Permit y ;,, CITY OF TIGARD - ,, ELECTRICAL PERMIT
PERMIT #: ELC2006 -00187
�,� DEVELOPMENT SERVICES DATE ISSUED: 4/11/2006
`'"
' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 - 4171
PARCEL: 2S111 BB -00700
SITE ADDRESS: 14305 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT : 016 JURISDICTION: TIG
Project Description: Upgrade of service 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: 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: 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:
MICHAEL & KNOETIG OWNER
14305 SW 100TH AVE
TIGARD, OR 97223
Phone: 503 - 577 -1084 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 4/11/2006 $80.30
[TAX] 8% State Surcharge 4/11/2006 $6.42
Total $86.72 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 (A11
952-01' -0010 - ou•h OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1 -80-2344. / /
Issu y: , _ f, ill i L . Permittee Signature: x � 4e'
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intende• or sale, lease, or rent. ���///,
OWNER'S SIGNATURE: y f'i2 DATE: 1 /4 lv
CONTRA • R 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 Application , „ f r oa OFFICE USE ,ONLY
C i t y of Tigard Date/By. II ()li • , lj Permit No.: g ;d . , —
" 13125 SW Hall Blvd., Tigard, OR 97223
' . A Phone: 503.639.4171 Fax: 503.598.1960 Dat e/B Revi
: ew Other Permit
T I G n R D Inspection Line: 503.639.4175 Date Ready/By: lu H See Page 2 for
Internet: www.tigard - or.gov Notified/Method: "I 16, Supplemental Information
YPE OF WORK PLAN REVIEW T
❑ New construction ddition /alteration/replacement Please check all that apply:
12 Demolition ❑ Other: ❑Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps — rating ❑Buildngover 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
El Multi - family ['Building over three stories ❑Feeders, 400 amps or more
❑ M aster builder ❑ O ther:
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND. LOCATION , ❑Egress/lighting plan RV park
❑Health -care facility ❑Other:
Job no.: Job site address: /93i$ - Sw /ea 64 ,iv e Submit 2 sets of plans with any of the above.
City /State/ZIP: T / a , t/( / o /2- y 7 L z 9' The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: .----- FEE* ,SCHEDULE Description I Qty. I Fee. I Total I **
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: 7 Gf ra v { A -' Lot no.: /U Ea. add'I 500 sq. ft. or portion 33.40 1
u
Tax map /parcel n Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
/� dwelling, service and/or feeder 90.90 2
`� // i G t Tt a �� Services or feeders installation, alteration, and/or relocation
200 amp s or less / 80.30 k)30 2
ROPERTY OWNER ❑TENANT 201 amps to 400 amps 106.85 2
401 amps to 600 amps 160.60 2
Name: ,,.,/b/I G 4 a, r c /G..(..0 e T C / 601 amps to 1,000 amps 240.60 2
Address: 3 2 () Uee CL , ` S/ 474y 4- Over 1,000 amps or volts 454.65 2
r C� Reconnect only 66.85 2
City /State /ZIP: p/. rpr / G /, �' e
/ relocation
x/ '7 I Temporary services or feeders installation, alteration, and /or
(�J) .-7 ? /0 ( ) 2
Phone: � � 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 f o r sale, lease, rent, or . ;-_-, exch. accordin: : a * S 447, 449, 670, and 701. / 401 amps to 600 amps 133.75 2
Owner signature: ...„ ,.// . ../ 7' . Date: (/i /40 Branch circuits — new, alteration, or extension, per panel
❑ APPLICANT . j , ,.CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
� B. Fee for branch circuits
Contact name: //', Gf J - i "4 c4 _ Dr\ without service or feeder fee,
first branch circuit 46.85 2
Address: /9 3 e 3 S 4/ /D 0 Z C ..rtv Each add'l branch circuit 6.65 2
City /State /ZIP: 7f u j -� ( 9 /L S 7 22 67 Miscellaneous (service or feeder not included) '
Pump or irrigation circle 53.40 2
Phone: ( ') ‘ jc 6 / ,5- 3 Fax: : ( ) Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
CONTRACTOR energy panel, alteration, or
Business name: extension. Describe: Page 2 2
Address: �A Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Investigation per hour (1 hr min) 62.50
Industrial plant per hour 73.75
•
Phone: ( ) Fax: ( ) ELECTRICAL PERMIT„ FEES *' ,
CCB Lic.: Electrical Lie.: Suprv. Lie.: Subtotal: 80. 30
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Date: State surcharge (8% of permit fee): $ , 4/
TOTAL PERMIT FEE d 6.72
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tri- County Building Industry Service Board
** Number of inspections per permit allowed.
1:\ Building \Pennits\ELC- PermitApp.doc 03/23/06 440 -4615 T(11 /05 /COM/WEB
Electrical Permit Application - City of Tigard .,
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY:
. 1
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- 260 -260)
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
BUILDING DIVISION - PERMIT #: ELC2006 001137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2006
Phone: (503) 639 -4171 4 74 0 010(11 1 \
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11117/7005 TIME: 7 :01AM PAGE: 69
SITE ADDRESS: 14306 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 016 TYPE OF USE:
PROJECT NAME: KNOETIG
DESCRIPTION: Upgrade of service panel.
OWNER: KNCETIG, MICHAEL PHONE #: 503- 577 -1084
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 039909 -01 503-577-1084 t
Corrections /Comments /Instructions:
PASS I PARTIAL APPROVAL I I CANCEL I NO ACCESS
FAIL ❑ CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: ' 6Z Date: Phone #: (503) 718
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2006- 00187
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/11/2008
Phone: (503) 639 -4171 "0�mgp� �
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Inspection Requests (24 Hrs.): (503) 639 -4175 `'' �..
INSPECTION WORKSHEET FOR DATE: 9/13/2006 TIME: 7:02AM PAGE: 32
SITE ADDRESS: 14305 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 016 TYPE OF USE:
PROJECT NAME: KNOETIG
DESCRIPTION: Upgrade of service panel.
OWNER: KNOETIG, MICHAEL PHONE #: 503 - 577 -1084
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/13/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 036447 -01 503 -677 -1084 Y
Corrections/Comments/Instructions:
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Inspector: v t466 L Date: T' 3' 0 Phone #: (503) 718- /4
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BUILDING DIVISION PERMIT #: EbC200&
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4111/2006
Phone: (503) 639-4171
Inspection Reque�o(24Hmj:(503)039'4175 .J 1 n� ^� ��
INSPECTION WORKSHEET FOR DATE: 4/12/2006 TIME: 7:01AM PAGE: 107
SITE ADDRESS: 14JQ5SW18DTMAVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 016 TYPE OF USE:
PROJECT NAME: |{N[)ET}(3
DESCRIPTION: Upgrade of service panel.
OWNER: KNOET|G, MICHAEL &MARTHA PHONE #: 683-577-1084
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 B8cthcaI final 027797-02 503-5771084 �
Corrections/Comments/Instructions:
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Inspector: Date: / --/ "— �� /= Phone #: (503) 718-
CITY OF TIGARD
. A
BUILDING DIVISION PERMIT #: ELC2006.00•187
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4111/2006
Phone: (503) 639-4171 /**1
Inspection Requests (24 Hrs.): (503) 639-4175 2.4,111
INSPECTION WORKSHEET FOR DATE: 4/12/2006 TIME: 7:04AM PAGE: 108
SITE ADDRESS: 14305 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 016 TYPE OF USE:
PROJECT NAME: KNOErie
DESCRIPTION: Upgrade of service panel.
OWNER: KNOETIG, MICHAEL & MARTHA PHONE #: 503-577-1084
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/12/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 027797-01 503-577•1084
Corrections /Comments/ Instructions:
V O a cc. es 6 )1--A0 od--1 0-r
(A) fy
I PASS El PARTIAL APPROVAL El CANCEL II NO ACCESS
1XFAIL El CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: )4--4 Date: Y-12- -0 6 Phone #: (503) 718-