Permit CITY OF TIGARD ELECTRICAL PERMIT
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PERMIT #: ELC2008 -00182
COMMUNITY DEVELOPMENT DATE ISSUED: 4/1/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133CD-10800
SITE ADDRESS: 11674 SW WILTON AVE ZONING: R-25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT : 140 JURISDICTION: TIG
PROJECT: GERDES
Project Description: Installing (1) branch circuit for 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: 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:
DON & SONDA GERDES MCCOY ELECTRIC CO INC
11674 SW WILTON 2014 SE 9TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: Contact #: PRI 503 -234 -7521
FAX 503 -234 -9473
FEES
Description Date Amount Reg #: ELE 26 - 82C
[ELPRMT] ELC Permit 4/1/2008 $46.85 LIC 8277
[TAX] 12% State Surchar 4/1/2008 $5.62 SUP 2175S
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.
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Issued By: / ` Permittee Signature: y�� �� 04/
dolrall
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.
e • 1 It Mar. 31. 2008 12:49PM MC COY ELECTRIC No.4056 P. 1
ia.....0 mass 21 A111 rs.pp FOR OFFICE 1 , ONLY
• City of Tigard C E® Kee7ve
DateBv d O 0 % ermu No.: / -( JI 1
° 13129 `w Hall Blvd., 1'Igard. O 9 3_; pl Rem
C • • . Phone 50, 639 4171 Pax. 503 598.1960 r other Permit
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TJGARD Insptxdonl.ine • 503.639.4175 I)oieReadylBy: lung 0 See Page 2 for
Internet H'ww.ti ardor goy ,- Nontied/Method Supplemental Information
� j � 6 �� j tt - .
. ' . .- .- ..,,,.TYPE`OF a. ; a d ���� -' --' :.:. • - . REVI.AVV.. -
❑ New construction Addition/__. t1' 1 crplac Ph - a., die all that apply (submit I sets of plans , vhtems checked betoa ).
❑ I)etllpli[i0n ❑ Service or feeder 400 amps or more ❑ Building over three stories
❑ Other: where the available fault eurremi ❑ Mannas and boatyards.
`'Ci1TEC�ORY _OE (.ONSTRtJC31fON , -.......::..._::-.m,..7.:::17;::...-: at 150 volts Of C) Floating boor:1ngs.
6,4: 10 grotmd. or exceeds 14.000 ❑ Commercial cultural
1- and 2- family dwelling ❑ Commercial /industrial 1 ❑ Accessory building amps for all nther installation. buildings
❑ Multi - family ❑ Mauler builder ❑ Other: 0 r•rre pump ❑ Installation of 75 KVA or
:i ; .. • " ' o.RM . .., ❑ E inngency c yarnn Israel
4 .44.nr: -.. _ .': .b - , r a TOB ,grx �1N ATIQN " 4' D�' ;OCATION.+ . — ": i -• "k+ -- _ , F. "I -ely derived system
• t:.._ i �: =: ^, ;:.� >: ":: ". :.`.':m.,; ❑ Addinon of new motor load of
Job nu.: D LILL5 Job site address: 100} am more occupancy
❑.iix or more residential units ❑ Recreational vehicle parks
City /State/L1 P: )'
[ LI Li L \ I -y- , 1._\\/- � ❑ Health-me frcilines, ❑ Supply voltage f more dim
) T i v / `... ❑ I lax, rdou. locations 600 volt. nominal
Suite/bldg. /apt. no.: Project name: C • ( ❑ Service m feeder bon amps or more
'i = ;: r s; - ' ; ik s SC:QE IJi. - '` = - = i'- w�; t-' - - -:Sv;
Cross street/directions to job site; Descnpaaa I Qty. t Ta •
New residential single- or multi-family dwelling unit.
includes attached garage.
Subdivision: L.01 no.: 1,(1(10 sq. ft. or less 145 1 5 4
fax map /parcel no,; Ea add'l 500 sq R. or portion 3340
t. ,:: -_raj .:, 14= ii' `f, =. t1,t = }, J.. IJ, 'U> .Rr R Z ;r: , y r r - ` S:: Limited energy, residential 75 (10
c 77 r �,, n
n 1'r ^ ?+ •IN{'i,taa t }r..:,t +r:r�• -d.,. •,.,- , F' +''H , d" ) e = r L�: _rr){1 _ h it,_, -. (w 4th above sq. ft.)
Limited energy, multi - family
` rr ' X & residential (with above sq. ii.) 75.00 2
Services or feeders installation, alteration and/or relocation
200 amps or less 80.30 El
„ _ - tar - -r -
r__: ` a .) tO-ixk y„:,: jl -i r Fp �{;--+ F 1i�,^ :ii =n i __� - n r ,,
: .:. -� .:. ,,.,,, --,�� ,�. t .: - �itl.e �, =r.�1 • T::::��ti - inr, ,, :r �' �1tiE_r!rif �i�{�c �. ;'{�'ly = llr�� , 201 tunes i0 400 amps 106.85 ) 2
Name: , I C C �J (/l (A l l c L V !� �1 -C� C 401 amps to 600 amps 1 60 2
Address: / / /V „� 601 amps to 1 ,0.60 2
l ( / ,� � , '7 _ Over 1,000 amp amps 24s ar volts 454 65 2
City/Stale/ZIP: ^-/ a r-)er)-3 r Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) Fax: ( ) 200 amps or lets 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 stile, lease, rent, or exchange, according to OItS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits- new, alteration. or extension, 'Cr and
r _.. A. Fee for bran circuits with
wr 1
.•,I', , .: glrli •,, a - - -;JC;IY��►�1'- ���, -��+ ; � -- �; �; � 7:: _ ' -"'O'” � - = cc or feeder f e
. +� ' : _ + . r �bYi�s_ . r � � - � � : � 'h ;:�'s r , - _ �FE.S10 - # - above service e,
Business name: /� C each branch circuit
Y - ` � • J ., 4 . a B. Fee for branch circuits
Contact name_ (A without service or feeder fee, 1 46 85 4 '
first branch circuit
Address: c. D . 3 l LA ( . ) t qi`�1 ('i s Each add] branch circuit
1 6.65 2
P25 •(-44 � G � C! Miscellaneous (service or feeder not included
City/State/ZIP: Each manufactured or modular ■
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welling, service and /or feeder
Phone: 90.90 Fax: 1. r,
of ! ' 1 4 73 Reconnect only MI F.- ma M� 6685 ,
Ell
}7 t c - Pum or irrigation c ircle 53.40 El
y r = -,:fga -e, ; '= _ 4. ,;,;- :jl ;(l 3IV 'di?► r, ;; : :,, , ;tai _:K sr- :: ::,'I m=-_ ;`: , Sign oroutlinclig tin 0
Business name: C C� Q , t Si__nal circuitry) or ltmitcd-
Address: r�r'- Jl .1" 'f ie l � exten Describe: Ion or Page 2 2
City /State/ZIP: • 1 Cy 0 \ 22,114 Each additional inspection over allowable io an of the above
Per inspection
Phone: ( ) 5%A, - t`�� Fax: ( ) SO, 62.50
_ Investigation per hour (I Is m; 62 50
C CJ3 Lic.: Electrical l.ic„ .2� �C�2 C Suprv. L ic.: a �S 5 lndustIndustrial plant per ho 73.75 -
_: - -,x: '',t:';'_ _:� i.I . TR :• : • :.
.'
Suprv. Electrician signature, required: --
tArv�.ta - „ Snhtotal: ( Ai'
Print na c.' `(\ ( Q, 14 _ ( Datc:,5� B) 1 Plait review (35% of parnrit tcC). �,�
�/1 1 State surch:uee (12% of permit tee). ,
Authorized signature: I
TOTAL PERMIT ELF... is 9 7
Print name: Date: This permit a p mires if a permit is not obtained nithla 11 tr
days after it has been accepted as complete.
rUiuimLmlYan+rrslELC- ramaApp due osr,7lpg • Number ofmspecnons allowed per permit
4•6as t 1'rt l t ni5 /C OMM'LO
INSPECTOR'S SIGNATURES ARE NOT •
Inspections Required for: a( r--, j/ t REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description • I PASS Date I By ✓ Code I Inspection Description PASS Date By
•
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 x 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 C _ 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 PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in
920 Suppression trip test 310 Crawl drain
315 Post /beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final
322 Shower pan
999 Sprinkler final 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
1: \ Building \Forms \InspCard- AOP- Blankdoc 02/02/07