Permit CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00467
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8113/200f?
Phone: (503) 639 -4171 (1
Inspection Requests (24 Hrs.): (503) 639 -4175 s'
INSPECTION WORKSHEET FOR DATE: 8/28/2008 TIME: 7:00AM PAGE: 40
SITE ADDRESS: 1492.1 SW 91ST AVE CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 010 TYPE OF USE:
PROJECT NAME: ail APU7_I O
DESCRIPTION: Installing (2) branch circuits.
OWNER: CHIAPUZIO, DOUGLAS & BARBARA PHONE #: 503. 684 -6088
CONTRACTOR: ()LIVERS PRECISION ELECTRIC CO PHONE #: 503.579 -7747
Inspection Request Scheduled For: Date: 8/2812008 Pour Time:
Code # Inspection Description Confirm # ! Contact # Message
120 Electrical rough -in 074766 -01 V 503 -684 -5088 N
Corrections /Comments /Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL CALL OR INSPECTION n ADDITIONAL F ES ASSESSED
Inspector: Date: 1 / Phone #: (503) 718-
CITY OF TIGARD ��
BUILDING DIVISION PERMIT #: ELC2008 -00 67
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8113/2008
Phone: (503) 639 -4171 , , i , i' I ' e
Inspection Requests (24 Hrs.): (503) 639 -4175 J L .
INSPECTION WORKSHEET FOR DATE: 8128/2008 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 14921 SW 91ST AVE CLASS OF WORK:
SUBDIVISION: MALLARD LAKES LOT #: 010 TYPE OF USE:
PROJECT NAME: CHIAPUZIO
DESCRIPTION: Installing (2) branch circuits.
OWNER: CHIAPUZIO, DOUGLAS & BARBARA PHONE #: 503-.684-5088
CONTRACTOR: OLIVERS PRECISION ELECTRIC CO PHONE #: 503 - 579 - 7747
Inspection Request Scheduled For: Date: 8/28/2008 Pour Time:
Code # Inspection Description Confirm # j Contact # Message
199 Electrical final 074766.02 503 -684 -5088 N
Corrections /Comments/ Instructions:
W PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1 / Date: 915 Phone #: (503) 718 -
t
ELECTRICAL PERMIT
CITY OF TIGARD
PERMIT #: ELC2008 -00467
COMMUNITY DEVELOPMENT DATE ISSUED: 8/13/2008
116Xk 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 AD - 14400
SITE ADDRESS: 14921 SW 91ST AVE ZONING: R - 4.5
SUBDIVISION: MALLARD LAKES LOT : 010 JURISDICTION: TIG
PROJECT: CHIAPUZIO
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/ 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:
DOUGLAS & BARBARA CHIAPUZIO OLIVERS PRECISION ELECTRIC CO
14921 SW 91ST AVE 17035 SW HIGH HILL LN
TIGARD, OR 97224 BEAVERTON, OR 97007
Phone: 503 - 684 -5088 Contact #: PRI 503 - 579 -7747
FAX 503 - 579 -5907
FEES
Description Date Amount Reg #: ELE 34-521C
[ELPRMT] ELC Permit 8/13/2008 $53.50 LIC 41435
[TAX] 12% State Surchar 8/13/2008 $6.42 SUP 2539s
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 thro .!h OAR 952 - 001 -0100. Y. - .'n copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By // ,� ' — _,/ Permittee Signature: ��C/�l(� 1!kft t p LL7c)
. I--
.....ca.
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.
Aug 08 08 10:24a Diana Oliver 503 579 -5907 p.1
\
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She/„•
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2 Electrical Permit Applicatio r , , i
` o� Land Use Approval
� Washington County,155 N. 1" AV, Suit , s 12, ''11 , OR 24
0 4r4Q r Phone: 503- 846 -3470, Fax: 503-84G-399', [ �`\ 1 � 0 A e rmct #
�
Inspection Requests: 503- 846 -3699, www.co.wasNGrlgton. 6 g l. \ v per # _.__ � � �pLf( 7
TYR OF WORK
0 New construction ❑ Addition/altcration/r la cement �� \ ` PLAN REVIEW
eP ❑ Othet�` ��.. - Please chock all that apply:
1 20
❑ Service or feeder400 amps ❑ Hazardous locations
CATEGORY OF CONSTRUCTION Y� or more where the available ❑Service yr feeder fi00 amps ur more
taut current exceeds
R, I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building y 10,000 amps at 150 volts or❑ Building over three tories
�] Multi -famil less to ground ❑ Marinas and boatyards
yards
Multi-family (] Master builder ❑ Other: , or ❑ n gs
❑ Floating buildings SITE INFORMATION AND LOCATION !nst0alllat° .i s for all other �Ituml
Commercial -use u r
Job no.: Job address: ,. ❑ Fire pump buildings
` E 1 r'- �ta.3 I ls'r ❑ Emergency system ❑ Installation KVAorlarger
City,Btate /ZIP: - ' ❑ Addition of new motor separately derived system ll \\ load of 1001IP or more ❑ "&""E'""1-2'""1-3 °cculxtncy
Suite /bldg.;apt, no.: Project name: I ❑ Six or more residential units ❑ Recreational vehicle par
❑ Supply voltage for more than
Cross street/directions to job site: 0 1lealth care facilities 600 volts nominal
FEE SCHEDULE
Description j Qty. Fee I Total J «
Subdivision_ Lot no.: Residential single- or multi - family dwelling unit. .
Tax map/parcel no.: Includes attached garage.
1,000 sq. N. or less 1 50.03 4
DESCRIPTION OF WORK Ea. add'I 500 sq. ft. or portion 42.00
�
(,,' Limited energy, residential
T _c1�i2C_LA X � to i p� `" �'� i�.e -_ (with above sq. ft.) 60.00 2
i 'T
Limited energy, multi - family
residential (with above sq. ft.) 66.00 2
A.EIROPERTY OWNER 1 ❑ TENANT Services or feeders installation, alteration, and/or relocation
Name: LJ 4159(225&44•• /7 1 k 200 amps or less 90.00 2
�J t� p p Z'i0 201 amps to 400 amps 120.00 2
Addre ss: . ( y ' r+!1 C S C r 401 amps to 600 amps _ 180.00 2
City/Sta[e/Z1P: _ 601 amps to 1,000 amps 270.00 2
1 � + v awl Over 1,000 tSv amps or volts 504.00 2 '
Phone:
° - ie�► ax: ) Temporary services or feeders Installation, alteration, and/or
Owner lastatto farm a: This installation is being made on residential or fa property owned by me or a member of relocation
aU
my immediate family, This property is not intended for sale, exchange or rent. (ORS 479.540(1) and 479.560(1). 200 amps or less 1 78.00 2
Owner signature: 201 amps to 400 amps 108.00 2
Date: 401 amps to 599 amps + 150.00 2
❑ APPLICANT 1 ❑ CONTACT PERSON Branch circuits - new, alteration, or extension, per panel
i A. Fee for branch circuits with
Business name: above service: or fccdcr fco, 8.50
Contact name: each branch circuit
B. Fcc for branch circuits , •
Address:
without service or feeder ✓ GO
fee. first branch circuit + 2
City/Stott /ZIP: Each add'l branch circuit b or 8.5o a
Phone: Miseelnaneous (service or feeder not included) G
( ) l Fax: ( ) Each manufactured or modular
E -mail: dwelling, service, and/or feeder 0100 2
Recoaacct only 78.00 1
CONTRACTOR Pump or irrigation circle 60.00 : 2
Business name: Q i 1ee s • ei is 1 • ea r r Sign or outline lighting 60.00 2
Address: I Signal circuit(s) or limited -
6._ (.4.4; . a _ �/ Ai energy panel, alteration, or 60.00
City /State/ZI': , - J 4 ! K �I e / i extension. Describe:
2
Phone: ( • _ Fax: O , • - ter! O Each additional inspection over allowable In any of the above
E-mail: OQ to). J Per inspection 99.00
CCB lie. no. 3 Investigation fa: isee ocmphsncc)
Electrical lic. no.: q --5.. 1 City or metro lie.: Y g G , Other:
Supervising electrician f�} a ELECTRICAL PERMIT FEES 1
sigrtantre, required: W 1Ml � 1f a `J 3' S Subtotal l� 5 j _sz
Print name: Wry! 011-v p r Date: Plan review (25% of permit fee}
Authorized State surcharge o of permit fee) a/
signature: TOTAL PERMPP FEE 57 got. Print name: Date: This permit application expires if a permit Is of obtained
within 180 days after it has been accepted as complete
'Number of inspections allowed pct permit Revision (1606106