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Permit CITY OF TIGARD ELECTRICAL PERMIT ° PERMIT #: ELC2008 -00260 COMMUNITY DEVELOPMENT DATE ISSUED: 5/8/2008 T I G ARP • 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 134DD -01500 SITE ADDRESS: 11777 SW TIEDEMAN AVE ZONING: R - 4.5 SUBDIVISION: LOT : JURISDICTION: TIG PROJECT: VAN DOORNINCK Project Description: Modifying (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: SIGNAL/PANEL: 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: 3 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: WOLTER VAN DOORNINCK CROWN VOLTAGE 6555 SW DALE AVE 12607 NE 199TH ST BEAVERTON, OR 97005 BATTLE GROUND, WA 98604 Phone: Contact #: PRI 360 - 666 - 0995 FAX 360- 666 -4673 FEES Description Date Amount Reg #: ELE 37 -984C [ELPRMT] ELC Permit 5/8/2008 $66.80 LIC 153934 [TAX] 12% State Surchar 5/8/2008 $8.02 SUP 41 16S Total $74.82 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: ty "�,j � � Permittee Signature: � C 7,Z2e 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. May 06 08 04 :04p CROWN,y0LTRGE, INC. 1 360 666 4673 p.2 . � qrn^� - p /f... _ ._. t� IV�^1 7 0 � � i,� , r,' � ,' S d'�e.l�'� `Y ,Electrical Permit Application a CUOu ? ? ! � k , �", ti;y 1t Massive. / I4rmit No / > u -0076 v • 1y F. City of `T t , ��, Date/11v (o • • Ti ,� { 13125 SW Hall lllvd,. ftt;ard, OR 972; 3 r 7 Y pl an It , :vi cw Other Permit: Permit: � (� � U(�� �� t . _ Phone 503,63)4171 Pax: 5O3.59f{, - 1960 , ;:i alNtiy: ... t' 1 111 .,, „ ..4, ction Line: 503.639.4175 Date Ready /By: Juris: Id Ste Paw for •T;) G A 1t D' N niilitvUMcdxxl tiupplemcnad Information . Internet: www.ugard -orgov _ TYPE OF WORK PLAN REVIEW Please :.heck a ll Uiat apply (submit 2 sec: ul plaits w/itemx t:hccked 6rlaw): ❑ New construction N ig AdJilirnUaltcratiurt /rcplaCCrecnt O Sp or Ibetici 400 amp!: or mote 0 building over i lice stories. ❑ Demolition ❑ Other: what; the available fault current ❑ Marina. ed boalynrtis exccwt. 10,000 amp'; 11 150 volts or ❑ Hearing buildings. C.�7 "1 ?CORX OF CONSTRICTION fCTiON less to rionod, or exceeds 14.000 ❑ CommerciaLu:e agrieultnnl P% - and 2 fainity dwell Mr, 0 Commercial /industrial ❑ Accessory building amps for all other installation... hu,tchnts. 14m pump. ❑ installation of 75 KVA of ❑Multi- I :rmily Q Master builder ❑ Other_ ❑ Lmatxncy systrm lartycr sry.mucly derived syslEnt. - JOB SITE INFORMATION AND LOCATION ❑ Addition of new motttt hu:,d of ❑ "A" "I'” 1.2" "I - � . I OnFll' or ntaro. occupancy. Job no,: Job site address: Ukl -?- SW 1 (k [] Six or more residential units. ❑ ItCCrc.lrurc,L W111CIC pole:. 1 1lcafth cane lieilitit5. ❑Supply vuh; r for 1110M thin - " ❑ 600 .Mils nominal Ci1,yrStatC %LIP: 1 t [ u:,tlntts lot „vn::: : _. Suite /bldg. /apt. no.: R Project name: ❑ Sery cc .. .fCCdCr 6110 amps or hoary', FEi? SCHEDULE . Cross street/directions 10 job site: utye ^prig, _ . r t - .1 ...!`” i -Tool 1 - - • - -- New residential single- or multi- family dwelling unit 'vehicles attached garage. _ .ot no.: 1,000 sry, ft, or less 145.15 . Subdivision: .... ,.. Ea.:Kul 500 sq ft. or pOnion 33,40 1 Tax map /parcel no.: Limited cmrgy. lesidential 75.00 2 - - •—' • - with sht" It. ) DESCRIPTION OF WORK _� `.,. : „._._. .. - -- ^^• Limited energy, multi - family C‘----14.. t . �� 1 �• residertli■,I (will: :26.)w sit. ti.) 75.00 L. " Services or feeder's installation, alteration. »udtnr rcl0tplipn 20_0 amps or ICSS _80.30 2 g-'Pj20PER TY OWNER 0 TENANT _ 201 mops to 400 amps 106.115 2 -- \ ` 401 amps to 600 tarp, 160.60 2 Name: v - • ��� \ r � GU1 amps to 1.000 amps 240.60 '- Address: Over 1.000 amps or volts 454.65 2 __. Temporary services or feeders installation, alteration, anti / or City/Stale/7 __relocation Phone: ( ) fax: ( ) 200 amps or Icss 60.1{5 l t 201 amps to 400 amps 100.30 2 Owner installation: This insudlation is being made on property that 1 own which is not intended for gale, lease, rent, or exchange, according O]t 447, 449, 670, and 701. 401 amps to 59') amps 133.75 2 13riinch circuits -- new, alter »lion, or ext cnsinn, per panel Owner sIpnatlir( llatC: __. -.._— A. Fcc loo branch circuits with ® APPLICANT ,•.. iI © CONTACT PF,11.4ON above service or feeder fee, 6,65 1 2 _ ,. 1 .. ._,, ..._..._ - each branch circuit .. Business name: CROWN VOLTAGE, INC. — B. Pee for branch circuits .. • without service or feeder fee, i Contact ,tame: STACY l int brooch Circuit 46, � 2 Each tidd'I hr:atch circuit 3 6 - • - . .6� / Address: . ,..._ _. MisccllauMru3 (service Ur feeder not inCltated) - .. City /State /ZIP: Each manufactured or :nodular 90.90 - ..,_ dwelling, urvice anti /or feeder Phone: ( ) I Fax :: ( ) Reconnect only 66.85 2 f. -mail: Pump or irrigation circle 53,40 I 2 CONTRACTOR Sign or outline lighting 53.40 2 Sign t:irewl(s) or hmnc - Business name: CROWN VOLTAC INC. energy panel, alteration, or , extension. Describe.: Rage 2 2 Address: 12607 NE I99 STREET City/State /ZIP: BATTLE GROUND, WA 98604 Each additional inspection over »Ilnwablc in sins of the shove_ -. Per inspection _ 62.50 Phone: (360) fi/ifr -0995 I Fax: (360) 666 -4673 investigation per hour (1 hr min) 62,50 IIIE C('R Lic.: 143934 Electrical Lie.: 37-984 Suprv. Lic.: 41165 Industrial plant per hour - 73.75 1_..' ELECTRICAL PERMIT FEES -- Suprv, f>lectrician signature, required :6 — subtotal: ( • (p. U hurt review (25% of permit fee): Print name: MARGARI:1' HOWES D'art: 1 �l Sta / ! surcharge (12% Orpermil fix). i Autborircd signature: _ (OTAL PLItMI 1' 1:E11: ` ' �/ I e 't hilt pCrrnir application expire. if »permit is nal ()Wined within 1 0 CITY OF TIGARD BUILDING DIVISION PERMIT #: EL C2008-00260 0S)260 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/8/2008 • Phone: (503) 639 - 4171 "`,,,i, il' Inspection Requests (24 Hrs.): (503) 639 -4175 .*. .` "L INSPECTION WORKSHEET FOR DATE: 9/25/2008 TIME: 7:0t)AM PAGE: 42 SITE ADDRESS: 11777 SW IIEDE :MAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: VAN DOORNINCK DESCRIPTION: Modifying (4) branch circuits. OWNER: VAN DOORNINCK, WOLTER PHONE #: CONTRACTOR: CROWN VOLTAGE PHONE #: 3 - Go.,666.0995 Inspection Request Scheduled For: Date: 9/25/2008 Pour Time: Code # Inspection Description Confirm # v' Contact # Message 199 Electrical find) 075879.01 360.666 -0995 N Corrections /Comments/ Instructions: V ��� PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS ri FAIL ❑ i ALL FOR INSPECTION ADDITIONAL FEES ASSESSED ,i,c 1I - Ins e ctor: Date: Phone #: 503 718 p ( ) CITY OF TIGARD BUILDING DIVISION PERMIT #: E-_t..t;2006 00260 13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: S fl3 /2006 Phone: (503) 639 -4171 A� Inspection Requests (24 Hrs.): (503) 639 -4175 W F'__.. INSPECTION WORKSHEET FOR DATE: 91/13/2008 TIME: 7 :00AM PAGE: 12 SITE ADDRESS: 11777 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: VAN DOORNINCK DESCRIPTION: Modifying (4) branch circuit=:. OWNER: VAN DOORNINCK, WOLTER PHONE #: CONTRACTOR: CROWN VOLTAGE PHONE #: 360-666-0995 Inspection Request Scheduled For: Date: 9/18/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 075632 -01 360-666-0995 N Corrections /Comments/ Instructions: vto 411kLL ate-- biev i cits. Q.NeRs 2. C- o I A C-UMEA 1 j W itA `l o' I ZZ$ N) Ai* GT1434 &Ld eNag.. Qcb•■ PK -40'0 ; 0 The electrical installation defects noted on this report shall be corrected and an inspection request made within 20 calendar days per OAR 918- 271 -0030 n PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS . 7& FAIL ACALL FOR INSPECTION ADDITIONAL FEES ASSESSED s Inspector: • N ®k3 L Date: Q l 1) Phone #: (503) 718- Plifkl CITY OF TIGARD BUILDING DIVISION _ PERMIT #: E 02008.00260 13125 SW Hall Blvd., Tigard, OR 97223 • DATE ISSUED: 5/8 /2008 Phone: (503) 639 -4171 f�l Inspection Requests (24 Hrs.): (503) 639 -4175 s�' P•__. INSPECTION WORKSHEET FOR DATE: 9/5/2003 TIME: 7 :00AM PAGE: 27 SITE ADDRESS: 11777 SWTIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: VAN D00RNINCK DESCRIPTION: Modifying (4) branch circuits. OWNER: VAN DOORN)NCK, WOLTER PHONE #: CONTRACTOR: CROWN VOLTAGE PHONE #: 360 Inspection Request Scheduled For: Date: 9/5/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Elecfical final 075111 -01 350.066.0995 N Corrections /Comments /Instructions: l ', ci5 [LaQ• De- 5TI jvvi`p I N d The electrical installation defects noted pANZL, on this report shall be corrected and an inspection request made within 20 calendar days per OAR 918- 271 -0030 $y -- e 6 LL F` x! Van - AT I6®• 3 � � Q)--r.seetitiElt ft, L-_ F1 %Tv► '• - m. II0..3() M■ I xr3%) 0 G -F -- P '►; o ;N 80 R©o■ • ;og 1-.z. tk:4 bev► 10 per.. F 64 wiksl L nria ssi N : b•N P U chi(' , aeciv GJ-l: b . .20 (M s. Lecrlac . ..51c4,6 - mss- LAtftlg • `f pNi\t■‘ 1'a I if . K. -- 106T127 NI , ❑ PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS FAIL A CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: GM N U ) Le Date: q.,5 A Phone #: (503) 718- Vi% CITY OF TIGARD BUILDING DIVISION PERMIT #: Et..c2oos- on26() 13125 SW Hall Blvd., Tigard, OR 97223 .7 . . ' DATE ISSUED: utiy:.).000 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 1 .1.. INSPECTION WORKSHEET FOR DATE: 5/14/2008 TIME: 7:04AM PAGE: 19 SITE ADDRESS: 11777 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: VAN DOORNINCK DESCRIPTION: Modifying (4) branch circuits. OWNER: VAN DOORNINCK, WOE rER PHONE #: CONTRACTOR: GROWN VOLTAGE PHONE #: 360-666-0995 Inspection Request Scheduled For: Date: 51 1 4 12000 Pour Time: Code # Inspection Description Confirm # Contact # Message 126 Wall cover 069872-01 360-666-0995 N Corrections/Comments/Instructions: ( 1 A / ' / d 4 .,„_/ . , Tri / • 1 41, Am 1 ' ,---- 4 ( .. .6 . I V PASS fl PARTIAL APPROVAL fl CANCEL I NO ACCESS MIL El CA L FOR INSPECTION Ill ADDI IONAL ES AS ESSED 1 : , & Inspector: '4 /: Date: , _ hone #: (503) 718- . . I . . CITY OFTIGARD BUILDING DIVISION = • PERMIT #: ELC20016- 002.60 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 502006 Phone: (503) 639- 4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . ��; ``'I INSPECTION WORKSHEET FOR DATE: 519/2006 TIME: 7:00AM PAGE: 36 SITE ADDRESS: 11777 SW TIEDEMAN AVE CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: VAN DOORNINCK DESCRIPTION: Modifying (4) branch circuit.. OWNER: VAN DOORNINCK, WOLTER PHONE #: CONTRACTOR: CROWN VOLTAGE PHONE #: 360- 66G 0096 Inspection Request Scheduled For: Date: 5/9/2008 Pour Time: Code # Inspection Description • .. # Contact # Message 7 125 Wall cover , 169639.01 360 - 666.0995 \ Y Corrections /Comments /Instructions: T A— c,6rnan E®2 J.64.- 6 _ K. E k %' V w Nt L. 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