Permit CITY OF TIGARD ELECTRICAL PERMIT
• PERMIT #: ELC2008 -00530
COMMUNITY DEVELOPMENT DATE ISSUED: 9/11/2008
TIGA 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133CC-70071
SITE ADDRESS: 14160 SW BARROWS RD 1 ZONING: R -25
SUBDIVISION: SCHOLLS VILLAGE CONDOMINIUMS LOT : 7 -1 JURISDICTION: TIG
PROJECT: WALLIS
Project Description: (1) branch circuit.
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: 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:
LISA WALLIS SUNSET HEATING & COOLING
14160 SW BARROWS RD #1 0607 SW IDAHO ST
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: 503 - 250 -2002 Contact #: PRI 503- 234 -0611
•
FAX 503 - 234 -0439
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 9/11/2008 $46.85 LIC 161085
[TAX] 12% State Surchar 9/11/2008 $5.62 SUP 4638S
Total $52.47 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.
• INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: &tcd X)y - cxj53t) REQUIRED ON GREEN INSPECTION CARD.
✓' Code Inspection Description PASS Date I By ✓ Code I Inspection Description I PASS Date By I
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 k"` 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
910 Sprinkler rough in PLM - Plumbing Permit
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test
995 Misc. inspection: 315 Post /beam plumbing
320 Plumbing rough -in
998 Alarm final
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
CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2008 -00530
COMMUNITY DEVELOPMENT DATE ISSUED: 9/11/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S 133CC -70071
SITE ADDRESS: 14160 SW BARROWS RD 1 ZONING: R -25
SUBDIVISION: SCHOLLS VILLAGE CONDOMINIUMS LOT : 7 -1 JURISDICTION: TIG
PROJECT: WALLIS
Project Description: (1) branch circuit.
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: W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st WIO SRVC OR FDR: 1 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:
LISA WALLIS SUNSET HEATING & COOLING
14160 SW BARROWS RD #1 0607 SW IDAHO ST
TIGARD, OR 97223 PORTLAND, OR 97239
Phone: 503 - 250 -2002 Contact #: PRI 503 - 234 -0611
FAX 503 - 234 -0439
FEES
Description Date Amount Reg #: ELE C117
[ELPRMT] ELC Permit 9/11/2008 $46.85 LIC 161085
[TAX] 12% State Surchar 9/11/2008 $5.62 SUP 4638S
Total $52.47 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.
, -,
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Electrical Permit Application" • ilm()I-1-14 1 1 1 ,,\I ,
. ,
, .
III • : . City of Tigard .. . . Received -- APAL ,, 114. Permit No.: - , - 4' .. I.*
13125 SW Hall Blvd., Tigard, OR 97223 „ , - - • -,--y ', ,, -''', pianR .” w
16 Phone: 503.639.4171 Fax. 503.59061) V '', - ;., 4 '-'-'-- ' ( -2 ' ';--'' ' '-}} Didejl e
Other Permit: L c , . ..,, _ ,e 0
Tit i. Inspection Line: 503.639.4175 - n r: F ;,- g C\: e: ' ( c , 7R c."=',; Dine Ready/By: GS Sa Page 2 for
i..a Internet: www.tigard-or.gov ' -,): , ' • '. \ '-' ' ' ' -; .`"' ' Notified/Method:
IMINI Supplemental Information
, r'ner,:.iI:;V: ' :" : ,. .. 7 E+ 17 ' ,41, Vrl f.A I . ';';;;X:".. - 'W . ;;ZIII'r.7 - 1 .- 7.: 7 1iTn'I77, , '‘;'7111nriAlle.n44.')' : - . ,. .. - • • .: ' ' ,;'; :2',I-, :...:. - 3m1.4 . 44 - tay.7...:11.7 , .. , • - : •
.. ..
. ?.: .:;,...-;,:' :1.,•i=..., .- •
0 New construction Addition/alteration/replacement
Please check all that apply (submit X sets of plans w/items checked elow):
2-
0 Service or feeder 400 amps or more 0 Building over three stories.
0 Demolition 0 Other:
where the available fault current 0 Mariztas and boatyards.
! '. ' . .7 l'in31.1. exceeds 10,000 amps at 150 volts or 0 Floating buildings.
0 ,, ,„ ... ..,„„,,,. , „tz. ,,,;;„•.;1„-).„4„.:,...--.....,,-,; • ~.--'‘.' '. - '''4';';;•=t - ', ; ' - ; ' - , ''' '''; less to ground, or exceeds 14,000 0 Commercial agricultural
'0 I- and 2 dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings-
0 Fire purnp. 0 installation of 75 KVA or
0 Multi 0 Master builder 0 Other:
larger separately derived system.
'''''RM11217eli4V2r115"11,7%,;-24117:"Irl";:1K.C.-7::-MCRaL111 7111 l9 E A m dth er tf Y te
o sn tor load of 0 "A", "E", "1-2", "1-3",
. . . : .(
,t 100HP or more. occupancy.
Job no.: Job site address: ._. , i t0 c, :,_:: 1 .-.4. ) , k ,, - v -c ,-._„...>
DISix or more residential units. °Recreational vehicle parks.
City/State/ZIP: — l',. ; : ,..,-; '"; (-. ? - ;,`,. --'.. 0 Health facilities. 0 Supply voltage for more than
0 Hazardous locations. 600 volts nominal.
_
., ) ------ 1 ,
' vice or feeder 600 amps or more
Suite/bldg./apt. no.: . Project name: t ,L::, (., °Ser
.,,( L s ',
OffleSEIMErr..F77-'...7. e
Cross street/directions to job site:
Description Qty. Fee. Total •
New residential single- or multi-family dwelling unit.
Includes attached garage.
Subdivision: .
l Lot no.: 1.000 sq. ft. or less l 145.15 4
Ea. add', 500 sq. ft. or portion 33.40 1
Tax mapiparcel no.:
Limited energy, residential
75.00 2
DESCRIPTION-',..''`,.-,•••,;:..,DtSc44Yrfolii-l*W,o1W ;, [i;:-• ..;; (with above sq. ft.)
. ,
Limited energy, multi-family
75.00 2
1-
residential (with above sq. ft.)
Services or feeders installation, alteration, and/or relocation
. _ 200 amps or less 80.30 2
?,',E".E.c.iii)e4:TE_Filt,0140,.,----..1:;.:.',.-[4.=,:-..,iii:,....w..40.14§4W:alfrOmf.K. 201 amps to 400 amps 106.85 2
,
Name: , : .-. . _
401 amps to 600 arnps 160.60 2
.•
601 amps to 1,000 amps 240.60 2
Address: i t ( ( ,.. ( -1 't,,) Over 1,000 amps or volts 454.65 2
Temporary services or feeders installation, alteration, and/or
City/State/Z1P: "7 i q , ,. -' c ;1 : C f ' , L C.: 1 ' ' T; ., . '
relocation
,
Phone: ( '....,;( -2•27:..7 -..,- 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
S :.'.,:' :',:.;,',-•-• ',-.. a*Prii*AWf; 2f '•• • ,:' , ; '...; tr . `'2„ .-: "ID CONT, '.7,-, .•' if above service or feeder fee,
6.65 2
each branch circuit
Business name:
B. Fee for branch circuits
Contact narne: without service or feeder fee, i
46.85 i Li- :::',-;-. 2
first branch circuit
Address:
Each add'I branch circuit
, 6.65 I 2
N1iscellaneous (service or feeder not included)
City/State/ZIP:
Each manufactured or modular
90.90 2
dwelling, service and/or feeder
Phone: ( )
Fax : ( )
Reconnect only 66.85 2
E-mail:
Pump or irrigation circle 53.40 2
' ,-,* —'' ;`.' ''..1"'' '.1.1:7n," Sign or outline ligh _ ting 53.40 2
Sial e limited-
Business name: Sunset Heating & Cooling go ircuit(s) or
energy panel, alteration, or
Address: 0607 SW Idaho St extension. Describe: Page 2 1 2
City/State/ZIP: Portland, OR 97239 Each additional inspection over allowable in any_of the above
Per inspection 62.50
Phone: (503) 234-0611 I Fax: (503) 234-0439
Investigation per hour (1 hr min) 62.50
CCB Lie.: 161085 i Electrical Lic.: c117 Suprv. Lic.: 1-( S .... Industrial plant per hour 73.75
7 ,,,,,...._Agazga
Suprv. Electrician signature, required: ____•-•1
Subtotal
Print name: Randy Ess i ) Date: , :: 7 1, : k... ,,i;-;-" Plan review (25% of permit fee):
State surcharge (12% of penult fee): 7 .5.; -
Authorized signature: . .40c,-/-Z.----
TOTAL PERMIT FEE: ,f-, - 2 ii
'Ibis permit application expires if a permit is not obtained within 180
Print name: Casey
Wiser I Date: ` ' ! ; i .,':,---.:?.! days after it has been accepted as complete.
•
Number of inspections allowed per permit.
1 \BuildingkPermitsT.LC-PermitApp doc 05/23/06
44 0 4 6157(11/05/ansl/WEB
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City of Tigard
TIGARD Tidemark Refund Request
This form is used for refund requests of land use, engineering and building application fees.
Receipts, documentation and the Request for Permit Action or Refund form (if applicable) must be
attached to this form. Refund requests are due to Tidemark System Administrator by Friday
at 5:00 PM for processing each Monday. Accounts Payable will route refund checks to Tidemark
System Administrator for distribution. Please allow 1 -2 weeks for processing.
PAYABLE TO: Sunset Heating & Cooling DATE: September 22, 2008
0607 SW Idaho St.
Portland, OR 97239 REQUESTED BY: Dianna Howse
Attn: Shauna D'Ambrosia
TRANSACTION INFORMATION:
Receipt #: 2008 -3216 Case #: ELC2008 -00530
Date: 9/11/08 Address /Parcel: 14160 SW Barrows Rd., #1
Pay Method: CreditCard Project Name: Wallis
EXPLANATION: Per applicant's request as customer cancelled job. Refund 80% of permit fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: [BUILD] Permit Fee Example: 245- 0000 - 432000 $ Amount
[ELPRMT] ELC Permit 220- 0000 - 431510 $37.48
[TAX] 12% State Surcharge 100 - 0000 - 207020 4.50
TOTAL REFUND: $41.98
APPROVALS:
If under $500 Professional Staff
If under $7,500 Division Manager `1 `fi t
If under $22,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: I Date: I `- 4 '; J 1 By: 1
1:A Building \ Refunds \ RefundRequest.doc 05 /23/07
• City of Tigard, Oregon • 13125 SW Hall Blvd. • Tigard, OR 97223
•
•
TIGARD
September 24, 2008
Sunset Heating & Cooling
0607 SW Idaho St.
Portland, OR 97239
Attn: Shauna D'Ambrosia
Re: Permit No. ELC2008 -00530
Dear Ms. D'Ambrosia:
The City of Tigard has canceled the above referenced permit(s) and enclose a refund for the
following:
Site Address: 14160 SW Barrows Rd., #1
Project Name: Wallis
Job No.: N/A
Refund: ❑ Check # in the amount of $
® Credit card "return" receipt in the amount of $41.98.
❑ Trust account "deposit" receipt in the amount of $
Notes: Per applicant's request as customer cancelled job. Refund 80% of permit fees.
If you have any questions please contact me at 503.718.2430.
Sincerely,
/(d5717(1
Dianna Howse
Building Division Services Supervisor
Enc.
I: \Building\ Refunds\ Administration \LtrRefund- CancelPermitdoc 01/16/07
Phone: 503.639.4171 • Fax: 503.684.7297 • www.tigard- or.gov • TTY Relay: 503.684.2772
:r• C fl' V O �1 T I (era ± 9 ; 9/24/200s
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, I �Y Itit - SS\V 1 ya);:5i, \i \I
' . - ', ;.:: Tigard. DR 97223 503.639.4171
-
Refund Receipt #: 27200800000000003331 " Y: t i. A' :94-___
Date: 09/24/2008
•
Line Reins:
Case No Tran Code Description Revenue .Account No Amount Paid
ELC200S- 00530 Reversal - [ELPRMT] ELC Permit 220-0000-43 1 510 ( ;7.48)
IiLC2(108-00530 Reversal - [TAX] 12% State Sur 100 -0000- 20702(1 (4.50)
• Line Item Total: ($4198)
Refund:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount I'aitl
Credit Reversal SUNSET HEATING & COOLING 025912 Fax (41
Refund Total: ($41.98)
•
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CITY OF TIGARD
13125 SW lint! Blvd. \: \ :�I
V. I'igant.OR 97223 503.639.4171
Receipt #: 27200800000000003216
Date: 09/11/2008
Line Items:
Case No Tran Code Description Revenue A CCO11111 N ' o Amount Paid
ELC'2008-00530 [ELPRNMT] PLC Permit 2 0000- 4315I(I 46. 85
ELC200$- 00530 [TAX] 12% State Surcharue 100- 0000- 2070?0 5.62
Line Item "total: S52.47
Payments: •
Method Payer User II) Acct. /Check No. .approval No. How Received Amount Paid
CreditCard SUNSET HEATING & COOLING BTT 025911 Fax 52.47
Payment Total: S52.47
•
' Budding Division NOiSIl L A 1,1 I(18
. "! MOLL J�.LIO
r c; �; n Request for Pernnit Action
800Z 61 d 3S
TO: CITY OF TIGARD QaAlgpaa
Permit System .Administrator
13125 SW Hall Blvd., Tigard OR 97223
Phone: 503.718.2430 Falc 503.598.1960 www.tigard- or.gov
FROM: ❑ Owner ❑ Applicant Contractor ❑ City Staff
(cheek one)
REFUND OR Name:
rN VOicE TO: (me""InrEvidaaq SWIM* * t 1 . ti . �* ► 11 ' i
V 0 1 D Mpg Address: uan I (Min ST T
9 o?. cP City /State /Zip: �C _ o
Phone No.: , (5v3) a
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (V):
4 CANCEL PERMIT APPLICATION.
REFUND PERMIT FEES (attach receipt, if available).
INVOICE FOR FEES DUE (attach case fee schedule and explain below).
❑ REMOVE CONTRACTOR FROM PER.MIT (do not cancel permit).
Permit #:
Site Address or Parcel #: 14-t (co 6(LWEv't Rd._ I 1
Project Name: C (a >< /)
Subdivision Name: 504,CA IS V 1 L 111 itot #:
EXPLANATION: r ali CUA A CD\eftla OW CLO f ivi -P
lin°
. ,
Signature: %, 4. t. e _ Date: a' 1 03
• , Print Name: 6V •VI VYMSLik—
aarmairadier
1. The D;.coatot ox Bufcbug Official may xuthoare the =hind of
e) saf fa which was enuatotaly paid of collated.
b) not mote dean 2.0% of the lend use application fee when an sgpiaatlao is withdaso of crnw]ed before say =lea effort bat been op:odt .
c) not mow than BIM of ale tend eat application fee for issued poarrrite.
c) not mots than We of the Wang plan review fee what an application is csocelod Woos any plan taview effort has been exploded.
d) sot more than 80% ache building pmnic Eat lot issued pamtie prior to any inspection requarns
a Refunds will be =rued to the nsiginal Papec in the same method in which payment was tees std. Pleat allow 1.2 weeks fox ptoces ing oefuwda
FOR OFF' CF. ON1. -V
Ric to - Admix: Date Rte to B - : Admire: Date y . a, B',, 7
Refund Processed: Date ' 0,' IffriliMil Invoice Processed Date B
Permit Canceled: Date - .. . Q' '' i. Pale] Ta 4ddesi: Date L
i. Date ` o, Method T • Amount
;\&admx =0 . ' ennWc oncl. Rev OS/24 06
ZO /Z0 39Vd 9NIlti3H 13SNflS 6Et'0t'EZE06 6t:Zt 800Z/6t/60