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Permit CITY OF F TIGARD I GA R D ELECTRICAL PERMIT III ° PERMIT #: ELC2009 -00062 ° COMMUNITY DEVELOPMENT DATE ISSUED: 2/17/2009 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S134BD-06700 SITE ADDRESS: 11655 SW. _SRRINGWOOD_DR_„ ZONING: R-4.5 SUBDIVISION: ENGLEWOOD NO.2 LOT : 155 JURISDICTION: TIG PROJECT: ANDERSON Project Description: Install panel. 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/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE/FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: 1 PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: SHANE ANDERSON OWNER 11655 SW SPRINGWOOD DR TIGARD, OR 97223 Phone: 503 - 329 - 2903 Contact #: FEES Description Date Amount Reg #: [ELPRMT] ELC Permit 2/17/2009 $86.95 [TAX] 12% State Surchar 2/17/2009 $10.43 Total $97.38 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 wit : - • one : - ordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for mor- an 180 days. A . NTIO . . • regon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OA" 952 - 001 -0010 through , • 95'- 00,0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Iss • ed By: - � � • Permittee Signature: 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: 7 /6? 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. Y•Ele Permit Application FOR OFFICE USE ONLY City and Received Pe No `J of Tigard Date/By: o� /7 /Q 9 E,C ptGIOQ�p.� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' Mi .' ' Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: TI G A R D Inspection Line: 503.639.4175 Date Ready /By: to IA See Page 2 for Internet: www.tigard - or.gov Notified/Method: "/ I a Supplemental Information TJI�P OF WORK PLAN REVIEW ❑ New construction LvJ Addition /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 Iij- 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. A ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "I -3 ", • Job no.: Job site address: �/ SS / S I OOHP or more occupancy. s (� may L.4 'd/ ❑ Six or more residential units. ❑Recreational vehicle parks. City /State /ZIP: / ❑ Health -care facilities. ❑ Supply voltage for more than 4.,/,a1' / 42/°. 9� 5 ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: Project name: � /S e . ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to job site: / /SA /S /� ' o C,c.." Description I Qty. I Fee. I Total I • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map /parcel no.: Ea. add'l 500 sq. ft. or portion 33.40 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. ft.) \ Limited energy, multi - family 75.00 2 1 0 9 ! / 1. (, Noe e (, residential (with above sq. ft.) Services or feeders installation, alteration, and/or relocation 200 amps or less / 80.30 Fo. 59 2 PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2 Name: .....<;47.07/2 ./0:4-1,2/3" dH 401 amps to 600 amps 160.60 2 601 amps to 1,000 amps 240.60 2 Address: f/65S SU S�YJ4., 0 ,,t;...3./ *-.47 Over 1,000 amps or volts 454.65 2 City/State /ZIP: �' Temporary services or feeders installation, alteration, and/or ,-/ j c.i� r (- 9 707 - 3 relocation Phone: (so3 ) 3 9' _Z ye's 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 to 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 I 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel g A. Fee for branch circuits with ❑ APPLICANT ❑ 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, 46.85 2 first branch circuit Address: Each add'I branch circuit / 6.65 f 2 Miscellaneous (service or feeder not included) City/State /ZIP: Each manufactured or modular 90.90 2 dwelling, service and/or feeder 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: g o • Q5 Print name: Date: Plan review (25% of permit fee): "er—' State surcharge (12% of permit fee): /O, ' Pj Authorized signature: TOTAL PERMIT FEE: ? Print name: Date: This permit application expires if a permit is not obtaine within 180 days after it has been accepted as complete. • Number of inspections allowed per permit. I:\ Building '.PermitsELC- PermitApp.doc 05/23/06 440-4615T(I1 /05 /COM/WEB Electrical Permit Application - City of Tigard Page - 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL WORK ONLY: Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ Burglar Alarm • ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL WORK ONLY: Fee for each commercial $75.00 • system (SEE OAR 918- 309 -0000) 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\ELC- PermitApp.doc 03/23/06 CITY OF TIGARD A , BUILDING DIVISION PERMIT #: ELC2009-00062 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/2009 Phone: (503) 639 Inspection Requests (24 Hrs.): (503) 639-4175 - INSPECTION WORKSHEET FOR DATE: 2/18/2009 TIME: 7:00AM PAGE: 27 SITE ADDRESS: 11655 SW SPRINGWOOD DR CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.2 LOT #: 155 TYPE OF USE: PROJECT NAME: ANDERSON DESCRIPTION: InEetall panel. OWNER: ANDERSON, SHANE PHONE #: 603-329-2903 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 2018/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 080582-03 503.329-2903 Corrections /Comments/ Instructions: PRe•,,kos. A at:. , • 0 PASS 0 PARTIAL APPROVAL 0 CANCEL ( NO ACCESS xi FAIL CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED Inspector: "9. Cr. Nat.b Date: Tyla Phone #: (503) 718- DP146 CITY OF TIGARD � f I BUILDING DIVISION PERMIT #: ELC2009 -0000 2 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/17/2009 Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 . _.11 "'IL. INSPECTION WORKSHEET FOR DATE: 2/18/2009 TIME: 7 :00AM PAGE: 29 SITE ADDRESS: 11055 SW SPRINGWOOL) DR CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.2 LOT #: 155 TYPE OF USE: PROJECT NAME: ANDERSON DESCRIPTION: Install panel OWNER: ANDERSON, SHANE PHONE #: 5n 329- 2903 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 211012009 Pour Time: 1 Code # Inspection Description Confirm # Contact # Message 115 E:leriria:ai service 080582 - 01 503 329 - 2903 N Corrections /Comments /Instructions: 4P <7 Ptkravlor. wweA) G C i c f ? I(Z' , 'f 10 . I CS' 110. 1.I . U PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS N AIL • ,CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: G- ' NO€ L( Date: 11 I O g Phone #: (503) 718- %IiiyD CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC200300052 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /17/2(09 Phone: (503) 639 -4171 ittar' Inspection Requests (24 Hrs.): (503) 639 -4175 IL. INSPECTION WORKSHEET FOR DATE: 21 /9/2009 TIME: 7 :00A1 1 PAGE: 28 SITE ADDRESS: 11655 SW SPRINGWOOD DR CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.2 LOT #: 155 TYPE OF USE: PROJECT NAME: ANDERSON DESCRIPTION: Install panel. OWNER: ANDERSON, SHANE PHONE #: 503- 32379Q3 CONTRACTOR: OWNER PHONE #: Inspection Request Scheduled For: Date: 7/ 18/2009 Pour Time: Code # Inspection Description Confirm # Contact # Message 120 EIec1ri oh in 080582 -02 503. 328 -2903 Corrections /Comments /Instructions: 01 PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Gm N 06 LC. Date: Id 1'9 Phone #: (503) 718- 7-411/6 City of Tigard, Oregon Page 1 of 2 City of Tigard, Oregon r : t. : , ; - [� • 1 f1!', S it' !Ln`lli:r,/. Jns +d, Hit 'r _`t t t.,.. t-1 1 l t, -. j C ' , m TIGARD A / to Cart // Name '' r . • 'I Search I Property 1 Planning 11 Crimes I Transportation I 1 Uldities 11 1 Ae ials I 1 FN.: I Street Viers (I • Print 1 Summary 1 Permit Summary I Community I Hazards 1 Explorer 1 11655 SW SPRINGWOOD DR Property Summary t --- Z r �� V Englewood Pam �, `. j_ �Pt 8 ` � Av 5 . 1 i gh t • a SCHOLLWOOD CT 4* n N Q .. :1 1 SPRINGWOOD DR g C t 2 et C� A 11 7y1 `� 1 - `OO pc t O COTTONWOOD LN Property Owner Info Tax ID Number: 1S134BD06700 Tax Account Number: R265741 Site Address: 11655 SW SPRINGWOOD DR Site City: Site ZIP: 97223 Owner: BROWN, GEORGETTE & MONIQUE F Owner 2: 11655 SW SPRINGWOOD DR Owner 3: Owner Address: Owner City: TIGARD Owner State: OR Owner ZIP: 97223 Acres: 0.18 Sq Ft: 7,840.8 Bldg SF: 1,403.00 Bldg Value: $ 102,310 Land Value: $ 184,000 Total Value: $ 286,310 Taxable Ass'd Value: $ 144,250 Sale Price: $ 0 Sale Date: Year Built: 1976 District & Community Info Municipality: Tigard Tigard Urban Sery Bndry: YES Tigard Neighborhoods: L Name Link to Website Area 2 Amp 2 Neighborhood New Water Service Area: Tigard Water Service Area http: / /tiggisiw /mox52_multimap/ index. cfm? fuseaction= property.summary &CFID= 104535 &CFTOKEN =... 2/18/2009