Permit C I T 1 r O F TIGARD ELECTRICAL PERMIT
III .1 PERMIT #: ELC2008-00130
COMMUNITY DEVELOPMENT DATE ISSUED: 3/6/2008
TLLA' o ,. 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 103DC -00500
SITE ADDRESS: 13705 SW 110TH AVE ZONING: R -3.5
SUBDIVISION: FAIRHAVEN COURT LOT : 004 JURISDICTION: TIG
PROJECT: DAVIS
Project Description: Installing (3) branch circuits for A /C, furnace, and an outlet.
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:
JANET DAVIS GRF ELECTRIC
13705 SW 110TH AVE 15460 S PARADISE LN
TIGARD, OR 97223 MULINO, OR 97042
Phone: 503 - 624 -6493 Contact #: PRI 503 - 829 -4146
FAX 503 - 829 -5747
FEES
Description Date Amount Reg #: ELE 3 -484C
[ELPRMT] ELC Permit 3/6/2008 $60.15 LAC 76751
[TAX] 12% State Surchar 3/6/2008 $7.22 SUP 1655S
Total $67.37 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 B . 1�� � —�� Permittee Signature: _ j �i� / ' �Q / j
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.
lac 06 08 11:38a GRFELECTRIC 5038295747 p.1
Electrical Permit Ap�lica- ti
, )lz (.4 HI I St O\L'
City of Tigard n
h
r i Reeeivcd 3 .
DardBy: 6/03- ('f, ena
ritNn.:._ c')
e.d— Dc13 0
r 13125SW Hall Blvd,,Tigarrd,OR 97MA p — 6 CU08 Plan Review C
Phone: 503,639.4171 Fax: 503.59�,7'46d` g)atc/Ay; Other Path: CdttjQ - //3
: „... A if 0 Inspection Lint; 5111.6394 CITY 175 C Q DateRoadym e: y. lime 43 Ste Fite 2 far J
Internet www.tigard- or.gov S r i TIGARD t iiY t'S Notified/Method: Supplemental locomotion
r 4 : I I N
TYPE 0 ` • ' K NV REVIEW I
Q Now construction `, Additionlalteration/replacemcnt Flute ehmk all dim app) (submit 2 sets n( plsm wJ(mnt; elxelced below)
❑ Serviu er fader 400 amps or Wrote 0 Building over throe stories. i
❑ Demolition ❑ Other:
where /fta svailable fault torrent ❑Marinas and boatyards.
CATEGORY OF CONSTRUCTION stead, 10,000 anon in ISO volts or ❑ flaetiolt huildiogs
less to ground, or exceed: 14,000 ❑ Commercial -ore agricultural
W1 -and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps far stl oilier imagstions, buildings.
❑ Multi - family ❑ Master builder D Ocher: DFire pylon. ❑ Installation al 73 KVAot
JOB S[TE IOYFpRMATTON AND LOCATION O Emergency system. larger repsratdy derived value.
❑ Adrlltion deem mow load of 0 "A" "E"."1.2"."1-0
Job no.: lob sire address: 10011P or more. tuctteamy.
S (, I / O ° Ste comae residential m l units. 0 Rea direst vehicle parks.
City/State/2.1P: 1 IP: L, (/ - 2- _ 3 QF.tealth -cue fro l.iioe. 0 Supply voltage for sore than
L ❑Hawrdeus locations. 600 volts notmioal.
Suite/b14. /apt. no. . ( Project name: , 0 Service or feeder 600 imps etmom
FEE SCREDtI.E
Cross streelidirections to job site;
n 'aria. I On. r rm. 7 7.4t I ' ,
New reaidentia I stogie or multi -Pamiy dwelling unit.
Includes attached garage.
Subdivision: 1 LOt no,: 1.000 sq. & of lees 145.15 4
Tax map /parcel no.; Fa add'I 500 sq, ft. or portion _ 33.40 t
Limited mew,residenrial 75.00 2
DESCRIPTION OF WORK (wilt above nut)
i t Limited energy, multi- family 75.(111 2
4 _ . . a 11. i a .. r 9 j-e ONLY residential (with 'bow sq. 0.) _
� / Services or feeders Installatin alteration, and/or relocatio
)"1,-) er e-- i l''. ell./ i l n ..11_ p'1 e O rs . ( 200 amps Or ICU 80.30 { 2
normal' owNrrR 0 TENANT 201 amps to 400 amps 106.85
r 2
Name: J ik 1. ,,, e _ t- p6, v i S 401 amps to 600 amps 160.60 2
Address: 3 0 S 601 turps to 1,000 amps 240.60 ' 2
1 0 Over 1,000 amps or volts F 454.65 2
City/Stale/ZIP: ) G .401 C, L . Temporary services or feeders installation, liberation. and/or
relocation
Phone; ( ) (p Z 4---/,1 ! 3 Fax: ( ) 200 mnps 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 p
intended for sale, tease. rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 1 2
Own= signature: Date: A. circuits new. alierattan or extension, cr 'anal
A. Fee For branch circuits with
AYPLICAN T i ❑ CONTACT PERSON above service or feeder fee, 6.65 2
Business name: / r /� _ each branch circuit
l 1 t� t r� B. Foe for branch t irauits
Contact name: wigwag service or feeder fee, ' 46,85 t� "..-2
A A..." Ara branch circuit I f a .
Address: Ai '/ 0 S , ' • .4 L_- Each add'1 branch circuit j 665 1-3- ' � 0 2
City/Sttttc/ZIP: /� /� Miscellaneous (service or (ceder not iacluded)
( LA- j l ,;1 U t� f' — 1- . Each manufactured or modular 90.90 2
Phone: dwelling. service and /or feeder
( ) r Z�-r , ;Fax:: ( � �) ' _ r) Reconnect only 66.85 2
E -mail: Ptunp or irrigation circle 53.40 2
CONTRACTOR Sign or outline lighting 53.40 Z
Business name: Signal circttit(s) or limited-
Address: extension. Descrb or Page 2 2
City/State/21P: Each additional Inspeelinn over allows/sir in any of the above
Per inspection I 62.50
Phone: ( ) I Fax: (• )
Investigation per hour (1 hr min) 62.50
CCB Lic.: Co Electrical ll,iC.: ' In dustr ial plant per hour f 73.75
ty }� E � —f{ (�1 Suprv. r
Supry Electrician signature, required. C - , J ELECTRICAL PERMiT FEES
Print mime. A A • - AA Date: • O J Plan review (25% of mink fee):
Authorized signature: d State surcharge (12% of permit fee): Z
TOTAL PERMIT FE . n
Print name: Date: This permit application empires It a permit is ant eatsioerrd within 160
days after it hat beam accepted ar oiraplere.
• Number ofinepccl ions Mimed perpermit.
is Bails,nalear•IulaLC.P .vtootoe etas cad 15Tt1I /OS/COMWEB
� � ' '
CITY ���~���, ���������������
n n�'m o n����ma��
BUILDING IVISION PERMIT #: []'(2O0�0D1�� " A | 131�5SVVHaUB�d,Tlgand.ORQ7223 DATE|8SUED� ��/2�08
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 °.40-'AL
INSPECTION WORKSHEET FOR DATE: 3/11/2n `t TIME: 7:00AM PAGE: 21
SITE ADDRESS: 137DSSYV11DTHAVE CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: 804 TYPE OF USE:
PROJECT NAME: DAVIS
DESCRIPTION: Insta (3) branch circuits for A/C, furnce, and an outlet.
OWNER: DAVIS, JANET PHONE #: 503-624-6493
CONTRACTOR: CRF ELECTA}(| PHONE #: 603-829-4146
Inspection Request Scheduled For: Date: 3/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # K8eao
4 62-^--
199 Electrical final 066478-01 508-829-4146
Corrections/Comments/Instructions:
.
*/'
r��� �� ��/� e 4 u/� _ r �
' ,A., / �� "� v
, ._
'• /^
��� _
` a .
PARTIAL APPROVAL 7 CANCEL NO ACCESS
FAIL CALL FOR INSPECTION [ji ADDITIONAL FEES ASSESSED
-� �//
Inspector: Date: `_� / / ' / �� Phone #: (503) 718'