Permit • II I CITY OF TIGARD' ELECTRICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: E-00456
DATE ISSUED: 7/5/2007 5/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 AD - 20100
SITE ADDRESS: 14872 SW 89TH CT ZONING: R - 4.5
SUBDIVISION: LADY APPLE LOT : 025 JURISDICTION: TIG
PROJECT: LADY APPLE
Project Description: Elec. for AC
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:
BEACON HOMES CONNECTIONS ELECTRIC
12703 SW 67TH AVE. PO BOX 7136
TIGARD, OR 97223 SALEM, OR 97303 -0026
Phone: 503 - 570 -8828 Contact #: PRI 503 - 390 -7914
FAX 503 - 463 -6863
FEES
Description Date Amount Reg #: ELE 24 - 248C
[ELPRMT] ELC Permit 7/5/2007 $46.85 LIC 65444
[TAX] 8% State Surcharge 7/5/2007 $3.75 SUP 3611S
Total $50.60 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 OU at 503.246.6699 or 1.800.332.2344.
Am
Issued By: ���� / // Permittee Signature: (/
•0 ----9..ss
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.
Electrical Permit Appli 1 ( i tt 111 1 1 t 1 1' I i 0.1 1
Tol City of Tigard Permit N O - A L �T .. do TJ-b 1 7 ��
13125 SW Hall Blvd., Tigard, OR 97223 it 1 f Plan Revie R eceived
Date/By: l
Phone: 503.639.4171 Fax: 503.598.1960 - u ( - v ' ( Date/By: Other Permit
Inspection Line: 503.639.4175 CITY OF TI ' I .� I - Date Ready/By: kris: : RI See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: J Supplemental Information
, e
_ _ t t t: '',5
❑ New construction ® Addition/alteration/replacement Please check all that apply:
❑ Demolition ❑ Other: ['Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
3z CATEGORY OF CONSTRUCTION - of I- and 2- family dwellings 4 or more new residential
1- and 2-family dwelling ['System over 600 volts nominal units in one structure
® y g ❑ Commercial /industrial 0 building
['Building over three stories ['Feeders, 400 amps or more
❑ Multi- family ❑Master builder 0 Other:
Occ an load over Manufactured structures or
.
DOccupant 1 o pers ons
99
JOB F OI A O I"'AN LOCATION ['Egress/lighting plan RV park
89TH ❑Health -care facility ❑Other:
Job no.: (Job site address: 14872 SW 89 CT. Submit 2 sets of plans with any of the above.
City/State /ZIP: TIGARD, OR The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: I Project name: ?°
Description I Qty. I Fee. I Total I **
Cross street/directions to job site: HALL TO SATTLER TO SW 88TH New residential single or multi family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: LADY APPLE I Lot no.: 25 Ea. add'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no Limited energy, residential 75.00 2
5 �r g: . " t e t .t . Limited energy, non - residential 75.00 2
. .,.,_g� „ ,�u ,y . > w4 . .) ,, ,.xr - . : Each manufactured or modular
ADD A/C dwelling, service and/or feeder 90.90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
r . :, PRO RTI . Tl NA1''''' amps to amps 10685 2
_ rz, .... .. . 401 amps to 600 amps 160.60 2
Name: BEACON HOMES NW, INC. 601 amps to 1,000 amps 240.60 2
Address: 12703 SW 67 AVENUE Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State /ZIP: TIGARD, OR 97223 Temporary services or feeders installation, alteration, and/or
Phone: (503)570 -8828 Fax: (503)570 -8869 relocation
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 600 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
°. - "" ', CT A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: BEACON HOMES NW, INC. branch circuit
B. Fee for branch circuits
Contact name: DAVID DALBEY without service or feeder fee, / 46.85 ig 5 2
Address: 12703 SW 67 AVENUE first branch circuit
Each add'l branch circuit 6.65 2
City /State /ZIP: TIGARD, OR 97223 Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: (503) 570 -8828 Fax: : (503 -570) 8869 Sign or outline lighting 53.40 2
E -mail: ddalbey @BeaconHomesNW.com Signal circuit(s) or limited-
. CONTRA. R energy panel, alteration, or
extension. Describe: Page 2 2
Business name: CONNECTIONS ELECTRIC
Address: PO BOX 7136 Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: SALEM, OR 97303 Investigation per hour (1 hr min) 62.50
Phone: (503) 390 -7914 Fax: (503) 463 -6863 Industrial plant per hour 73.75
CCB Lic.: 65444 Electrical Lic.: 24 -2448C Suprv. Lic.: Subtotal
Suprv. Electrician signature, required: Plan review (25% of permit fee) //
State surcharge (8% of permit fee) 3. 75
Print name: M0.r• 4 1 2 , ate: L _ �� '
TOTAL PERMIT FEE � tOt J
Authorized signature: This permit application expires if a permit is not obtained within 180
t � / days after it has been accepted as complete
`.JI•�
Print name: J I I Date: l.1 -),,,� * Fee methodology set by Tri -County Building Industry Service Board
J ��.• JJ
* Number of inscections Der oermit allowed.
CITY OF TIGARD
BUILDING DIVISION • PERMIT #: ELC2007 -00456
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007
Phone: (503) 639 -4171 . i , ° N 41m111111 � 1 i'
Inspection Requests (24 Hrs.): (503) 639 -4175 --- "-� ---•
INSPECTION WORKSHEET FOR DATE: 7/9/2007 TIME: 7:02AM PAGE: 33
SITE ADDRESS: 14872 SW 89TH CT CLASS OF WORK:
SUBDIVISION: LADY APPLE LOT #: 025 TYPE OF USE:
PROJECT NAME: LADY APPLE
DESCRIPTION: Dec. for AC
OWNER: BEACON HOMES, PHONE #: 503 - 570.8828
CONTRACTOR: CONNECTIONS ELECTRIC PHONE #: 503- 390 -7914
Inspection Request Scheduled For: Date: 7/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 051629 -02 503407 -0580 N
Corrections /Comments /Instructions:
/ ..........7
I►; PASS % •A APPROVAL ❑ CANCEL n NO ACCESS
n FAIL LL FOR INSPECTION ❑ ADDITION L F ES ASSESSED
16_K
Inspector: ■■ Date: Phone #: (503) 718 - __
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00456
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/5/2007
Phone: (503) 639 -4171 /wn°b i N�t�j
Inspection Requests (24 Hrs.): (503) 639 -4175 ��
INSPECTION WORKSHEET FOR DATE: 7/9/2007 TIME: 7:02AM PAGE: 34
SITE ADDRESS: 14872 SW 89TH CT CLASS OF WORK:
SUBDIVISION: LADY APPLE LOT #: 025 TYPE OF USE:
PROJECT NAME: LADY APPLE
DESCRIPTION: Elec. for AC
OWNER: BEACON HOMES, PHONE #: 503 - 570.8828
CONTRACTOR: CONNECTIONS ELECTRIC PHONE #: 503- 390 -7914
Inspection Request Scheduled For: Date: 7/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
145 A/C or heating unit circuit 051629 - 01 503 407 - 0580 N
Corrections /Comments /Instructions:
PASS 11 '' RTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL 4 ' ALL FOR INSPECTION n ADDITION , L FEES ASSESSED
Inspector: Date: _ il Phone #: (503) 718-
zzig7
.