Permit ELECTRICAL PERMIT
CITY OF TIGARD PERMIT #: ELC2006 -10014
D'Et/ LOPMENT SERVICES DATE ISSUED: 3/2/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1S134DA-05100
SITE ADDRESS: 11330 SW 108TH AVE ZONING: R -4.5
SUBDIVISION: DOREEN COURT LOT : 008 JURISDICTION: TIG
Project Description: (3) branch circuits for bath remodel. Job f# 9531.
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: 2 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:
ROBERT & L HENEGAR DAN CORRELL ELECTRIC INC
11330 SW 108TH PO BOX 16785
TIGARD, OR 97223 PORTLAND, OR 97292
Phone: Contact #: PRI 503 - 761 -7299
FAX 503 - 761 -2178
FEES
Description Date Amount Reg #: ELE 26 -103C
[ELPRMT] ELC Permit 3/31/2006 $60.15 LIC 67336
[TAX] 8% State Surcharge 3/31/2006 $4.81 SUP 46865
Total $64.96 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: ��`i( /f � Permittee Signature:
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.
5 0 3 7 6 1 2 I 7 8 p . 2
MAR 02 2006 9: 43FIM KliNWET 3200
i
,,, . • _ .
• 'Electrical rermia V: J t n FOR 01. FICK Ltill ().\(V
City of PennitNo.: Tgar
10
Received ...7__...7 __,A ,
Datell3 : ...!/ /- V . AO (.., ....,_ t -'
13125 SW Hall i Blvd., Tigard, OR 972% a i:
, 4 ., • Plan Review
Phone: 501639.4171 Fax: 503.598.19V° • k ' , D ate m y: Other Pennit:
Inspection Line: 503.639.4175 1 N'0 04 11.. Date Ready/By: Aida: , i B See Page 2 for
Internet: www.ci.tigard.or.us . kJ .01 ‘1... Notified/Method: 17 Cr" Supplemental kdormation
i • 1 '' . 111; •; c iti . ;;Rg,,giAr,Wiffii~Z;7t:0:,-AliCiAVO
0 New consfruction A:0. Ilion/alteration/replacement Please check all that apply:
['Service over 225 amps, comm'l 01 location
0 Demolition 0 Other:
i
. , . ...., „, „..,.., ,.,., , .... ['Service over 320 amps - rating DBuildng over 10,000 sq. ft.
1.4:-..V. WillIPATtri:M.4.a.r:17. . -,.. :2 Z ' -. ; . '!' ,*2titit4t: 4 *.*t(t*tOe i :'c .;Sij „:
' .*:: - k:7:'.''; ; :::. : :' : ; , ! of 1- and 2- fanlflY dwellings 4 or more new residential
1 - and 2 dwelling 0 Commercial/industrial 0 Accessory building [ISystem over 600 volts nominal units in one structure
1:113uilding over three stories °Feeders, 400 amps or more
0 Multi 0 Master builder 0 Other:
...,.. ,..,„ . - . , , , . , . „ „ , GOecupant toad over 99 persons GManufactured structures or
iNt:10:fi" DEgressflighting plan RV park
Job no. - .1' 3( Job site address: i 3) , _6 ‘, ,,_ le,(Yff -- °Flealth facility ElOther:
.4 Submit 2 sets of plans with any of the above.
City/StatefZIP: Th above are not applicable to temporary construction service.
,•
Suite/bldglapt. no.: Project name: / / arr
Description I Qty. I Fee. Total I "*
Cross street/directions to job site: Ni residential single- or multi dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea. add'l 500 sq. It or portion 33.40 1
Limited energy, residential 75.00 2
Tax map/parcel no.:
Lmted energy, non-residential 75.00 2
;..'77.; - 71;. ' ,,, aW I V - .? t : ; !: 1,#!"400 . 0* - 1***0440 , : : : ' ':: : : - 14,:i.R.P:TRA.:..EiTikii: : " . ;'•3':V Each manufactured or modular
dwelling service and/or feeder 90.90 2
7- - / .7 -4,11. i'> 4 2 1 ,e . ! (..,(,,) Services or feeders installation, alteration, and/or relocation
200 amps or less
qr10.:Patfitiailt***Ogiiiiii0;45gler:Flggn:Mtri: :' , 2 ° 1 am t° 4°13 am
7
80.30
106.85
160.60 2
2
2
Name: .- i i\ c „ .1d . rr -- fi3c,,,"1 601 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
Phone: ( ) I Fax: ( ) 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
g'.ii:.,;•"..i . : . - , -, :ii; - ;i$v i i*Ot i o•-" , „. - :.,. :: A. Fee for branch circuits with
service or feeder fee, each
ig... 6.65 2
Business name: branch circuit
B. Fee for branch circuits s
Address: --- .
Contact name:
without service or feeder fee, /
, 46.85 1 /6 / 2
first branch circuit
Each add'l branch circuit 2
City/State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) I Fax: : ( )
Sign or outline lighting 53.40 2
_
N E-mail: Signal circuit(s) or limited-
L-- a ';f;.9:0,: energy panel, alteration, or
S .. . extension. Describe: Page 2 2
( Business name: - pa n p-rei,/ (-
Address: A a._ ox le 7 Y S.- Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: & rg. 17 2.92_ Investigation per hour (1 hr min) 62.50
Phone;( s Ql■• t _.
.50 - 7„ 2 99 Fax:( x : ( ) 7&: ..... 2 42 sz y Intistrial_nlaitt per hour 73.75
' . , „irgn,:,..,}21;;X:_•,,•: ' : :, .„.' :;. ie,':'.';', t`i1X0';;=
' CCB Lie.: ..., Jr_ Electrical Lic . .-0 Suprv. Lic.: ,-- 4 :
....zr ..,.±.......-,.. Subtotal ,,p , I
W 4,0" mem
.. Suprv. Electrician signature, required: ., ...1-93 ape.
• ,re-/./t c._.-- ' .,- , . Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Print name: p ri .. „ .„.:_ e yir , Date: _
•"" - ' TOTAL PERMIT FEE
Authorized signature:
This permit application expires ifs permit is not obtained within ISO
a'kit12-----__ days after it has been accepted as complete
Print name: Date: ' Fee methodology set by Tri-County Bulb:hag Industry Service Board
"', Number of inspections per permit allowed.
CITY ������U��������
��nn m ��n on����oa�� ^
BUILDING DIVISION �
~~~,..~~~...~� ~°"°.~°"~~~~ / ' PERMIT #: ELC2006.10014
| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/212006
Phone: (503) 639-4171 Allk i
Inspection Requests �4Hmj:(5O3)630~4175 ���� ri ll �..
INSPECTION WORKSHEET FOR , DATE: 5/5/2006 TIME: 7:10Alvl PAGE: 51
,
SITE ADDRESS: 11330 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DOREEN COURT LOT #: 080 TYPE OF USE:
PROJECT NAME: HENEGAR
DESCRIPTION: (3) branch circuits for bath emodeI. Job f# 9531.
OWNER: HENEGAR, ROBERT PHO
� ' #:
CONTRACTOR: DAN CORRELL ELECTRIC INC PHONE #: 503401'7289
`
Inspection Request Scheduled For: Date: 5/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
�
199 Electrical final 029322-01 503-201-7138 Y
1
Corrections/Comments/Instructions:
/
C>
)(PASS Ell PARTIAL APPROVAL El CANCEL n NO ACCESS
pi FAIL I I CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
'/'
CITY OF TIGARD �
BUILDING DIVISION • PERMIT #: Et.C2OO6.10014
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/2/2006
Phone: (503) 639 -4171
. Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/27/2005" TIME: 7 ;Q4AMY1 PAGE: 108
SITE ADDRESS: 11330 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: DOREEN COURT LOT #: 008 TYPE OF USE:
PROJECT NAME: HENEGAR
DESCRIPTION: (3) branch circuits tor bath remodel. Job fit 9531.
OWNER: HENEGAR, ROBERT & LINDA PHONE #:
CONTRACTOR: DAN C„;ORRELL ELECTRIC INC PHONE #: 503-761-7299
Inspection Request Scheduled For: Date: 4/27/2006 Pour Time:
Code # Inspection Description ✓ Confirm # Contact # Message
199 Electrical final 028759.01 503201 -7130
Corrections /Comments /Instructions:
PhAi 1 /, 11,
- -�� E
(
0 � Q
n PASS I PARTIAL APPROVAL f i CANCEL NO ACCESS
' FAIL SALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
2 ( V Inspector: to Phone #: (503) 718✓ 1 1 (O