Permit CITY OF-TIGARD ELECTRICAL PERMIT
1 n COMMUNITY DEVELOPMENT PERMIT D: ELC2008-00371
DATE ISSUED: 6/25/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BB-08700
SITE ADDRESS: 16288 SW 104TH AVE ZONING: R -12
SUBDIVISION: SWANSONS GLEN LOT : 028 JURISDICTION: TIG
PROJECT: MORRIS
Project Description: Installing (1) branch circuit for hot tub.
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:
MICHAEL & GAIL MORRIS S & A ELECTRIC, INC.
16288 SW 104TH AVE PO BOX 218
TIGARD, OR 97223 BORING, OR 97009
Phone: Contact #: PRI 503 - 826 - 1707
FAX 503 - 826 -1710
FEES
Description Date Amount Reg #: ELE 3 - 520C
[ELPRMT] ELC Permit 6/26/2008 $46.85 LIC 148014
[TAX] 12% State Surchar 6/26/2008 $5.62 SUP 4833S
Total $52.47 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: /�j� Permittee Signature: Q /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: 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.
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• 13125 SW Hall Blvd., Tigard, OR 972231 2 4 2008 'en Ri""Y
° Phone: 503.639.4171 Ftac 503.598,19,601 ON Remit:
v:
Inspection Line: 503.639.4375 �a D'tc adyrPr. r.c >a Sa P etc 2. for
' Internet: ww•w.tieard•or.gw
ON OF Ti
IGARD Not' (7cdT4otlo& tr o SumwooKvtol.terormano•
ME °ErgitSING DIVISION PLANT RRV1EW
a New construction 0 Addti0n /altcratio<eplace nett balsa'ta,eelt .0 tit,. soy (aobaait j KU at gl4as wlmns ehvt* eel bclm+)
0 Serviu es racier 400 apps a Marc ❑ Building over ihreu a;WO&.
p Demolition her ,-- ..here ale available tali anon( ❑ Mttrinar and bo*Qxds.
CATEGORY OF CON RUCTIlON rereads 10,000 amp, it 130 volts or 0 Foatar b i ldinp.
‘151. ' � less to round, or oc cda 14, MO 0 Cen+mn=tid.utt .Qncij "ri1
anti 2- family dweiling 0 Commercial /industrial ❑ Accessory building amp" focel1 ntbainalllaniotu. build* p
❑ Multi -family C-t Master builder Q Ocher: ❑ Fire pimp. D Ireiallseca d 7) Kvn or
JOT* SIMM INFORMATION AND LOCATION ❑l rsers ryst.w+. 1•raer xp•r -217 1.3 ryas
a �s4i or new motor loa4 of o "A". �� •• l - r • . -,.,,
n r Toole a R(Vt. oaa•oaeey.
i
Job no.� if ("2 Job site address: ���L J
G ❑ Si, H more rc4idtntid units. <] Rcctz•Hona1 vicetek Fr6°
Ciry/StaxJZ1P:
" 0 ❑ tieuth•ea o taeiliuc :. ❑ Svpr•ly vottaFa k' more than
� . ��--� ❑Hazarrddarr• lorwii m. 640 roll nomtnd,
Suitc/bldg. /apt, no,; Project name: / ) id (3 Service or feeder 600 temp: or mom.
FZ SCHEDULE
Cross streelidircetitms to job site' - ,,.,.• r, Yes• •
New reeidetdat mingle- or mule - tenuity dwenine unit.
Includes attached rage.
Subdi vision: Lot nor.: 1,000 sc. t4. or less 145.15 4 4
Ea. sdd'1 500 sq. tt. oc portion 33,40 I
Tax map /parcel no.: Limited energy, residential
OLSc x?'IION OF WORK (with these se, f) 15.00 2
r — Limited of , multi - family I
C l NI ti (✓� residential with above • . ti 75.00 1 2
Services . feeders ices Latin. alteration aedlor r I cz inn
200 • '. or lctia ME 80.30 ! 2
RO1rERTl awNEJR ❑ TLNANi• 201 amps to 400 imps 106.85 2
401 amps 10 600 s i 160.60. 1 2
Iramc: i � \Z \_� � +
601 amps to 1,000 amps 1 240.60 ,
Address: Ova 1,000 amps or volts 454.65 2
7earporar7 services er feeders installation• alteration, ind/or
City/State/ZIP: relocation
Pl1anc: ( ) Fax: ( ) 200 ups or ic‘s 66.85 I
"
Owner installation: This instsgbsliorl is being made on property tbat I own which is Ac1c 2 01 1°"W to 400 'taws 100 1 -
intended for salt, lease, rent, or exchange, accotdin& to ORS 447, 449, 670, and 701. 401 *nips to 549 °naps 133.75 I 2
Owner 9i,IItl alllre: Date: Branch , or
Branch circuits - mew, 'Iteration txtc n fins per pulct
` A. Fee For branch circuits with I •
❑ APPLICANT ❑ CONTACT PY'�i9QN above savior or fader Pic,
{ cacti branch circuit 6.65 2
j Business name: B. Fee for branch air=it%
Contact )same: withou! service or Seeder 1ec 4{,.85 J - 2
first branch circuit ,
Address: Etch add'' branch circuit 6.65: ' 2
Miscellaneous (service or feeder not included)
City/StateZIP: Each manufacatred or modular
dwelling. vice and/or feeder 90'90 2
ser
Phone' ( ) Fax; : ( ) Reconnect only 66.85 2
E-mail: • or Teri •r• • on circle IIn 53.40 2
CONTRACTOR Sign or outline 1i king 53.40 • 2
Buslncss name: t � )_.-- Signal drasit(s) or limited-
- J 1 C�� t~�l �� �C energy panel, alteration, or
es
Addrs: V C) \ A ` p " extension. Deseret; Viii 2 2 1
City /StatelZJY: U (?� \ i s C (S _ C '7b C) -( F,ach additional las 'action over allowable is any of the "boys
Q � Per inspection 62 50
Phone
(5.X E-(p ( ?G� f Fax: ( 503) Bata • 1 - 71 CJ Investigation per hour (1 Ar sire) U 62.50
CCB Lic.: i `l ( Electrical Lit.: -0 ) 2,,)C Suprv. Lie.: e, 3 3,5 Industrial plant perhour 7175
ELECTRICAL 1"ERMrr FEES
Suprv..Flextrician signantre regtt ��� �1% — I
Subtotal: IN t t
Print name: Lj C'(t • - ski era , e: G(_ CZ Plan review (25% of permit fec):
State 'urchins (12% of P emtit fie) 7 , Co Z.
Authorized signature :— • • . -) TOTAL PER1vfa FEE: --- ,
Print name: �S y i C1? Date: 06 � , 7 L - CJ • / it person appleadre tars pi if a permit to not m to led within kite
Y 7 - h d, •der it RA! lean mu:weed a• co un plea.
' Nnmbr of inoveetioet afowai pa txmit.
t:•8.06na'4'e'.ttdr.I.0 r erm t App oc 0Y37/ttr, 4.6.44 i s'r(1 iM.Vc6MfWG8
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CITY OF TIGARD,
BUILDING DIVISION
PERMIT #: ELC2008.00371
D ATE 13125 SW Hall Blvd., Tigard, OR 97223 ISSUED: 6/25/2009
Phone: (503) 639-4171 -mblinimir IC' .
Inspection Requests (24 Hrs.): 639-4175 As M 2.
INSPECTION WORKSHEET FOR DATE: 7/8/200r TIME: 7:00AM PAGE: 48
SITE ADDRESS: 16288 SW 104TH AVE CLASS OF WORK:
SUBDIVISION: SWANSONS GLEN LOT #: 028 TYPE OF USE:
PROJECT NAME: MORRIS
DESCRIPTION: Installing (1) branch circuit for hot tub.
OWNER: MORRIS, MICHAEL. & GAIL PHONE #:
CONTRACTOR: S & A ELECTRIC, INC. PHONE #: 503-826-1707
Inspection Request Scheduled For: Date: 7/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 072309-01 503-730-9695 N
Corrections/Comments/Instructions:
cz? /1-irtf'
-- bis c.,,,,,_ l 1 --- ,4-'-i ‘-‘F Gf isKi
•
411 APPROVAL 0 CANCEL n NO ACCESS
111 FAIL V CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector:
Date: • e23' Phone #: (503) 718- 2 -C 7 7 7 Y
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