Permit 1 a CITY OF TIGARD ELECTRICAL PERMIT
11111 " PERMIT #: ELC2009 -00030
COMMUNITY DEVELOPMENT DATE ISSUED: 1/21/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114AB-13600
SITE ADDRESS: 16245 SW 93RD AVE ZONING: R -4.5
SUBDIVISION: KNEELAND ESTATES NO.2 LOT : 111 JURISDICTION: TIG
PROJECT: GURGES
Project Description: Install (2) branch circuits for hot tub and service receptacle.
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: 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: et Contractor:
CAR
CAR
C (4,1_1_ 1..-r-, �I k.�
"4��}w��T
, BEAR ELECTRIC
162D AVE ita_it5 eve qs# A.0 t P.O. BOX 389
TIG 97224 DONALD, OR 97020
"11" 02 97y1y
Phone: Contact #: PRI 503 - 678 -1355
FAX 503 - 678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
[TAX] 12% State Surchar 1/21/2009 $6.42 LIC 20919
[ELPRMT] ELC Permit 1/21/2009 $53.50 SUP 488IS
Total $59.92 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: 1 _ 1 � . i P ermittee Signature: . , =�1 � . `k
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.
01/21/2009 WED 9:59 FAX 5036781108 Bear Electric. Inc. a 001/002
•
RECEIVED
Electrical Permit Application • - FOR OFFICE!UgEONLY!
: - City of Tigard JAN 21 2009 Received . •
" 13125 SW Hall Blvd., Tigard, OR 97223
1 : . Phone: 503.639 4171 Fax: 503 598.19
I I CITY OF TIGARD a ,
p p i ai n e-t R 3 ,iew - 2 1 • act ....A Permit No,: C i 0
Date.By: Other Permit
TIGARD BUILDING DIVISI Read B y :
Inspection Line: 503.639.4175 torts: El See Page 2 for
J. ..._._
' . Internet: www.tigard otifiediMethod: Supplemental Information
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„, . . ...,, . ..,. ...
• . TIT of.18.o% ...,... - - -...: . ....:•-q . : - ---- - - . • "iiiWidilfek•
•. . '. . . - . .
0 New construction )Kddition/alterati on/replacement Please check all that apply (submit 2 sets of plans wlitems checked below):
• 0 Service or feeder 400 amps or more 0 Building over three stories
0 Demolition 0 Other: where the available fault current 0 Marinas and boatyards. .
. ....... . ,.. - . - .
&,:kik4W:61t• .. - ...-.: • .. exceeds 10.000 amps at 150 volts or 0 Floating buildings. •
'''' '. --'' less to ground. or exceeds 14.000 0 Commercial-use agricultural
; al - and 2-family dwelling 0 Commercial/industrial 0 Accessory building amps for all other installations. buildings.
CI Multi-family 0 master builder 0 Other: 0 Fire pump, 0 Installation of 75 KVA or
. JOB Sat INFO INKELQN AND LOCATION - .
.. . 0 Einergemy system. larger separately derived system.
0 Addition of new motor load of 0 - A - . "E -- I •2'
• . _ .. . .... .. . .. .. „. .
. . . . , ... , . . .
Job no.: Job site address: 1 t L I C . 5‘ C%‘3` Ave 100 inure or more. occupancy.
0 Six or ore residential units. 0 Recreational vehicle parks. .,
City/State/Z1P: Tic c ----1 -22H 0 Health.care facilities. 0 Supply voltage For more than
0 Hazardous locations. 600 volts nominal. .
Suite/bldg./apt. no.: `) Project name: /4-1 1-7 E6k4,-) 7- or feeder 600 amps ot more.
• . : ....' . . : - 1 : • ; - . - ::=; .'• .=
Cross street/directions to job site: Description I gay. -- I Fee. I Total I •
New residential single- or multi-family dwelling unit.
Includes attached garage. ..
Subdivision: : I Lot no.: . 1,000 sq. ft. or less 145.15 4
•
Ea, add sq. ft. or portion 33.40
Tax map/parcel no.:
_ Limited energy, residenti '
al
. .,..,.......,.. 75.00 2
, . ... ,,,.. . I . .
,:'.: .. • - - :. j,; '..,:,', I: ;■;..” ;1„::,■ ,,,,,...„.„„ „..,. (withabc,,,e s ft.) •
Limited energy, multi-family
1-c \ CA---\ \- - V A VD c_iscc ,,k ,...,1-__-a residential (with above sq. ft.) 75.00 2
•
q Services or feeders installation ,alteration, and/or relocation
2
i . 200 amps or less 80.30
•
. .
. ,
u OWN k. -• .• . . • . . 0 -TENiya •.,•'' : 201 amps to 400 amps 106.85 2 ,
..
Name: 401 amps 10 600 amps 160.60
2
•
. 601 amps 10 1,000 stops 240.60 2
Address: Over 1,000 amps or volts 454.65 2
• , City/State/ZIP: Temporary services or feeders installation, alteration, and/or
relocation •
Phone: ( ) 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 10 400 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
...,.. - : ' - • tai=-IttftiCklitt : : .' : ' ''.' ' ,-'-'' ' - • Ci-CONUCPPEASON ".:. ' ' above service or feeder fee,
•
each branch circuit
Business name:
B. Fee for branch circuits
without service or feeder fee,
Contact name: 46.85 tit 2
first branch circuit
Address: Each add't branch circuit k .., 6.65 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 : :Y: : - - ..:,: ..:. Sign or outline lighting 53.40 2
•
Business name:
Signal circuit(s) or limited-
energy panel, alteration, or '
Address: C) BO X o..).0.1 extension. Describe: Page 2 2
City/State/ZIP: DiOnCL\di_OR, °k—ICriC) . Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( 50,3> u 1355 I Fax: ( 503/ 01 5l•__ 1 \ 0 Investigation per hour( to inin)__ 62.50
CCB Lic.: 20c) ic Electrical Lie.: 2:14-)07 Suprv. Lic.: LI 13 iZ Industrial plant per hour 73.75
. i , 7 MECIVCAL. PF,1040
7 FF-E,S-.
Suprv. Electrician signature, required: - ...' .... 4 Subtotal: 53• SO
III ,
Print
name. cfrA CA1,0 r- 2) 1 11 • ' Date: 1-2- t :-C3C1 Plan review (25% of permit fee):
•-• \---r • s---. State surcharge (12% of pconit fee): .. 4
- —
Authorized signature: TOTAL PERMIT FEE O(
This permit .application expires if a permit is not obtained within ISO
Print name: Date: days After it has been accepted as complete.
--
• — • N.,,h,.• it inspections aliened per permit.
I Ittttldttte re+.11tts I I.< •I'cnn Jo: 11: 2 :(• 1.+11-1f I I Oi ( ()NI ktfifi
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CITY OF TIGARD
.-,
BUILDING DIVISION
A, PERMIT #: FLC2009-00030
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 112112009
Phone: (503) 639-4171 I*/ Pi .ill„iiil 1
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2/5/200ri TIME: 7:00AM PAGE: 7
SITE ADDRESS: 16245 SW 93RD AVE CLASS OF WORK:
SUBDIVISION: KNEELAND ESTATES NO.‘ LOT #: 111 TYPE OF USE:
PROJECT NAME: HILDEBRANDT
DESCRIPTION: Install (2) branch circuits for hot tub and service lec..eptacle.
OWNER: HILDEBRANDT, CAROLE PHONE #:
CONTRACTOR: BEAR ELECTRIC PHONE #: 603 1
I
Inspection Request Scheduled For: Date: 2/512009 Pour Time:
Code # Inspection Description _Confirm # Contact # Message
199 Electrical final 080329-01 503.678-1355 Y
I
Corrections/Comments/Instructions:
_.--
. _
• NAM
A\
v,,
c,,, \
,A.,\
7, \
PARTIAL APPROVAL D CANCEL El NO ACCESS
fl FAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: G' i N6(1)L.‘" Date: 1: S Phone #: (503) 718- Wit"
1
CITY OF TIGARD
SUILDIN(a DIVISION PERMIT #: r:t (.;20J3-E10f1 }t1
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/21I2009
Phone: (503) 639 -4171 ���I
Inspection Requests (24 Hrs.): (503) 639 -4175 t_
INSPECTION WORKSHEET FOR DATE: 1/27/2009 TIME: 7:QOAM PAGE: 24 •
SITE ADDRESS: 16245 SW 93RD AVE CLASS OF WORK:
SUBDIVISION: KNEEL AND ESTATES N0.2 LOT #: 111 TYPE OF USE:
PROJECT NAME: HILDI:E3RANDT
DESCRIPTION: Install (2) branch circuit= for hot tub and service receptacle.
OWNER: HILDEk3RANDT. CAROLE PHONE #:
CONTRACTOR: BEAR ELECTRIC PHONE #: ?°.A.)3-.678-13%
Inspection Request Scheduled For: Date: 1/27/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 0799 %01 501873 -1355 \ y
I CU' ■AbE•P.. Cr(Z.b 0 00 1
Corrections /Comments /Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector:. 3' (SL t Date: 1 ' 1-11' 1 Phone #: (503) 718- le7'
CIT ■ OF TIGARD
SUILDINd DIVISION PERMIT #:
•
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639- 4171���tiLC200R- 00030
Inspection Requests (24 Hrs.): (503) 639 -4175 A..._
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: O 2.MS' 6 loo '1 3 A V CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: t. - 2,1 ' Pour Time:
Code # Inspection Description Confirm # Contact # Message
Corrections /Comments /Instructions:
Pbn p,ez. ooD
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
r �
Inspector: `7 r 0e Date: 21 Y* VI Phone #: (503) 718- )-414k