Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2007 - 00721
COMMUNITY DEVELOPMENT DATE ISSUED: 10/19/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S136AB-03900
SITE ADDRESS: 10034 SW 71ST PL ZONING: R - 4.5
SUBDIVISION: LOCUST TERRACE LOT : 006 JURISDICTION: TIG
PROJECT: DAHME
Project Description: (2) branch circuits to connect gas furnace and a/c units. Job NO. 90674
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: 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:
BRENDA DAHME JACOBS HEATING AND NC
10034 SW 71ST PL 4474 SE MILWAUKIE
TIGARD, OR 97223 PORTLAND, OR 97202
Phone: 503 - 641 - 6121 Contact #: PRI 503- 234 -7331
FAX 503 - 296 -5351
FEES
Description Date Amount Reg #: ELE 26- 807CRE
[ELPRMT] ELC Permit 10/19/200" $53.50 LIC 1441
[TAX] 8% State Surcharge 10/19/200" $4.28 SUP 704LHR
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 503.246.6699 or 1.800.332.2344.
Issued = ���`� ,r / /// Permittee Signature: S'I /7 /
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.
Ilik
Electrical Permit Applicati FOR OFF i i uti1.1'
City of Tigard RECEflJED Received • Pc
i' u 13125 SW Hall Blvd., Tigard, OR 9724,] r . Plan Review
Phone: 503.639,4171 Fax; 503.5911. l ' T 1 7 2007 Dale/13 ,: other Penult:
T 1 u.A R a Inspection Linc: 503.639.4175 / � ® Date Ready /By: ta See Page 2 for
Internet; www.tigard or.gov CfTY . [IGI KIl® Notified/Method: ► Supplemental information
•'r it I., :.�, , *;.,, �fj1 n p y l ue, ri n .'b!,Ji i.v r a f "It• 'S!21f:',; . ,ri!I ,r d.:t ,.;•,,.ti�: ".1!.f;,:. ,. ���: •)- �'^' -- ��r'l F`��7�','1`;;{{�� G, °t!„��1�' )
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In New construction ei Addition/alteration /replacement Please cheek all that apply (submit lams of plans w /floras chocked below):
❑ St:rviee or fader 400 amps or more ❑ Building over uucee SWAGS.
Q Demolition 0 Other: where t available fault current ❑ Marinas and boatyards.
r 4 r r 'Mw .. I:J : f i .: : ∎ . a. ' . ,,, . 0, 0 n
t ! 1 ;;i , 4 :' t la a, a r 1: 4 • c 9 ' , v o' I 6 y ■ l r > mi' ' . ; j exceeds l UO ups it 150 volts or ❑ Floating buUdinga.
it b -f,, a , ,,, r ,1 ; f ,::. � I , ;e ,k „u: ±Jiu i�l' ..,,.. . ..
, l 91d° —'
less to ground, or exceeds t a,Otxl ❑ Coauuoreial -use agricultural
® 1 and 2- family dwelling 0 Commercial /industrial Q Accessory building amps for all other installations. buiIdin,I.
❑ Multi - family 0 Master builder ❑ Other: ❑ hire pump. ❑ installation of 75 KVA or
!� t ❑ Emergency system, larger separately derived system,
l I I I,ii:' Il l i U�y�s�r�s w'i B' !Y`i!` till U 0 ,4 ,I .., : �, !ie ,` 1 !' i rl, • i •
.,,I L II I' ll' ii , r. , I@FbdeSei' 5.,,,,. � .. , 1 � _. I lu; Y -t�• .�'�•(�a * ,.ha:rr.a.. , a6�.,�:;i1 ❑ Addition ol'new motor load of ❑ °A” "fi" "1 -2" "1-3"
Job no.: 90674 Job site address: 10034 SW 71" PI tooirn or more. occupancy.
❑ six err more residential units. 0 Recreational vehicle parks.
City / State/ZIP Tigard, OR 97223 0 ldeaith.care facilities. ❑ Supply voltage for more than
❑ Hazardous locutions. 600 volts nominal.
Suitt/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or mote.
2' °f.:'�i 'i r - :;I 6.: ;1' : ` ' ' j " atilit 1 '.:.� ril 'I'�'T;rtl'„il�llli'iili4�1 *.q
Cross street/directions to job site: m errier oa 1 Qty. l Fee. ] 'row I •
New resideutlnl single or multi- family dwelling unit.
Include; attached garage.
Subdivision: Lot no.; 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map / f ry Limited energy, residential
` lilf9W'R4Lit MI ,`! sa';' o `' t e a a lt' ; .. 1, fly `y & :I �; r, i `: ' ..., Y , , :', 1 i.!s (with ahoy"' e sq, 8,) v 75,00 2
• , '� �iL it I:i �,ii.::' ! I : ' ; r•��'� p,'ra .
Limited energy, multi-family 75.00 2
Reconnect air conditioner and furnace.
residential (with abOvu sq. ft.)
Services or feeders installation, alteration, and/o relocation
200 amps or less 80.30 2
11 ll�� ` d'' l f , P:'lk 11 !' a, ,,d� ,r lg. .1 Cl r'alia,ili_
it�';I ,.. `�I py r ` li'i.' IYi;l�ilc,?;jl 201 am 40 s 106.85 2 s to 0 am
I xe , , i, , . li , 4u ,ii: I Sri, a�! th:! it.'1t�lic,,,s;rl.�,;;zl;.r P P
Name: Brenda Dahme 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 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: (503)641 - 6121 Fax: ( ) 200 tamps or Ie I 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 133.75 _ 2
Branch circuits - sew, alteration, or extension, per panel
Owner signature: Date: A. Fee fur
n ! nl�:!t p •• I i 4� ,(1'., e, , . .: r.. l r 0 ;!'1 e� f !'S -I ` 0I'1'i'i 1.00.,5 !' above se or fccdcr fcc l (p '1)) 11 1 I
t ,
�rlll Y�ii I.w.4,.1� _ .�r,. . . . i.y ell I,f r..YrV r Mlrfy� I , , .. , .. , . .t .... .. ,.... ' 6.6 2
each branch circuit
Business name: B. Fee for branch circuits
Contact name: first r err service or feeder fee, I 46.85 i t ,85' 2
first branch circuit
Address; Each add't branch circuit 6.65 2
Miscellaneous (service ur feeder not included)
City / State/Z1P: Each manufactured or modular t
dwellinfe. service and/or feeder 90.)0 2
Phone: ( ) Fax; : ( ) Reconnect only 66.85 2
E-mail: }gyp � Pump or irrigation circle 53.40 2
:k �1, . '; 811 `' l,
_ r 1I rr - ,� t( i ' ) n ,1 i� i ��r1 a . , ,,r , royaad�, F ; ; 4::;iii, ,; 'y a`: ,.: tl ! +
1. 1l: :, .h !'RII�1.. 1'I:YdFil..,er '�.Mlillfi(1PMYN �1:: = :v,ii : r .I....� .�,'J" w' .I, ,, .11;.. . Sign or outline lighting 53.40 2
Business name: Jacobs Heating and Air Conditiuning Signal p a n e l, al e r limited -
energy panel, alteration, or
Address: 4474 SE Milwaukie extension. Describe: Page 2 2
City / State/ZIP: Portland, OR 97202 Each additional inspection over allowable in An , af the above
Per inspection 62.50
Phone: (503) 234-7331 ..-- Fox: (503) 80. 9108 Jnvcstigntiun per hour (1 hr min) 62.50
i al L c.: 26-: 17CR Suprv. Lic.: 704LHR Industrial plant per hour 73.75
.r !ii{:X. - ! " r yiCseraf r 1. ;J1 ; tl'... C :u :nti H d41" 44.11. , b
Suprv. Electrician signattuc, rcquir• • " Subtotal; 3d r J 3. 50
Print name; Fred Punkin Date: 10!19/07 Plan review (25% of pcmtit fee):
State surcharge (8% of permit fee): 4trey 4, a
Authorized signature: l 1 I TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 18o
Print name: Michelle LeClair Date: 10/19/07 days after it has hem accepted as complete.
• Numbs of inspoctiotts allowed per permit.
la uusinsweri tuto\ELC- l'ermitAsedoea5/7 -7/06 4w- aolaT(ItN5/coss/'Bn f
50/Z0 30Vd ONI203H SI300VF LSZ6ET8E05 �r / �
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CITY OF TIGARD iih rrn
BUILDING DIVISION frii( gT PERMIT #: ELC2007-00721
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10//912007
Phone: (503) 639 -41712 I C I .
Inspection Requests (24 Hrs.): (503) 639 -4175 ." __..
INSPECTION WORKSHEET FOR DATE: 11/212007 TIME: 7 :01AM PAGE: 46
SITE ADDRESS: 10034 SW 71ST PL CLASS OF WORK:
SUBDIVISION: LOCUST TERRACE LOT #: 006 TYPE OF USE:
PROJECT NAME: DAHME
DESCRIPTION: (2) branch circuits to connect gas furnace and a/c units. Job NO. 90674
OWNER: DAHME, BRENDA PHONE #: 503 -641 -6121
CONTRACTOR: JACOL3S HEATING AND NC PHONE #: 503 -234 -7331
Inspection Request Scheduled For: Date: 11/2/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message fat)
199 Elect final 058903-02 503.234 -7331 Y
Corrections /Comments/ Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CAL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:. Date: P l Z /07 Phone #: (503) 718 -