Permit .,1G � ,,?;,.q, CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00865
COMMUNITY DEVELOPMENT DATE ISSUED: 12/27/2007
TiGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 103AA -01911
SITE ADDRESS: 10515 SW JOHNSON ST ZONING: R -4.5
SUBDIVISION: COTTONWOOD PLACE LOT: 018 JURISDICTION: TIG
PROJECT: DIAZ - CORTEZ
Project Description: (2) branch circuits for kitchen remodel.
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: WISERVICE 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:
ALEJANDRO DIAZ - CORTES OWNER
10515 SW JOHNSON
TIGARD, OR 97223 .
Phone: 503 - 309 - 3540 Contact #:
FEES
Description Date Amount Reg #:
IEI.,PRMTI ELC Permit 12/27/200' $53.50
(TAXI 8% State Surcharge 12/27/200' $4.28
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. _ - • 1 800.332.2344.
Issued By:
42‘, .dam Permittee Signature: . 4 /
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.
El .4 i r .
Electrical Permit App n '` � " ' ` FOR o u sE o
- � ° • V Received � : , . - '� .
City of Tigard Date/By: a Q Permit No.:
; - 2
1 3125 SW Hall Blvd., Tigard, OR 97223 , y 0/ 7 / 7 C �7 —��6 5
. g 200 Pl an R eview
Phone: 503.639.4171 Fax: 503.59 I� �O 1 Other Permit:
DateB
T I G n R D , • Date Ready /By: lur s: la See Page 2 for
Inspection Line: 503.639.41
Internet: www.tigard- or.gcil 1 tar t iut>`/
ti � T Notified/Method: � SupplementalInformation
�(1/ DI VISION PLAN REVIEW
❑ New construction ❑ dltion/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
❑ 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 ", "1 -2 ", "1 -3 ",
Job no.: Job site address: / 0,5" AS- d S 100HP or more residential occupancy.
4 ❑ Six or more residential units. ❑ Recreational vehicle parks.
/ZIP
/S
Cit
❑ Health -care facilities. ❑ Supply voltage for more than
City/State/ZIP: ) ❑ Hazardous locations.
y 1-4,./ Qj� � O 1; � � Z 2- � 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ 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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF .WORK (with above sq. ft.) 75.00 2
' Limited energy, multi - family 75.00 2
k 14C r7 r"- 4C t c.sr O C -- LA �+� J -S' O - residential (with above sq. ft.)
`e Services or feeders installation, alteration, and/or relocation
I'_° f eC `< << c _,, tor 'C 200 amps or less 80.30 2
PR • OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: A(....\ q 4 b ' ■ et Z — C___0 k--"kc-._.S
. \��- 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: / 9 - / . S > $ . ( a , �• t Over 1,000 amps or volts 454.65 2
City /State /ZIP: C / ��� / -
r / `T � Temporary services or feeders installation, alteration, and/or
/ zZ relocation
5
Phone: ( _c p y 3sS/ Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is r i • made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent .t ,.!•.• • ording to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
��� r Z Branch circuits — new, alteration, or extension, per panel
Owner signature:�, = Date: O2 A. Fee for branch circuits with
❑ APP •1' ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee, /
first branch circuit 46.85 /,lj 2
Address: Each add'l branch circuit / 6.65 4,,.6. 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 Sign or outline lighting 53.40 2
Business name: Signal circuit(s) or limited -
energy panel, alteration, or
Address: extension. Describe: Page 2 2
City /State /ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( ) Investigation per hour (I hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal: t. 3 , 51)
Print name: Date: Plan review (25% of permit fee):
State surcharge (8% of permit fee): 4. � —
Authorized signature: TOTAL PERMIT FEE: c ?•'7
This permit application expires if a permit is not obtained within 180
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(tt/05 /COM/WEB
Electrical Permit Application - City of Tigard
Pagel - Supplemental Information
i ,
LIMITED ENERGY PERMIT FEES:
'RESIDENTIAL.WORK ONLY:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved:
n Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other:
4 COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918- 260 -260) •
Check Type of Work Involved:
❑ Audio and Stereo Systems
❑ Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ 'Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
❑ Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for 'all other installations
I: \ Building \Permits TLC-Permit App.doc 03/23/06
i j, a CAL PERMIT
ill
OF CARD
PERMIT #: ELC2007-00865
COMMUNITY DEVELOPMENT DATE ISSUED: 12/27/2007
'.TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 '503.639.4171
PARCEL: 2S103AA -01911
SITE ADDRESS: 10515 SW JOHNSON ST ZONING: R -4.5
SUBDIVISION: COTTONWOOD PLACE LOT : 018 JURISDICTION: TIG
PROJECT: DIAZ - CORTES
Project Description: (2) branch circuits for kitchen remodel. ADDING (7) ADDITIONAL BRANCH CIRCUITS FOR WORK ALSO
TAKING PLACE IN BATHROOM AND GARAGE.
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: 8 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:
ALEJANDRO DIAZ - CORTES OWNER
10515 SW JOHNSON
TIGARD, OR 97223
Phone: 503 - 309 -3540 Contact #:
FEES
Description Date Amount Reg #:
(ELPRMT] ELC Permit 12/27/200' $53.50
j "I'AX] 8% State Surcharge 12/27/200' $4.28
IELPRMT] ELC Permit 1/4/2008 $46.55
(additional fees not listed here) REQUIRED ITEMS AND REPORTS
Total $109.92
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 -001 • 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.
y: ,..09,00,- /
Issued Permittee Signatur
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.
CITY OF TIGARD
BUILDING DIVISION Is
PERMIT #: ELC2007 -0()8 65
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/27/2007
Phone: (503) 639 -4171 *to ^;irc',la�l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/2/2008 TIME: 7:O0AM PAGE: 13
SITE ADDRESS: 10516 SW JOHNSON ST CLASS OF WORK:
SUBDIVISION: COTTONWOOD PLACE LOT #: 018 TYPE OF USE:
PROJECT NAME: DIAZ- CORTES
DESCRIPTION: (2) branch circuits for kitchen remodel. ADDING (7) ADDITIONAL BRANCH CIRCUITS FOR WORK
ALSO TAKING PLACE IN BATHROOM AND GARAGE.
OWNER: DIAZ- CORTES, ALEJANDRO PHONE #: 503308.3640
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 0(,7746-01 503 - 300 -3610 N
Corrections /Comments/ Instructions:
6rc 04,u310 1,41-41-A rh) ),& wet remuii
Coro(444 61-41497 atAi co-vautky Awr,
/
i ] PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CA L FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718 -
CITY OF TIGARD ` -- ,---`
O
BUILDING DIVISION � ilk PERMIT #: ELC2007.00665
13125 SW Hall Blvd., Tigard, OR 97223 n� DATE ISSUED: 12/27/2007
Phone: (503) 639 -4171 I""b „ .iIJI&
Inspection Requests (24 Hrs.): (503) 639 -4175 s' ": _..
INSPECTION WORKSHEET FOR DATE: 411/200F3 TIME: 7:01AM PAGE: 24
SITE ADDRESS: 10516 SW JOHNSON ST CLASS OF WORK:
SUBDIVISION: COTTONWOOD PLACE LOT #: 0113 TYPE OF USE:
PROJECT NAME: DIAZ-CORTES
DESCRIPTION: (2) branch circuits for kitchen remodel. ADDING (7) ADDI 11ONAI. BRANCH CIRCUrIs FOR WORK
ALSO TAKING PLACE IN BATHROOM AND GARAGE..
OWNER: DIAZ- CORTE.S, ALEJANDRO PHONE #: 503-309-3540
CONTRACTOR: OWNER PHONE #:
1
Inspection Request Scheduled For: Date: 4/1/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message 0 �nn
V 0
120 Electrical rough-in 067G4R -01 50;332.9 -9704 N 1
Corrections /Comments / Instructions:
14 1 � /
/
4 .: e / a t�il /, ..1111.0 �• 'O/ %s Q .- . / / 1
• o •
- _ J -- .” "...",,,A L' ./ 6 1 d 4 4 � - 11).1 A 2/ , e, ., � r /
X ' I _ /ii I 4 4 /. .I 1f'-te ' g LL 1 ;r / e; _ / 4 / — ■
�' DIM r
•' '1 i i , MTT�1 il
J. Plignir
?)\A c litV/if 1900/11 Zv t pe,,,,,J h
, lic\i2Amiid tipip` naiiitv-o-isf\
1
ta'ASS ❑ PARTIAL APPROVAL ❑ CANCEL f NO ACCESS
FAIL CALL FOR INS CTION
1. � ❑ ADDITIONAL FEES ASSESSED yvei •
Inspector: - �� ' - 4 6 +'ti dtp Date: ii.' Phone #: (503) 718 -- A
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007- 00865
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/2/12007
Phone: (503) 639-4171 .1,P. V
Inspection Requests (24 Hrs.): (503) 639-4175 ...— ---.
INSPECTION WORKSHEET FOR DATE: 1/1W20013 TIME: 7:00AM PAGE: 12
SITE ADDRESS: 10515 SW JOHNSON ST CLASS OF WORK:
SUBDIVISION: COTTONWOOD PLACE LOT #: 010 TYPE OF USE:
PROJECT NAME: DIAZ
DESCRIPTION: (7) branch circuits for kitchen ren lode]. ADDING (7) ADDITIONAL BRANCH CIRCUITS FOR WORK
ALSO TAKING PLACE IN BATHROOM AND GARAGE.
OWNER: DIAZ-CORTES, AIEJANDRO PHONE #: 503-309-3540
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1/10/2008 Pour Time:
Code # Inspection Description Confirm if • Contact # Message
120 Electrical rough-in 062974-01 503-305-3540 'V
Corrections/Comments/Instructions:
(
„2----------„
____----
)cl q-
0 PASS 01 PARTIAL APPROV' D CANCEL ill NO ACCESS
FAIL III - , 0 - INSPECTION 0 ADDITIONAL FEES ASSESSED
—
Inspector: Al(\t3L. Date: 1 -1 '() 'Q Phone #: (503) 718- 1_.4f
CITY OF TIGARD
BUILDING DIVISION 1 PERMIT #: ELC2007.00865
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 17J27/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/8/2008 TIME: 7 :01AM PAGE: 15
SITE ADDRESS: 10515 SW JOHNSON ST CLASS OF WORK:
SUBDIVISION: COTI ONWOOC) PLACE LOT #: 018 TYPE OF USE:
PROJECT NAME: DIA7_ - CORTF S
DESCRIPTION: (2) branch circuit for kitchen remodel. ADDING (7) ADDITIONAL IONAL BRANCH CIRCUITS FOR WORK
ALSO TAKING PLACE IN BATHROOM AND GARAGE.
OWNER: DIAZ-CORTES, ALEJANDRO PHONE #: 503 309 - 3540
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 1f13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electhical rough-in 062768 -01 503- 309 -3540 N
Corrections /Comments /Instructions:
Wt+t..NQ• t b- CM' -
6 S z trZwc.4.1)• K tiAgiNN c-nvoT rocs
Na
- ilk , s i N 60 4 5 Fes. E1.1571
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6.68 L Date: 44a O"4 Phone #: (503).718 - 2 1ik