Permit .V ='° ���� ®� TIGARD
ELECTRICAL PERMIT
�"� °
7
COMMUNITY DEVELOPMENT PERMIT #: ELC2007 -00357
DATE ISSUED: 5/24/2007
vT.i 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S103CD -05300
SITE ADDRESS: 11660 SW TERRACE TRAILS DR ZONING: R - 4.5
SUBDIVISION: TERRACE TRAILS LOT : 014 JURISDICTION: TIG
PROJECT: PETERSON
Project Description: (2) branch circuits for a/c and service outlet.
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 HMI 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:
PETERSEN, DALE STEVEN AND SOHLER ELECTRICAL CONSTRUCTION
LAMBERT, TRACY A 41131 SW BURGARSKY RD
11660 SW TERRACE TRAIL DRIVE GASTON, OR 97119
TIGARD, OR 97223
Phone: Contact #: PRI 971 - 832 -0807
FAX 503 - 214 -6246
FEES
Description Date Amount Reg #: ELE C121
[ELPRMT] ELC Permit 5/24/2007 $53.50 LIC 167949
[TAX] 8% State Surcharge 5/24/2007 $4.28 SUP 594S
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By / .//f/1/, �, Permittee Signature: ..t . A- - 1 �,�-f
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• a. w,.
. ono n a.n aria¢ FOR OFFICE USLC iF Y.:
City of Tigard fv'>�Y 2 Li ltetxivtd
13125 SW Hall Blvd!s"ud. OR 97223
, Tigard. I 2001 r ndtdt3 _ 5 Permit No.. it . _�3e'j
Plan Review �+ T
Phalle: 503.639.4171 Fax 503.59$_ ;960. A =+- »;;ir �l: DatelBy- Other Permit: HEC.20pl•- -00283
Inspection Line 503.639.4175 ` r: , k . j
god ° eV �.- �� Dale o 1 = Sa Pa i for
Irintern= wtvay.ei.ti or_us Na o e[hed.
.. -. El PV C laform>tno
t l _: .. E LAi!1 REVFEW
❑ New construction dditionfalteration /rt:placentent Please check all that apply:
DService ova - 225 amps, comer') QHlsrardous location
Q Demolition ❑ Other:
°Service over 320 amps - rating ❑Buildng over 10.000 st
' CATEGORY ; OF ' CON4*te IQN-:: • ' - : of 1 - and 2 - family dwellings 4 or more new resident "t"� - and 2- family dwelling ❑ Commercialrindttsttial ❑ . Cl Cling
Aeeessoty bui1diit°System over dOD volts nominal units in one snv���•e
❑ Multi- family 0 Master buider ❑ Other:
over thus stories []Feeders. 400 craps or r,
-- -._ 00ccupant load over 99 persons (]Manufactured structure
JOB 'S1TE 1NFORI4IAT[bii Aim - 0iftION ' DEgr=lli plan RV park
Job no.: J Job site addtrss QHtalth -care facility ❑Other-. ciAkiiii I i I ' o re U' S W .T < RRfI C -' ir-IVE Submit 2 s.-ts of plans with any of the above.
City /State/ZIP: / L f} 1` q 7) 2 7 The • above arc not applicable to temporary construction service
Serite/bld a P t no_: ! — : i ' :4 = ..;_- ? ... 7,:' ;
Project rarer- pe - tes-c FSE SC$EDt1r E.
Danalpdon ' Qty. 1 Fm 1 Taal
Cross street/directions to job sit=
New residential single- or multi-family dwelling snit.
Includes attached garage
1,000 sq_ iL or less - 145.15
Subdivision:
1 Lot no_: Ea_ adds 500 sq. R or portion 33.40
Tax map/parcel ha. ;
Limited mcgy, residential 75.00
1...uu 1 energy, non raideutial 75.00
. :. DESCRIP 1ON'OL -.WORK - • ' :: • • . - :' = F+'. -h manufactured or modular
4/c. Sz 2 / - L l "7 / )- /` .i _ dwelling, service and/or feeder 90.90
Services or feeders installation, alterat and/or relocation
Ai
J 200 attars or lea 80.30
::�QlPRO PERTY- OWNER" - , • . : / � - ! � r . - , •Q_cTFVATH'F 201 n 4 z et- - d` 1f 60 amps to 400 amps 106.85
amps to 1. 600 arnps
am 160.60
Name:
j / r l 5 601 amps to 1.000 amps 240.60
L Address it I /O 6 C) ' li✓ - V i1 c - T /( over 1,000 amps or volts 454.65
City /StdtrIZIP: 7;1„2 3 2 only 66.85
c� Tea�or sy services or fenders installation, alteration, and/or
Phone(503) "63 /.-5 6e3 I Fax ( ) ndootion
Owner installation: This installation is be in g made oa property that I own wt>ich is not 200 amps or less 66.85
intended for sale, leas-, ran, or exchange, according to ORS 447,449, 670. and 701. 201 amps to 400 amps 1 33.75
signature _ Owner �� 401 ads to 600 amps 133 -75
Srandrcircuits- new, alteration, or extension, per panel
APPL : - _ .. ...KCT• .P - - . . A- Fee for branch circuits with
+ j
4 I ' 7 serv OT feeder fee, each
Business name: S O F7F747 c-i r « /�
1 ( r..-- r S' Ti branch circuit 6.65
Contact name: B . Fee for braneb =cults C
Tn •e_. .5 , k � with.. service or feeder fee, ' y ∎9
Address_ L7/11?( S - p .-' J J each branch circuit
4 6.85 k
E� `4 Y 4 4r - C k f / �/ each
add'! brandy deem[ 1 6.65 ��
City/Statc/ZIP: (rr 4n rt./ / U 7 ? � NriseeiIaneous (serviec or feeler amt included)
Phone ( x 171) ?� _op G Fax:: (56 ) Pump m- iSTal taboo Bade ! 53.40
Sign or outline fighting 53.40
E-mail: Signal eircuit(s) to limited-
•
- CUkt2RAC]? o* ? -, = energy panel, alteration. or
Business natter 1 jr", C . S J extension_ Desetbc Page 2
So 4 Ica? Eie, G7 e.e� Co I-
Address: Erich additional Inspection over allowable in any of t he above
Per City/State /ZIP: 1 6250 f f
Investigation per hour ft br min) 62.50
Phone ( ) Fax: ( ) Industrial plant per hour J 73.75
Lie.: (� 7 ` - •. r - - - = - rxE(.'TFtiCAL PEitivSTr F'
GCB 1
I 9y r El ectoral Li L r:. t 1 Snpry: Lie.: ft_ ,. Subtotal S
Strprv_ Electrician signature, of p
Plan review (25
regrind j •' Y /
/ � r y1� a l �j`/ �-�(25permit fee)
reamer: i r 1/ j f ' C• Lf fie: f \J State surcharge (8% f
Print � - �
Authorized signature: 1'e., n A/1
TOTAL PERMIT FEE S 7 / tj
,(�� j This permit application expires if a permit is not obtained within 180
Print name: 1� days after-It been accepted u complete
5 Ni. h-e - s S d LIZ- � • Fee raethadotogy set by Tri.county Building industry
Nato +ber a Service Hoard
rmpcamtas per per mit allo
4 n. 7 GiestPm*dut1:l.GPerarAva.,roe 17N7 .unycrc,•........, .+..,....R
Z'd BLOT- SB6 -EOS JeigoS eo[ eBT =60 LO bZ R