICTION: TIG
PROJECT: UPRIGHT
Project Description: Check grounding and bonding, repair as required.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0.00 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:
UPRIGHT, COLLEEN M OREGON ELECTRIC GROUP
15510 SW OAKTREE LN 1010 SE 11TH AVE
TIGARD, OR 97224 PORTLAND, OR 97214
Phone: NA Contact #: FAX 503 - 535 - 2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 -95C
[ELPRMT] ELC Pcmiit 6/25/2007 $66.85 LIP 203
[TAX] 8% State Surcharge 6/25/2007 $5.35 SUP 4818S
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 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 b _ L:0_a l C , l" 4 Permittee Signature: d'„.i. c p/ „ r ', ._i
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.
-25 -2007 10:52AM FROM -OR ELECTR '�r . 5035352763 T -774 P.001/002 F-300
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City of Tigard 'Received
y . .i A i �L� Permit ,-y--.&0,93.3
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13125 SW Hall Blvd, Tigard, OR 97223 JUN pla R i,i , w
Phone: 503.639A171 Fax: 503.598.1960 !Y Da[ e/>3 Other Permit:
Inspection Line 503.639.4175 11/ 0 ,�1j I Date Ready /Byr, rn 0 see Page 2 for
Internet: www.citigardor.uc Non ad/Method Supplemental Information
. TYPE i 0 ' , , 1 ' [UT V 1 a 5 ` %, PLAN R EVIEW
❑ New construction ® Addition /alteration/replacement Fuse check all that apply:
ID Service over 225 amps, comm'l ❑Ha2<adous location
El Demolition CI Other.
-- ❑ Service over 320 amps - rating ['Bulldog over 10,000 sq. R,
1 CATEGORY OF CONSTRUCTION 1 of I- and 2- family dwelling,. 4 or more new residential
❑ 1 - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
® Multi family ❑ Mastcr builder ❑ Other ['Building over three stories ['Feeders, 400 amps or more
❑Occupant load over 99 persons ❑Manufftctured structures or
J08 SITE INFORMATION AND LOCATION °Egress/lighting plan RV park
Job no.: 21373 Job site address: 15510 SW Oak Tree Lane ❑Health - care facility ❑Other
-
Submit 2 sets of plans with any of the above.
City/State/Z1P: The above are not licable to temporary parary ewnstruetion service.
Suite/bldg./apt no.: I Project name: Colleen Upright FEE' SCHEDULE
•- Description I 4!. _ 1 Fenti l Taal
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.: En add'I 500 sq. R or portion 33.40 1
Tax map/parcel no.: Limited energy, residential 75.00 2
Limited energy. non - residential 75.00 2
DESCRIPTION OF WORK . 1 Each manufactured or modular
check grounding and bonding, repair as needed dwelling savicc and/or feeder _ - 90.90 2
Services or feeders Installation, alteration, and/or relocation
200 amps or less 80.30 2
-
❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106,85 2
401 amps to 600 amps 160.60 2
Name: Colleen Upright 601 amps to 1,000 amps 240.60 2
Address; 15510 SW Oak Tree Lane Ova 1,000 amps or volts 454.65 2
Reconnect only J 66.85 61p, 15, 2
City/State/ZIP: Tigard, OR 97224 Temporary services or feeders installation, alteration, and/or
Phone: relocation
( ) 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 600 amps 133.75 2
Owner signature: _ Date: Branch circuits - new. alteration, or extension, per panel
❑ APPLICANT J ❑ CONTACT PERSON A Fcc for branch circuits with
service or feeds fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: widiout service or feeder fee, 46.85 2
Address: each branch circuit
_Each add'I branch Circuit 6.65 _ 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax:: ( )
Sign or outline lighting 53.40 2
E-mail_ Signal circuits) or limited -
CONTRACTOR energy panel, alteation, or
extension. Describe: Page 2 2
Business flame; Oregon Electric Group
Address: 1010 SE 11th Ave Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State/ZIP: Portland, OR 97214 - Investigation per hour (1 hr min) 62.50
Phone: (503) 234 -9900 I Fax: (503) 535 - 2763 Industrial plant per hour 73.75
EL•EcrRICAL PERMIT FEES -
CCB Lic.: 203 I Electrical Lie.: 26 -95C I Suprv. Lie.: 48185 Subtotal W t1. g5
Suprv. Electrician signature, requin:Q° C. Plan review (25 % ofpermit fee)
Print name: Z j ' rd M 4. II r'oii t. Date: 06/25/07 State setrrl TOTAL (8% of permit fee) 5 , 35
s TOTAL PERMIT FEE 7z a0
a
Authorized signature: This permit app
licadon expires If a permie ie rat ohtaieed within Ilan
Print name: R � � � .1) -- Date' 06/25/07 • cl otter It has txea Building as complete
Se
r Foe methodology so by lti- County Building Indtutry Service Board
•' Number of inspections per permit allowed
i :\ Bill ldiny\1'enmiu\EZC•PomirApp.doo 12/03 440.4615T00102/COM/Wa1
CITY OF TIGARD 444
BUILDING DIVISION L ,,,,,,,,,,,A PERMIT #: ELC2007 -00433
13125 SW Hall Blvd., Tigard, OR 97223 r DATE ISSUED: 6/25/2007
Phone: (503) 639 -4171 p .,ilf , �
Inspection Requests (24 Hrs.): (503) 639 -4175 „.1
!!�i °Tf_�,
INSPECTION WORKSHEET FOR DATE: 6129/2007 TIME: 7:00AM PAGE: 65
SITE ADDRESS: 15510 SW OAKTREE LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO-10 LOT #: 552 TYPE OF USE:
PROJECT NAME: UPRIGHT
DESCRIPTION: Check grounding and bonding, repair as required.
OWNER: UPRIGHT, COLLEEN M, PHONE #:
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503. 234 -9900
Inspection Request Scheduled For: Date: 6/29/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051116 -01 503- 357 -4013 N
Corrections /Comments/ Instructions:
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FAIL /VA CALL FOR INS ECTION 1 1 ADDITIONAL FEES ASSESSED •
Inspector: Date: / Phone #: (503) 718-