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Permit
ELECTRICAL PERMIT S yr , • PERMIT #: ELC2007 -00789 ;; COMMUNITY DEVELOPMENT DATE ISSUED: 11/26/2007 ;TIGARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 134C D -00600 SITE ADDRESS: 11855 SW KATHERINE ST ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS NO.3 LOT : 076 JURISDICTION: TIG PROJECT: BENZ Project Description: (1) service with (4) 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: SIGNALJPANEL: 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: 4 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: BENZ, WILLIAM J CARRICK ELECTRIC 11855 SW KATHERINE ST 2965 SE 75TH AVE. TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: Contact #: PRI 503 - 591 -8474 FAX 503 - 591 -8389 FEES Description Date Amount Reg #: ILE 34 -439C (GLPR:MT] GL.0 Permit 11/26/200' $106.90 1,1C 120169 1' AX1 8% State Surcharge 11/26/200' $8.55 SUP 22955 Total $115.45 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: 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. Electrical Permit A licat I " ��. ` ' FOR OFFIC USE ONLY`, ^ » t w ' tY ' , w - � � � Received City of Tigard -- Plan Re : ` � /24/o 7 f313 Permit NoOke ,�^� , 76, 114 V 13125 SW Hall Blvd., Tigard, OR 97 23 \ • 1 Plan Review "�✓, " d Phone: 503.639.4171 Fax: 503.598 6 �� ( Date /By: Other Permit: TIG A ItI' Ins Line: 503.639.4175 CITY V ®F 1f6}� Date Ready /By: Juris: 0 See Page 2 for 7- 61 e- - Internet: www.tigard or.gov �® Notified/Method: Supplemental Information • . QUILMNODIVISI ® . TYPE OF O ' - ; PLAN REVIEW ❑ New construction 19 Addition/alteration /replacement 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 10 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 - ", "1 - ", £)SS S %.")- KA e I < S4 , 100 or or more more. R occupancy. Recreational Job no.: Job site address: // 0 Six or more residential units. ❑Receational vehicle parks. City/State/ZIP: �' 4 A r 0 /' 6 ❑ Health -care facilities. ❑ Supply voltage for more than ❑ Hazardous locations. 600 volts nominal. Suite /bldg. /apt. no.: Project name: ?e ,,j-z. ❑ Service or feeder 600 amps or more. . FEE SCHEDULE ' Cross street/directions to job site: Description 1 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 1 Tax map /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) AP Limited energy, multi - family 75.00 2 , ,] aP S✓ 4, D/� 7 .n. 1 4 Np c /(L. C. v t -t 6 n-- residential (with above sq. ft.) ( Services or feeders installation, alteration, and/or relocation .r 1 ce.. e e au o 2 6 L 200 amps or less i 80.30 cfl a ?I) 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 1 06.85 2 Name: 7, 1/ N f .,., 2 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: // ' c 5 s' w, k4i4e,,iv P . Over 1,000 amps or volts 454.65 2 City/State /ZIP: r H Temporary services or feeders installation, alteration, and/or /r,'ti0 / U • Y relocation Phone: (54 , 3 ) •Z Zq. y6 5 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 ❑ CONTACT PERSON. above service or feeder fee, each branch circuit Y 6.65 �J� 2 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: Each 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 . . CONTRACTOR. . 53.40 2 Sign or outline lighting I ' ` k (�e� ff� Signal panel, or limited - Business name: C to 0_,,,_ energy panel, alteration, or Address: 1�8 7 5' N , t^J, /CA I,,�, ( e lija pa extension. Describe. Page 2 2 City/State /ZIP: n .//p N to 6 n , q 7 Z z i Each additional inspection over allowable in any of the above / Per inspection 62.50 Phone: ( S 03) S) /- sq 7 9 Fax: ( Sd 3 ) $ h I 5 ' 3 e. (001.1C Investigation per hour (1 hr min) 62.50 CCB Lic.: / Z 0 / t; / Electrical Lic.: 3c/, 7 c Suprv. Lic.: L L5 C 5 Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES • Suprv. Electrician signature, required: . Subtotal: / 0 (9,S0 Print name: a Da te: �y Plan review (25% of permit fee): rJ�`� �O ° �� r State surcharge (8% of permit fee): . 5- `j Authorized signature: - 61 �� TOTAL PERMIT FEE: i j f .715 f2C/ _ This permit application expires if a permit is not obtained within 180 Print name: rr ,„ 64 n.- ✓z- , ;-,ft 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(t1 /05 /COM/WEll Electrical Permit Application - City of Tigard - Page 2 - Supplemental Information it LIMITED ENERGY PERMIT FEES: RESIDENTIAL 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* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 system (SEE OAR 918- 309 -0000) Check Type of Work Involved: n Audio and Stereo Systems ❑ Boiler Controls ❑ Clock Systems ❑ Data Telecommunication Installation ❑ Fire Alarm Installation n HVAC n Instrumentation ❑ Intercom and Paging Systems ❑ Landscape Irrigation Control* ❑ Medical ❑ 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 I:\ Building \Permits\ELC- PermitApp.doc 03/23/06 (°� • Y- -*TIGARD b . ELECTRICAL PERMIT CM PERMIT #: ELC2007 -00789 I: C_ ot/IMUNITY DEVELOPMENT DATE ISSUED: 11/26/2007 Tlcna 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134CD SITE ADDRESS: 11855 SW KATHERINE ST ZONING: R -4.5 SUBDIVISION: LERON HEIGHTS NO.3 LOT : 076 JURISDICTION: TIG PROJECT: BENZ Project Description: (1) service with (4) branch circuits. 4/3/08, ADDING (3) FEEDERS. 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 HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 4 W /SERVICE OR FEEDER: 4 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: BENZ, WILLIAM J CARRICK ELECTRIC 11855 SW KATHERINE ST 2965 SE 75TH AVE. TIGARD, OR 97223 HILLSBORO, OR 97123 Phone: Contact #: PRI 503 - 591 -8474 FAX 593- 591.8389 - 503 -(o4 - 273 FEES Description Date Amount Reg #: ELE 34 -439C [ELPRMT] ELC Permit 11/26/200' $106.90 LIC 120169 [TAX] 8% State Surcharge 1 1/26/200' $8.55 SUP 2295S [ELPRMT] ELC Permit 4/3/2008 $240.90 (additional fees not listed here) REQUIRED ITEMS AND REPORTS Total $385.25 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 rule - - = • h in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain cople rules or direct questions to OUNC at 503.24..6699 or 1.800. ' . - • . Issue. :y: / / i�` � , Permittee Sign- re: _ D 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: CON - • CTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: I 1 Cali 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. up • , 04/03/2008 9 : 36 FAX 5036458273 CARriICR Z 001 r^ a t rd ti- '4",2,, 1� __ ��r)r< $ ` P_ >gtl0 � I t,o; t :ii 1%1 ( l tl ,l1tlN 1 y , J City of Tigard 9: Received 1 , ■ C,t Permit Na-: C14 Z007 r tt r Date/ 13125 SW Ball Blvd Tigard, Rt PrAVEI 97223(P P lan Review omen permit: } + a Phone: 503.639.4171 Fax: 503.598.1960 Deem • - s� page Z tar : ,, . ' IneptCtion lane: 503.639.4175 APR 3 2008 N te ar '; s ect Page 2 lnwrmation Internet; trnvw.ugard-or.gov _ - -- • TYPE CO WO 1 u G k D PLAN REVIEW Addi_ , Fllterati0n/rep180CraCt�f ' , Place cheek ail that apply (submit 1 seta of plans wfiterrts chaired below): 0 New construction 0 � . ~ . 0 service or feeder 400 amps or more ❑ Bulling ova titres manes. 0 Demolition ❑ Other: where the available fault current © Marines and Maras. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 130 volts or 0 Floating buildings. Leas to ground, or exaocds 14,000 0 Commercial -use agricultural Q 1- and 2- family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations, buildings. Master builder El Fire per. 0lnstallation of 75 KVA or 0 Multi-famil C] Q Other ❑ F411e y nom- larger separately derived system. JOB SITE INFORMATI AND LOCATION CI Addition of now motor load of 0 "A ", "g... " - ", "1-3". 100HP m MOM ocoapaacy- Job no.: lob site address: © six or more resideetid ualts. ❑ Recreational veldole parks. E3 Healtb- ar re facilities. 1_1 Supply voltage for mo than City/State/ZIP: 0 Hazardous locations, 600 volts nominal. C) Service or feeder 600 amps or more Suite/bldg./apt. no.: Project name: — FEE SCHEDULE Cross street/directions to job site: a ,"' T . ■ — New residential single- or mull! - family dwelling unit. Includes attached garage. Lot no.: 1,000 sq. ft, or less _ 145.15 4 Subdivision: E. midi 500 sq. R. or portion 33 .40 1 Tax map /parcel n o,: _. Limited energy, residential 75.00 2 with above sq. f1.) DESCRIPTION OF WORK Limited energy, multi- family 75.00 2 residential (with above sq, ft.) - Services or feeders installation, alteration, and/or relocation 200 amps or less 3 80.30 "yob 402 0 PROPERTY OWNER Q TENANT 201 amps to 400 amps 106.85 2 401 maps to 600 amps 160.60 2 Name: - 601 amps to 1,000 amps 240.60 2 Address: Over 1.000 amps or volts 454.65 2 _ _ Temporary services or feeders installation, alteration, and/or City/State/ZIP: _ relocation -. —' Fax: ( ) 200 amps or less 66,85 - 1 Phone: ( ) 201 amps to 400 tun ., lin 100.30 2 Owner installation: This installation is being made on property that 1 own which is not 201 amps to 399 amps 133.75 _ 2 intended for sale, lease, rent, or exchange, according to ORS 447, 449.670, and 701. Branch circuits . new, ■iteratios or extension, per pans ._ Owner signature: _ Date: A` Fee for branch circuits with 0 APPWCAMr 0 CONTACT PERSON above service or leerier fix, 6.65 2 each branch circuit Business name: B. Fee for branch circuits - — _ without service or leader fee, 46.85 2 Contact name: first branch circuit Each ride branch circuit 6.65 j 2 Address: - Mlsctllaneoua (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwel ' service and feeder Phone: ( ) w l Fax :: ( ) Reconnect only 66.85 , 2 E -mil: _ Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 , Signal circuit(s) or limited - Business name: - energy panel, alteration. or extension. Describe: Page 2 2 Address: _ — _ - City /State/ZIP: Eacb additional his . don over allowable in an of the above — - Per inspection 1111 62.50 r Phone: ( ) Fax: ( ) Investigation per hour (l hr tutu) ill 62.50 11111 . Su Lie.: Industrial ,lent per hour 73.75 CCB Lie.: Electrical Lic.: Suprv. ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: T _ Subtotal: 2, 90 Plan review (25% of permit fee); Prim name: I Date: State surcharge (12% of penult fee): r Y . ' 0 Authorized signature: TOTAL PERMIT FEE: d` k ` r $'O - This permit application expires if a permit Is not obtained *tt to 180 Print name: Date: days after 11 has been accepted as complete. ■ Number of inapeetions alowad per permit, mikeea gkvensa.um c srm4rapp.doc osrum% 440.4atST(1 lro ucoMnvea CITY OF TIGARD BUILDING DIVISION PERMIT #: FL C2007-00709 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/2007 Phone: (503) 639 -4171 '11 Inspection Requests (24 Hrs.): (503) 639 -4175 ":_— INSPECTION WORKSHEET FOR DATE: 1/30/2009 TIME: 7:06AM PAGE: 20 ,// SITE ADDRESS: 11055 sw KATHERINE sr CLASS OF WORK: ( C ) SUBDIVISION: LERON HEIGHT I3 NO.3 LOT #: 076 TYPE OF USE: PROJECT NAME: faFiV. - . _-- • DESCRIPTION: (1) service with (4) branch circuits. 4/3/08, ADDING (3) FEEDERS. if OWNER: BENZ, WILLIAM J, PHONE #: CONTRACTOR: CARRICK ELECTRIC PHONE #: 503- 591.11474 Inspection Request Scheduled For: Date: 1/30/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message • 199 EIeclrical final 08007501 503. 708 -0836 N Corrections /Comments /Instructions: N N . PA SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: 70-- Date: / , 0 - q Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION .ii PERMIT #: EI_C2007.00789 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/26/2007 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 VI It INSPECTION WORKSHEET FOR DATE: 4/2/2008 TIME: 7:00AM PAGE: 63 1Z t Cr SITE ADDRESS: 11866 $W KATHERINE ST CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 076 TYPE OF USE: PROJECT NAME: BENZ DESCRIPTION: (1) s ervic e with (4) branch circuit:. OWNER: BENZ, WILLIAM J, PHONE #: CONTRACTOR: CARRICK ELECTRIC PHONE #: 603-591-8474 Inspection Request Scheduled For: Date: 4/2/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 109 Electrical final 067674.01 503-708-0836 N Corrections /Comments /Instructions: N1 v o , \ I" > -M . -. Ate ii-P. _,( S g-A Daiz_._ .---L---- Es' —1, 1.1 b- --s ,,„ ,4_, s ,-./.4 . i.- . -.----, . i i .. ,._ ,,, _,,,, :ter –' III -- • ❑ PASS / ' ARTIAL APPROVAL ❑ CANCEL ,/a NO ACCE 4 :far '� CALL g ' N 111 ADDITIONAL FEES ASSESSED I/k Inspector: ■— Date: Phone #: (503) 718- U p ----••■■ 10 • . CITY OF TIGARD BUILDING DIVISION PERMIT #: C=I_C2007 Jr17t3r3 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/260007 7 Phone: (503) 639 -4171 Ave Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 11/27/2007 TIME: 7:01AM PAGE: 24 SITE ADDRESS:. 11066 SW KATHERINE ST CLASS OF WORK: SUBDIVISION: LERON HEIGHTS NO.3 LOT #: 07G TYPE OF USE: PROJECT NAME: BENZ DESCRIPTION: (1) service with (4) branch circuits. OWNER: BENZ, WILLIAM mi l, PHONE #: CONTRACTOR: CARRICK ELECTRIC PHONE #: 503- 591 -8474 Inspection Request Scheduled For: Date: 11/27/2007 Pour Time: Code # Inspection Description Confirm #� Contact # Message 120 Electrical rough. in 060312 -01 \ 503 -591 -8474 N Corrections /Comments /Instructions: R PASS ❑ PARTIAL APPROVAL - ❑ CANCEL ❑ NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G--1 0 v e) Date: u Ili O') Phone #: (503) 718- 71410