Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00036
DEVELOPMENT SERVICES DATE ISSUED: 1/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 BB - 01502
SITE ADDRESS: 14137 SW 103RD AVE ZONING: R - 12
SUBDIVISION: TIGARDVILLE HEIGHTS LOT : 001 JURISDICTION: TIG
Project Description: (1) 200 amp service, (5) 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: 5 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:
RICHARD GORGER WEBER ELECTRIC INC
14137 SW 103RD AVE PO BOX 231154
TIGARD, OR 97223 TIGARD, OR 97281
Phone: 503 - 705 -6057 Contact #: PRI 503 - 620 -1906
FAX 503 - 620 -6819
FEES
Description Date Amount Reg #: LIC 44087
[ELPRMT] ELC Permit 1/18/2006 $113.55 SUP 4028S
[TAX] 8% State Surcharge 1/18/2006 $9.08 ELE 34 -442c
Total $122.63 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 By: � Permittee Signature: : _ f 1
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.
„F
Electrical Permit A 111.1M E :1l,- ' FOR OFFICE USE ONLY
Received
City of Tigard Date/B . A di • '.. Permit No.:6 —gyp 7 C
1 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.196 8 2006 / /� � ' l Date/B . Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: INIM ® See Page 2 for
Internet: www.ci.tigard.or.us CITY o i �g �� t Notified/Method: Supplemental Information
CITY Ad �l Jf'
if • D'ItMfi�VYO,ilr • PLAN REVIEW
❑ New construction )..2 Addition / /replaccement' Please check all that apply:
El Demolition El Other: ❑ Service over 225 amps, comm'l ❑Hazardous location
❑ Service over 320 amps - rating ❑ Buildng over 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 0 System over 600 volts nominal units in one structure
❑ Multi - family ❑Master builder ❑Other: ❑Building over three stories ['Feeders, 400 amps or more
['Occupant load over 99 persons ['Manufactured structures or
JOB SITE INFORMATION AND LOCATION ❑Egress/lighting plan RV park
Job no.: Job site address: d ❑Health -care facility ❑Other:
�4, 3 $2 12 r Ave Submit 2 sets of plans with any of the above. ,
City /State/ZIP: / 45 { A „ / l ( • The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: FEE* SCHEDULE
Description I Qty. I Fee. f Total I ”"
Cross street/directions to job site: hP,, r in c f �£( New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'I 500 sq. ft. or portion 33.40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
-� dwelling, service and/or feeder 90.90 2
U/3 y t'
/ l(..5 L t r , ` G 4 G ( -t, trrc.14v.� _�c e- S� r K 1 - S e r N ./ c� Services or feeders installation, alteration, and /or relocation
J / Ct ✓rti zt 4e 200 amps or less / 80.30 2
, r e c 201 amps to 400 amps 106.85 2
❑ PROPERTY OWNER ' T ENANT -
2 r 401 amps to 600 amps 160.60 2
Name: i t r_ , r LOU, ; e..: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) •7(.9 _ Co co 5 7 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 600 amps 133.75 2 •
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
. ❑ APPLICANT ❑, CONTACT PERSON A. Fee for branch circuits with .
service or feeder fee, each }� 2
Business name: branch circuit 5 6.65 �
Contact name: B. Fee for branch circuits
without service or feeder fee, 46.85 2
Address: first branch circuit
Each add'l branch circuit 6.65 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax:: ( ) Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited -
CONTRACTOR energy panel, alteration, or
' f extension. Describe: - Page 2 2
Business name: (use • er , /L.2ci,^tc_ 1Nc-
Address: Each additional inspection over allowable in any of the above
!moo /3 „,0 2 3 / / '5 4 Per inspection 62.50
City /State/ZIP: 5 „ ` A , Qfz, eT 7 Z 3-t - 0,4 Investigation per hour (1 hr min) 62.50
Phone: (�' ) 6,2_0 — j,04,, Fax: (s23) [-�•Zr_._ 6,e(, _ Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
• CCB Lie.: I o' 7 Electrical Lic.: 3q_44g2 .c Suprv. Lie.: 4023' S Subtotal f /3, 3”
Suprv. Electrician signature, required: 7-7...7 Plan review (25% of permit fee) •
Print name: /�7 Date: State surcharge (8% of permit fee) / , d g
/ ' ! t.,..": U S ` r- : ( /j 6 TOTAL PERMIT FEE ; 7 ) - (..3'
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.
i:\ Building \Permits\F.LC- PennitApp.doc 12/03 440- 4615T(10 /02/COM/WEB
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
i
'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:
1 .COM IERCIAL WORK 'ONLY:
Fee for each commercial system $75.00
(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- PennitApp.doc 04/03
CITY OF TIGARD
A 4.
BUILDING DIVISION PERMIT #: ELC2006-00036
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1812006
Phone: (503) 639-4171 av*
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 3/1612007 TIME: 7:01AM PAGE: 68
SITE ADDRESS: 14137 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 001 TYPE OF USE:
PROJECT NAME: GORGER
DESCRIPTION: (1) 200 amp sentice, (5) branch circuits.
OWNER: GORGER, RICHARD PHONE #: 503-705-6057
CONTRACTOR: WEBER ELECTRIC INC PHONE #: 503-620-1906
Inspection Request Scheduled For: Date: 3116/2007 Pour Time:
Code # Inspection Description Coi • • Contact # Message
199 Electrical final 044922-01 503-819-7360
Corrections/Comments/Instructions:
CM 3 PI31 (AN)
\\\(\
PASS n PARTIAL APPROVAL n CANCEL NO ACCESS
I I FAIL n CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: Ei E. • Date: 31.f 1 4 CY) Phone #: (503) 718- 2-44
CITY OF TIGARD
BUILDING DIVISION , PERMIT #: CO 0,06 — C 30
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 m a ulI't
Inspection Requests (24 Hrs.): (503) 639 -4175 J. ''L.
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: I 1- 7 1 / 37 /03 4 4 4 CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
•
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: a? — 0 t 4p Pour Time:
Code # Ins► - ription Confirm # Contact # Message p
Correcti. /Comments /Instru
/ � 1)111P114--
tit r
`r'Xs ? mwgi R.Ea,oici,s A F rJAL i s C-11
The electrical installation defects noted
on this report shall be corrected and
an inspection request made within 20
calendar days per OAR 918 -271 -0030
ft; Le /
/6
7
PASS - ARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: — Date: 0 I Phone #: (503) 718
CITY OF TIGARD _. A
BUILDING DIVISION e1.4 PERMIT #: E
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/18/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1120/2006 TIME: 7 PAGE: 73
SITE ADDRESS: 11137 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 001 TYPE OF USE:
PROJECT NAME: GORGER
DESCRIPTION: (1) 200 amp service, (5) branch circuits.
OWNER: GORGER, RICHARD PHONE #: 6'03-706.607
CONTRACTOR: WEBER ELECTRIC INC PHONE #: 603.620-1906
Inspection Request Scheduled For: Date: 1/20/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
tea
115 EletifiCal service 025359-01 503-7Q56067
Corrections/Comments/Instructions:
STI&J /
FT
7_)
or
i kSS VA P TIAL APPROVAL n CANCEL 0 NO ACCESS
I I FAIL /1 ALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
4/111111111■ /Z°-
Inspector: Date: Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION - c PERMIT #: ELC200 -0 0' 3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11181200(;
Phone: (503) 639 - 4171 i N I1
Inspection Requests (24 Hrs.): (503) 639 -4175 � 4:_4
•
INSPECTION WORKSHEET FOR DATE: 1/19/20 TIME: 7 :03Am PAGE: 18
SITE ADDRESS: 14137 SW 103RD AVE CLASS OF WORK:
SUBDIVISION: TIGARDVII_LE HEIGHTS LOT #: 001 TYPE OF USE:
PROJECT NAME: GORGER
DESCRIPTION: ( 200 amp service, (') branch circuits.
OWNER: GORGER, RICHARD PHONE #: finis -'70rf 0 ;7
CONTRACTOR: WEBER ELECTRIC INC PHONE #: (M- 620,1906;
Inspection Request Scheduled For: Date: 1/19/2006 Pour Time:
Code # - - : - - .. • Description Confirm # Contact # Message
115 Electrical r ACO 025286.01 503 - 819 -73180 Y
Corrections /Comments /Instructions: )
t `ON \A,() 14 •
I b
'VA%
n PASS I I PARTIAL APPROVAL I I CANCEL .. Y\10 ACCESS
FAIL CALL FOR INSPE TION ❑ ADDITIONAL FEES ASSESSED
/ /
Inspector: / , Date: 1 h/i Phone #: (503) 718 - Z-q
i
. 215-6/7
Inspections Required for: ELC2006 -00036
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground/slab cover
410 Fill 110 Temporary electrical service
415 Grading X 115 Electrical service
205 Footing X 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post/beam structural 150 Hot tub /spa/pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors X 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post/beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post/beam plumbing
995 Misc. inspection: 320 Plumbing rough -in
998 Alarm final 322 Shower pan
999 Sprinkler final 330 Water service •
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
1:\Building \Inspection Cards\Forms \AOP- InspCard- Blank.doc 12/09/2005
CITY OF TIGARD
DEVELOPMENT SERVICES ELECTRICAL PERMIT
PERMIT #: ELC2006 -00036
L• �� 1 DATE ISSUED: 1/18/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111138-01502 •
SITE ADDRESS: 14137 SW 103RD AVE ZONING: R -12
SUBDIVISION: TIGARDVILLE HEIGHTS LOT : 001 JURISDICTION: TIG
Project Description: (1) 200 amp service, (5) 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: 5 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:
RICHARD GORGER WEBER ELECTRIC INC
14137 SW 103RD AVE POBOX231154
TIGARD, OR 97223 TIGARD, OR 97281
Phone: 503 - 705 -6057 Contact #: PRI 503 - 620 -1906
FAX 503 -620 -6819
FEES . C
Description Date Amount Reg #: LIC 44087 P
[ELPRMT] ELC Permit 1/18/2006 $113.55 SUP 4028S 0
ELE 34 -442c
[TAX] 8% State Surcharge 1/18/2006 $9.08
1
Total • $122.63 REQUIRED ITEMS AND REPORTS O
0
0
W
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 b
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. r.
Issued By: , ,,), ;., Permittee Signature: 7 ./ri\
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.