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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #:. ELC2008 -00220 r COMMUNITY DEVELOPMENT DATE ISSUED: 4/17/2008 T i G A R D = 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 111 CC -09400 SITE ADDRESS: 15720 SW GREENS WAY ZONING: R -12 SUBDIVISION: SUMMERFIELD NO.2 LOT : 121 JURISDICTION: TIG PROJECT: BROWN Project Description: Installing (1) service and (14) 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/ SVCI FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: 14 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: JEFFREY M. BROWN DO RIGHT ELECTRIC INC 15720 SW GREENS WAY 11852 NE CHATEAU DR TIGARD, OR 97224 WOODBURN, OR 97071 Phone: 503 - 291 -9191 Contact #: PRI 971 - 570 -8103 FAX 503 - 982 -0042 FEES Description Date Amount Reg #: ELE C250 [ELPRMT] ELC Permit 4/17/2008 $173.40 LIC 174201 [TAX] 12% State Surchar 4/17/2008 $20.81 SUP 52055 Total $194.21 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 503.24•...99 •r%. 32.2344. Issued By: �L` —,....nag �---� Permittee Signature: /�,:� ���i/ 4111 ; OWNER INSTALLATION ONLY / The installation is being made on property 1 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. -`' " xt' "A z * Sw#ll i if"tit $7fiF -, - a,:;!''.,,ii.. N �,R R : - i . r^ w Electrical Permit Application y. , ,., 8d, `,NO OFFICE usE oNLV,� , -u t % y Q � Receive C of Tigard ¢ Dat Permit Perm No.. C C L _ ' vV V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ti ' - Phone: 503.639.4171 Fax: 503.59 9 no' 0 ' 1 ' q nVO Date/By: Other Permit: ' RIG!A'ItID Inspection Line: 503.639.4175 - t 1 �/ Date Ready /By: Juris: ® See Page 2 for & \� ,�� �1 ottfied/Method: Supplemental ^r Internet: www.tigard-or.gov �� ., ' . TYPE OF WORIt1S1 jai k> w. PLAN REVIEW - ❑ New construction ----;[ 'Addition /alteratio relaVCrllent Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards. „, . ' ' .. CATEGORY OF - CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings. ❑ Multi- family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or 'JOB` SITE. INFORMATION AND LOCATION . ❑ Emergency system. larger separately derived system. ❑ Addition of new motor load of ❑ "A ", "E ", "I - ", "I - ", � , b Six or or more. occupancy. Job no.: Job site address: ) 5 -7 F� fr'P�5V ❑ Six or more residential units. ❑ Recreational vehicle parks. L City/State /ZIP: T ` CI ❑ Health -care facilities. ❑ Supply voltage for more than � `' 0 ❑Hazardous locations. 600 volts nominal. Suite/bldg./apt. no.: Project name: ��n !/l/ I ' ❑ Service or feeder 600 amps or more. FEE .SCHEDULE Cross street/directions to job site: Description I Qty. 1 Fee. 1 Total 1 • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 I Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 — r e , f I R P �� , ('ei residential (with above sq. ft.) 4 Services or feeders installation, alteration, and/or relocation 200 amps or less 1 80.30 X7) 3c 2 PROPERTY OWNER 1 ,❑ TENANT . 201 amps to 400 amps 106.85 2 Name: T� �/ � /n/ 401 amps to 1, 600 amps am 140.60 2 `,J N (/ � 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State /ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) 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 599 amps 133.75 2 Branch circuits - new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with . ❑ 'APPLICANT ' 1 ❑ CONTACT PERSON above service or feeder fee, 1 q 6.65 9 3, /a 2 each branch circuit Business name: B. Fee for branch circuits Contact name: without service or feeder fee, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: E manufactured or modular dwelling, service and/or feeder 90.90 2 . ) Phone: ( ) Fax: : ( ) Reconnect only 66.85 2 - ' E -mail: Pump or irrigation circle 53.40 2 ' CO . . Sign or outline lighting 53.40 2 I � ,' kt El r -f� 71 ener panel, alteration, or Signal circuit(s) or limited - Business name: De r �C Address: I ( SS , C{t,L` Le. Pr' extension. Describe: Page 2 2 City/State /ZIP: ) I,, '� ���� 1 Each additional inspection over allowable in any of the above jn "�l� "'^"�`� oz Per inspection 62.50 Phone: ( `h / ) S- U < , t : ` 03) 9 O, 00 Investigation per hour (1 hr min) 62.50 CCB Lic.: / 7 .o 1 Electrical Li C v Suprv. Lic -: ,,0 5S. Industrial plant per hour 73.75 (4 /e/ / ELECTRICAL PERMIT FEES Suprv. Electri natbre, required: • /� Z f U I ( � l U Subtotal: / 7 d( p Print name. / 6 Date 5/ ej Plan review (25% of permit fee): • P_ , ,en, ,, t v State surcharge (12% of permit fee): da, --/ t Authorized signature: TOTAL PERMIT FEE: a y_ a-f T his permit application expires if a permit is not obtained within 780 Print name: Date: days after it has been accepted as complete. • Number of inspections allowed per permit. I:\Building\Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11 /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: LRESIDENTIAL WORK ONLY: - - - -- Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* n Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: ❑ Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation ❑ HVAC n Instrumentation ❑ Intercom and Paging Systems • ❑ Landscape Irrigation Control* ❑ Medical n Nurse Calls ❑ Outdoor Landscape Lighting* ❑ Protective Signaling n Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1:\ Building \Permits\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD �,.. - BUILDING DIVISION PERMIT #: ELC2008.00220 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4117/2008 Phone: (503) 639 -4171 Ake „li Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 4/111/2008 TIME: 7:01AM PAGE: 11 SITE ADDRESS: 15720 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUMMERFIELD NO.2 LOT #: 121 TYPE OF USE: PROJECT NAME: BROWN DESCRIPTION: Installing (1) service and (14) branch circuits. OWNER: BROWN, JEFFREY PHONE #: 503 - 791 - 919 1 CONTRACTOR: E)O RIGHT ELECTRIC INC PHONE #: 971 - 51711.8103 Inspection Request Scheduled For: Date: 4/18/2008 Pour Time: Code # Inspection Description Confirm.# Contact # Message 120 Electrical rough - in ( 060603.02 \ 971-570-8103 N \. 1 Corrections /Comments /Instructions: .- K PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 6--- N (,17 LE-- Date: a 01) Phone #: (503) 718- Vittt CITY OF TIGARD ^.r - BUILDING DIVISION PERMIT #: ELC2008 00220 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 4/17/2008 Phone: (503) 639 -4171 A 4 Inspection Requests (24 Hrs.): (503) 639 -4175 ��' „ "__.. INSPECTION WORKSHEET FOR DATE: 4/18/2008 TIME: 7:01AM PAGE: 12 SITE ADDRESS: 15720 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUMMMERIILLD NO.2 LOT #: 121 TYPE OF USE: PROJECT NAME BRO I DESCRIPTION: installing (1) service and (14) branch circuits. OWNER: BROWN, JEFFREY PHONE #: 503 CONTRACTOR: DO RIGHT ELECTRIC INC PHONE #: 971 - 570.8103 Inspection Request Scheduled For: Date: 4/18/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 115 Electrical service 068603-01 971 -570 8103 N Corrections/ Comments/I nstructions: rAvR G-0ot Q 0 (Lc's i 1) Site PASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Cr N t YO t t-- Date: 9 i V 61 Phone #: (503) 718- *IC----‘ CITY OF TIGARD BUILDING DIVISION PERMIT #: F LC20013.00220 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: ' 4I17/20013 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 ,„_tsfr jll'I INSPECTION WORKSHEET FOR DATE: 4/16/2008 TIME: 7:01AM PAGE: 10 SITE ADDRESS: 15720 SW GREENS WAY CLASS OF WORK: SUBDIVISION: SUMMERFIELI) NO.2 LOT #: 121 TYPE OF USE: PROJECT NAME: BROWN DESCRIPTION: Instaiiinq (1) service and (14) branch circuits. OWNER: F3RO\NN, JEFFREY PHONE #: 503291 -9191 CONTRACTOR: DO RIGHT ELECTRIC INC PHONE #: 971 - 570-8103 Inspection Request Scheduled For: Date: 4/18/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 1255 !loll rover 068603 -03 971 - 570 -8103 N Corrections /Comments / Instructions: PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED — Nte Inspector: lT Date: 4 ` 61 Phone #: (503) 718- % . .