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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2008 -00483 COMMUNITY DEVELOPMENT DATE ISSUED: 8/21/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DC-14700 SITE ADDRESS: 13269 SW TAMERA LN ZONING: R - SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT : 002 JURISDICTION: TIG PROJECT: PEDERSON Project Description: Installing (3) branch circuits for heat pump, furnace and GFI 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: SIGNAUPANEL: MANF HM/ SVCI 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: 2 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVCIFDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: RICHARD & FLORENCE PEDERSON WEST SIDE ELECTRIC CO INC 13269 SW TAMERA LANE 1834 SE 8TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 771 -7871 Contact #: FAX 503 - 231 -9987 PRI 503 - 231 -1548 FEES Description Date Amount Reg #: ELE 26 -135c [ELPRMT] ELC Permit 8/20/2008 $60.15 LIC 13306 [TAX] 12% State Surchar 8/20/2008 $7.22 SUP 4654S Total $67.37 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: Permittee Signature: �� r AP i � 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. ' 5682319987 00:34:40 08 -20 -2008 2 /2 •` Electrical ' W,, o i iv l trn k E ,, St AT'',` 4s./ h A r Permit Application ,t =, y , �t ", u P P „fix , svM r, I • FOR OFFICE USE ONLY e o Bo ° ,,,,,wire RECE Rtccrvcd x _ ,.. ,. 1 < t 1 . i City of T D,tcn3y Pen „i1 No.. 13125 SW } tall Blvd.. Tigard, OR 97223 Plan Review Y �. ` 2 ' . :. , Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: T I ` ''! "'' ' Inspection Line: 503.639.4175 AU 6 2 4 2 008 GARD; Date Ready/13y: �"'S. a sec Page 2 for r:aaa:nr > ;a ;raa Internet: ,vww.tigard- or.gov Noti hcd/Method: / .0 Supplemental information TYPE OF rvo CITY OrTI('iARD New PLAN REVIEW 1 cw construction ddition /alter l g Please check all that apply (submit 2 sets of plans ��� /items checked helms.): �AIG DIVISION cement ❑ Service or feeder 400 amps or more ❑ 13uilding over three stories. ❑ Demolition El 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 El 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 ❑ " V "L "' "I _'',• "I 3" : "±': Job no.: Job site address: occupancy. S �] Z � _ r !i'aa . ) ° + % j - Cr SG .J f � W -� J,,, . ❑ Sitox otu' or more. or more residential units. 0 Recreational vehicle parks. City /Stale /ZIP: ---r, � (.. - 7 ^ t ❑ Health -care facilities. ❑ Supply voltage for more Than r,. 1 e- ■ -4 7 ❑ Hazardous locations. 600 volts nominal. � _ S Suite /bldg. /apt. no.: 1 Project name_ ( ❑ Service or !ceder 600 amps or more. c� Sr' 1 r / `� FEE SCHEDULE Cross street/directions to job site: Description 1 Qts. I Fee. l Total I • New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. 0. or less 145.15 4 Ea. add'I 500 sq. 0. or portion 33.40 1 Tax trap /parcel no.: Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) / � r---- Limited energy. multi - family 75.00 /�-Q c 2 S' 2 -- ` � "L4 r.i . !, L Le . 4 C� el F e- A ( 1,( * residential (with above sq. fl.) Services or feeders installation, alteration, and /or relocation -- 200 amps or less 80.30 2 l PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: `v1, (\-/L. ( C to 401 amps to 600 amps ! 60.60 2 t ? - Ci- 601 amps to 1,000 amps 240.60 2 Address: 1 T (-> G ( f C - r,t vi/ , 4 Lt Over 1,000 amps or volts 454.65 2 City /State /ZIP: ' r c_ „j - _ O/—� Z / -, Temporary services or feeders installation, alteration, and /or r relocation Phone: (50 >) S .?,/,._ 4 , L.) S Fax: ( ) 200 amps or less 66.85 I Owner installation: This installation is being made on property that I own which is not 201 amps to 400 am ps 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 I _ I ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2 each branch circuit Business name: B. Fee for branch circuits without service or feeder fee, tt (� C Contact manic: t 46.85 (� !, 7 first branch circuit Address: Each add'I branch circuit 7 6.65 t - 5. ) t? 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular 90.90 Phone: dwelling, service and /or feeder ( ) Fax:: ( ) Reconnect only 66.85 2 E - mail: GLENNG@WESTSIDEELECTRIC.COM Pump or irrigation circle 53.40 2 CONTRACTOR Sign or outline lighting 53.40 2 Business name: WEST SIDE ELECTRIC CO. Signal circuit(s) or limited- energy panel, alteration, or Address: 1834 SE 8111 AVE. extension. Describe: Page 2 2 City /Stale /ZIP: PORTLAND, OR 97214 Each additional inspection over allowable in anv of the above Per inspection 62.50 Phone: (503) 231 -1548 Fax: (503) 231 - 9987 Investigation per hour (I hr min) 62.50 CCB Lic.: 13306 Electrical Lic.: 26 - 135C Suprv. Lic.: 4654S Industrial plant per hour 73.75 ELECTRICAL PERIMII'F FEES Suprv. Electrician signature, required: Subtotal: / t 1,, Print name: RANDALL ROBERTS Date: Q / o A Plan review (25% of permit fee): /� + / 1 O State surcharge (12 %, of permit fee): "7 , z 2 Authorized signature: - "�, {,{ ��; '6// , », /f ,�� TOTAL PERMIT FEE: ( ., - 3 '7 . Ls 111111 . This permit application expires if a permit is not obi:1;n within 180 Print I Ill! name: Date: day's after it has been accepted as complete. • Number of inspections allowed per permit. 1 : tiu/ Iung\l'enui :s\ El.C•I'cnnitApp.doc 05/23101, 440-1615T( I /WED CITY OF TIGARD ELECTRICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: ELC2008 00483 DATE ISSUED: 8/21/2008 T 1 c A D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 P • ARCEL: 1S133DC-14700 SITE ADDRESS: 13269 SW TAMERA LN ZONING: R -12 • SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT : 002 JURISDICTION: TIG PROJECT: PEDERSON Project Description: Installing (3) branch circuits for heat pump, furnace and GFI 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 HM/ SVCI 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: 2 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: RICHARD & FLORENCE PEDERSON • WEST SIDE ELECTRIC CO INC 13269 SW TAMERA LANE 1834 SE 8TH AVE TIGARD, OR 97223 PORTLAND, OR 97214 Phone: 503 - 771 -7871 Contact #: FAX 503 - 231 -9987 PRI 503- 231 -1548 FEES Description Date Amount Reg #: ELE 26 - 135c [ELPRMT) ELC Permit 8/20/2008 $60.15 LIC 13306 [TAX] 12% State Surchar 8/20/2008 $7.22 SUP 4654S Total $67.37 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 ...•111, ...•111, Permittee Signature: � - l 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. INSPECTOR'S SIGNATURES ARE NOT Inspections Required for: c 8? c oys3 REQUIRED ON GREEN INSPECTION CARD. 1 ✓ • Code I Inspection Description PASS Date By ✓ Code 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 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 ,)( 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 910 Sprinkler rough -in PLM - Plumbing Permit 915 Fire alarm rough -in 305 Plumbing underslab 920 Suppression trip test 310 Crawl drain 995 Misc. inspection: 315 Post /beam plumbing • 998 Alarm final 320 Plumbing rough -in 999 Sprinkler final 322 Shower pan 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: L 499 Final inspection 599 Final inspection I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07