Permit C=ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2003 -00096
A � DEVELOPMENT SERVICES DATE ISSUED: 2/26/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 PARCEL: 1S125DB
SITE ADDRESS: 09425 SW 74TH AVE
SUBDIVISION: PP1990 - 008 ZONING: R
BLOCK: LOT : 001 JURISDICTION: TIG
Project Description: Alteration of (1) 200 amp or less service panel and (12) branch circuits.
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: 1 W /SERVICE OR FEEDER: 12 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:
KRAMER, TIM J + RUTH M GRESHAM ELECTRIC
9425 SW 74TH AVE 1577 SW 25TH
TIGARD, OR 97223 GRESHAM, OR 97080
Phone: Phone: 503 -491 -8140
Reg #: ELE 26 -1004C
LIC 129653
FEES SUP 4429S
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 2/26/03 $160.10
[TAX] 8% State Tax 2/26/03 $12.81 Rough -in
Elect'l Service
Total $172.91 Elect'I Final
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and alt 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 0 5269 -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 -3 -2344
Issue By : d) ; ( , defa.--2� Permit Signature: K' / f s�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: `,k4 OQ . �, ' e I . / A � DATE:
LICENSE NO: � /,
Call 639 -4175 by 7:OOpm for an inspection the next business day
Electrical Permit Application FOR OFFICE USE ONLY • : -
Received ,� / , Electrical , Q
Date/By: O` �`* e) Permit No.: Ze —a / 0
C of Ti and Planning Approval Sign
Y g Date /By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date/By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post- Review Land Use
/ + I 1
Internet: www.ci.tigard.or.us ■ y 64 I' Date /By Case No.:
Contact Juris.: ® See Page 2 for
24 -hour Inspection Request: 503- 639 -4175 c 2 W Name /Method: Supplemental Information.
° :~ , TYPE ,QF :WORK•: : :4 .. P _ . W'(P. ka aPRly0P z:;
�LAN lease,chec 1l that`
111 New construction 111 Demolition ❑ Service over 225 amps- ❑ Health -care facility
commercial ❑ Hazardous location
111 Addition/alteration/replacement ❑ Other: ❑ Service over 320 amps- rating of ❑ Building over 10,000 square feet,
' , ; -''', CATEGORY OF, CONSTRUC,TI'ON, <: _" ,r, 1 & 2 family dwellings four or more residential units in
❑ 1 & 2- Family dwelling ❑ Commercial/Industrial ❑ System over 600 volts nominal one structure
❑ Building over three stories ❑ Feeders, 400 amps or more
❑ Accessory Building ❑ Multi- Family ❑ Occupant load over 99 persons ❑ Manufactured structures or RV park
❑ Master Builder ❑ Other: ❑ Egress/lighting plan ❑ Other:
- ' , r: =„ JOB SITE' INFORMATION and;LOC.fAT -- Submit sets of plans with any of the above
�} bit) [(( ,� The above are not applicable to temporary construction service
Job site address: 9�5� �� 7T iT UYi ,.:: r :...7 FEE *s.SCHEDUJLE , : *:: : :: I g.- -
Suite #: Bldg. /Apt. #: Number of inspections per permit allowed
Project Name: Description Qty Fee (ea.) Total 1
New residential- single or multi - family per
Cross street/Directions to job site: dwelling unit. Includes attached garage.
Service included:
1000 sq. ft. or less 145.15 4
Each additional 500 sq. ft. or portion thereof 33.40 1
Limited energy, residential 75.00 2
Subdivision: Lot #. Limited energy, non residential 75.00 2
• Tax map /parcel #: Each manufactured home or modular dwelling
,; „- :: ;; ; i, A „.'DESCRIPTION >OF.rWORK ,;., „, service and/or feeder 90.90 2
Services or feeders - installation,
alteration or relocation:
200 amps or less 1 80.30 2
201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
' :.
W =NER :,:•:,:”; 601 amps to 1000 amps 240.60 2
PROPERTY O , __4 ` n . ® TENANT
Over 1000 amps or volts 454.65 2
Name: T1 yo ?t.-'f1' l L vet_7n -✓ Reconnect only 66.85 2
Address: y'l 2.a S , tit) , 7 1 111 /'i ✓e' Temporary services or feeders - installation,
alteration, or relocation:
City /State /Zip: ' % 90.-v• Q a 7030 200 amps or less
66.85 1
f 201 amps to 400 amps 100.30 2
Phone :,5 3 � '�G `/ Z7y Fax
p , ; ` ' , :0 CONTACT: PERS 401 to 600 amps 133.75 z
PLICANT h �. / � � 1 � f Branch circuits -new, alteration, or
Name(?'��: ( , l � � extension per panel:
/ J A. Fee for branch circuits with purchase of
Address: � j 0 .5 AI . Pa_ditr 6 l(�t -C 1 service or feeder fee, each branch circuit /2' 6.65 2
City /State /Zip: S OR. S 7 (73 t7 B. Fee for branch circuits without purchase of
service or feeder fee, first branch circuit 46.85 2
Phone: yv3 -6.6&--16.7 L/ 6 Fax:6 - ,6 7 - 2 t-( 7 ' Each additional branch circuit 6.65 2
Email dee 1 4 i Bryn, 091,E t al b.9-7-1"- Misc.(Service or feeder not included):
pump or irrigation circle 53.40 2
,x a! , >' C NTRAC;TOR ...'.. �
-- '' Each Each sign or outline lighting 53.40 2
Job No: Signal circuit(s) or a limited energy panel,
/ _ alteration, or extension Page 2 2
• Business Name: (DpG� yp,.., - ( - fr/ c 1 , Description:
Address: 1, --77 1 j1.A.) „1-5.4"1_,-.
Each additional inspection over the allowable in any of the above:
City /State /Zip: tpb_e_L,,...r L>sc, q7d ge.) Per inspection per hour (min. 1 hour) 62.50
Phone:5 -03-/ tq+ /43/ Fax: Investigation fee:
CCB Lic. #: Other:
J :'_ g , -":.:' ,E -� ; Electrical :`PermitoEees * � .,- ��.
�.-•
Supervising electrician , Subtotal $ i t 4.0. rc
signature required: Uj . i� Plan Review (25% of Permit Fee) $
Print Name. , /rte Lic. #:4'4,VI S State Surcharge (8% of Permit Fee) $ /?- gJ
TOTAL PERMIT FEE $ / 7th -9J
Authorized Notice: This permit application expires if a permit is not obtained within
Signature: Date: 180 days after it has been accepted as complete.
*Fee methodology set.by Tri- County Building industry Service Board.
(Please print name)
is \Dsts\Permit Fortns \ElcPermitApp.doc 01/03
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
Fee for all systems $75.00
Check Type of Work Involved:
n Audio and Stereo Systems
n Burglar Alarm
n Garage Door Opener
n Heating, Ventilation and Air Conditioning System
El Vacuum Systems
n Other
COMMERCIAL WORK ONLY:
Fee for each system 575.00
(SEE OAR 918 - 260 -260)
Check Type of Work Involved:
n Audio and Stereo Systems
n Boiler Controls
n Clock Systems
n Data Telecommunication Installation
n Fire Alarm Installation
n HVAC
n Instrumentation
0 Intercom and Paging Systems
Landscape Irrigation Control
n Medical
n Nurse Calls
I 1 Outdoor Landscape Lighting
n Protective Signaling
n Other
Number of Systems
* No licenses are required. Licenses are required for all
other installations
i: \Dsts\Permit Forms \ElcPermitAppPg2.doc 01/03
CITY OF TIGARD 24 -Hour .
BUILDING _ Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested , 6 _ ..?so AM PM BUP
Location q 4 /g - - 7 Suite MEC
Contact Person 0—P �—<_—.e., Ph ( ) 79 3— p 70 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3 — 0cp O 9
Footing
Foundation Access: ELC
/�
Ftg Drain c K-- L i� 1' rag, iJ . c.�, / r, 4 q '" �-er C ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors .
Ext Sheath/Shear
Int Sheath/Shear .
Framing
-
Insulation
Drywall Nailing
Fi rewal I
Fire Sprinkler . (7
Fire Alarm
Susp'd Ceiling .
Roof
Other:
Final
n'N
PASS PART FAIL
PLUMBING N. /
Post & Beam /
Under Slab
Rough -In
L /
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
/
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
L
Rough -In
UG /Slab
Low Voltage
- Alarm
•irbl Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
I4 PART FAIL
0 Please call for reinspection RE: 111 Unable to inspect - no access
Fire Supply Line
ADA C / ,0/
Approach/Sidewalk Date 0. 3 Inspector 7 - Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
CITY` nGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
MST DIVISION Business Line: (503) 639 -4171
3 BUP
Received Date Requested L ,gyp / AM PM BUP
Location ! 5 1 ! �v - Suite MEC
Contact Person Tff Ph ( ) 793 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC 3-66 b
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear ;� ( L , 1 � ) hj C' 4dir,A �� J� W� � 5 g A C W f1�j
Framing �1 YV 1 1 11 ,I '^�' ! J J I
Insulation / 4
Drywall Nailing ► (� eM 1� ; � 1.1
Firewall �` TL 10 ( 5 VIA\N
Fire Sprinkler `
Fire Alarm 4 w p G i\te L p'i7A S)
Susp'd Ceiling
Roof c
Other:
Final
PASS PART FAIL '`� C (--� Ro 1_1 �' 514) 1 tG�) 1 L
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
•
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
.ou•h s
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PAR FAIL
SITE 0 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA �. / / • Ext
or
Datta Inspector
Approach /Sidewalk I.
Other:
Final DO NOT REMOVE this inspection record rom the job site.
PASS PART FAIL
18'5
312
11'8 _ 19'8
A
1 Li
r
I. 8'8 +, • t
Bath }� - A /610e21/ .j�
117 8'7 x 9' , _ S /I 22, 6c- /� �610,/ 1. ,..r.v e d rco Goo
11'2
-- -M er Bedroom
�O 11 2 _ Bedroom # ji�
Is 18'5 '1 — 1 , I-_
8
0
C
LIVING AREA I 1 r , U 7 '' \ e ' N
376 sq ft U - -o — j
Laundry ft /� + S k' �x�
\ 12' x r6 12 , c7 / -�C ew
7Th L 1 k� Kramer Kra r i esidence 0 o 17
_ v ,fir
1/ . 2.5 5, vv, '2 y t k Drawn By: Cecil Smith e 1 Living room w
17'9 x 14'
e I . —12
Cecil Smith dba Healthy Home Builder.Com
Trt G7^'' I, 0 It_ ' 7 0.,33 305 N. E. Palmbald Dr. Gresham OR 97030 Ktchen & Dining -`
Office #: 503- 666 -8746 11'4 x 18' 18'8
Office Fax. # 503-667-9479 3� �_ y -- x _
q - q 12' \
Scale. 1 /8n I - On m m V5 1/2 Entry
I 4'5x8'7
— F L _--
o
LIVING AREA
1157 sg ft
I 11 , 17'8 177
h
312 1
1 31'2
111 . 1813
— — 1 — — giI
30'8
,1— — 10'8 — 9.8
0 • 1 ;110 r,c I
I r m
o
1 0
I � - -' 11
I ,__
- -- I 3 L - - -- UP �u - - - 0 _
i 1 Li I I
„A:
_ -1 - - - -� / N 14' ( . d 15'10 � �
IJ J
�+• 10'5 16'4
[1] p ` ) P
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a m N 12' N
^ a L n
M
154 L „ , , , , / ) „,
n
/ / J 8'2
/ / _
/ / I
tO
6dsting .umpPump / / LIVING AREA m a1 it, `
/ / 1122sgft
O - - / L - - _ I 4'4 0'6 i 16'4
L LIVING AREA
073021 fl
17'1 12'7
( 298 -1 Kramer Residence Second Floor
Kramer Residence Basement Scale 1/8' = 1' - 0” Scale : 1/8" = 1' - 0"