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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2008 -00136 COMMUNITY DEVELOPMENT DATE ISSUED: 3/10/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2 S 104AA -00500 SITE ADDRESS: 12475 SW 127TH AVE ZONING: R -4.5 SUBDIVISION: BELLWOOD LOT : 054 JURISDICTION: TIG PROJECT: FEDERIUK Project Description: Panel change. 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: SIGNAUPANEL: 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: 0 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: ISAAC & NAOMI FEDERIUK BADGER ELECTRIC INC. 12475 SW 127TH 4415 NE SANDY BLVD STE 205 TIGARD, OR 97223 PORTLAND, OR 97123 Phone: Contact #: PRI 503 - 288 -4756 FAX 503 - 493 -7173 FEES Description Date Amount Reg #: ELE 3 -57IC [ELPRMTI ELC Permit 3/10/2008 $80.30 LIC 156581 [TAX] 12% State Surchar 3/10/2008 $9.64 SUP 3596S Total $89.94 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: 5.e_k2 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. MAR -7 -2008 09:18A FROM: BADGER ELECTRIC, INC 503- 493 -7173 TO: 50359819G0 P.2 1Jw1.al l...p■ 3 /.l 1111.111111. A11l111111111.. 1 WED i City of Tigard �Q igR� R - ! L U U D 3�' P eri l N o : C� 2r .be — 1 ; 13125 SW Hall Blvd., Tigard, OR Phone: 503.639.4171 Fax: 503. 'F9d ®F TIGRR® Date/By: )hirer Permit: i , i i , Inspection Line: 503.639.4175 1Nla DIVISION �eReady/By imis. el See Page 2for Internet: www•tigard or.gov Notified/Method: Supplemental Information OF WORK PLAN REVIEW ❑ New construction Addition/alteration/replacement Please cheek all that apply (submit 1 seta of plans wntents checked below): ❑ Demolition Ohm. O Service or feeder 400 amps or mare Q Building over t stories. where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10.000 amps at 150 voila or ❑ Floating buildings. lees 1 -.-anti 2- family dwelling 0 Commercial/industrial Accessory building to ground, or exceeds 14,000 p Commercial -use agricultural g amps far all other installations. buildings. ❑ Multi - family ❑ Master builder ❑ Other ❑ Fire pump. 0 Installation of 75 KVA ar Jas SITE INFORMATION AND LOCATION 0 Emergency system. larger separately derived system. ©Addition of new motor load of ❑ "A" "E" "I -2" "I.3" Job no.: l Job site address: ‘2.4-1S Sires) ri" —ii'AvE 100HP or more. occupancy, Six or mere residential units, ❑ Recreational vehicle parks. City/State/ZIP: 0 Health-care facilities. 0 Supply voltage for more than ❑ Hazardous locations, 600 volts nominal. Suitelbidgfapt. no.: I Project name: .E K .... ❑ Service or feeder 600 amps or more. FEE SCHEDULE Cross street/directions to Job site: roe.ertarr.a I Qty. I Wee. l Tout ) • New residential single- or multi- family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Tax map/parcel no.: Ea. a dd'1500 sq ft. or portion 33.40 ` 1 Limited energy, residential 75.00 2 DESCRIPTION OF WORK (with above sq. a.) _ Limited energy, multi - family 75.00 2 �yIAO residential (with above sq. i1.) Serviees or feeders installation, alteration, and/or relocation 200 amps or less ) 80.30 9 C 2 ❑ PROPERTY OWNER 0 TENANT 201 amps to 400 amps 106.85 2 Name: + ' 1 NCI „ 401 amps to 60(1 amps { 60.60 2 �C v I 601 amps to 1,000 amps 240.60 2 Address: Over 1,000 amps or volts 454.65 2 City/State/ZIP: Temporary services or feeders installation, alteration, and/or relocation Phone: ( ) I 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 599 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, er panel ❑ APPLICANT I ❑ CONTACT A. Fee for branch circuits wi /h TACT PERSON above service or feeder fee, 6,65 2 Business name: each branch circuit B. Fee for branch circuits Contact name: wirhour se rvice or feeder foe, 46.85 2 first branch circuit Address: Each add'I branch circuit 6.65 2 Miscellaneous (service or feeder not included) City/ State/ZIP: Each manufactured or modular dwelling, service and/or feeder 80:40 2 Phone: ( ) I Ftix :: ( ) Reconnect only 66.85 2 E-mail: Pump or irrigation circle 53,40 2 . CONTRACTOR Sign or outline lighting 53.40 2 Business name: M Signal circuits) or limited - energy panel, alteration, or Address: /1 /1 \ 5 , c - , _- ^ s m extension. Describe: Page 2 2 City/ State/ZIP: 44 Jam-- ve q- - g ) ) j Each additional inspection over allowable in an 1 otthe above Phone: ('gb:Ci) Zg ,Q / Fax: l Q Per inspection 62.50 8" 1 (�)) 1 ' '1 ) Investigation per hour (I hr min) 62.50 CCB Lic.: 1`S(s,Sq i , Electrical Lie.: •3 - S1 i C j Suprv. Lic.: � j ' jq( Industrial plant per hour _ 73,75 Suprv. Electti required: to /( 0 ELECTRICAL PERMIT FEES Subtotal: go ... 0 , Print name: "S' ( . _ ,� O Plan review (25% of permit fee): Authorized signature: �JUV�1 State surcharge (12% of permit fee): 9-(-) 3 a •� TOTAL PERMIT FEE: . — ��� Print name: l Date: This permit appliatioa expires Ifs permit is not obey rf' , ltiist , y v days after it has been accepted as complete lTD CITY OF TIGARD 1 , - , .. BUILDING DIVISION PERMIT #: ELC2008-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: :341012008 Phone: (503) 639-4171 itropitilit Inspection Requests (24 Hrs.): (503) 639-4175 „JR"- ' -...... INSPECTION WORKSHEET FOR DATE: 4/14/2008 TIME: 7:00AM PAGE: 24 SITE ADDRESS: 12475 SW 127TH AVE CLASS OF WORK: SUBDIVISION: BELLWOOD LOT #: 054 TYPE OF USE: 1 PROJECT NAME: FEDERIUK DESCRIPTION: Panel change. OWNER: FEDERIUK, ISAAC &NADIA! PHONE #: CONTRACTOR: BADGER ELECTRIC INC. PHONE #: 503-288 Inspection Request Scheduled For: Date: 4/1412008 Pour Time: Code # Inspection Description C Contact # Message ''..... 199 Electrical final ti:'. 068143M1 ') 503-288-4756 Y Corrections/Comments/Instructions: 9 \,._\ .. _ o . -.' -0 1 0 3 • N \ A Ai \ • . PASS 0 PARTIAL APPROVAL 7 CANCEL El NO ACCESS ‘... FAIL I I CALL FOR INSPECTION ADDITIONAL FEES ASSESSED — Inspector: C 3-1 Nbe 1 ---t . Date: IA '1 Phone #: (503) 718- 11146 t - _ CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2008-00136 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3110/2008 Phone: (503) 639-4171 a AP KO( - Inspection Requests (24 Hrs.): (503) 639-4175 4) INSPECTION WORKSHEET FOR DATE: 3/17/2008 TIME: 7:01AM PAGE: 48 SITE ADDRESS: 12476 SW 127TH AVE CLASS OF WORK: SUBDIVISION: BELLWOOD LOT #: 064 TYPE OF USE: PROJECT NAME: FEDERIUK DESCRIPTION: Panel change. OWNER: FEDERIUK, ISAAC & NAOMI PHONE #: CONTRACTOR: BAWER ELECTRIC INC. PHONE #: 503-288-4756 Inspection Request Scheduled For: Date: 3/17/2003 Pour Time: Code # Inspection Description Confirat_# Contact # Message 199 Electrical final 066619-01 503-288-47156 ‘N..„ $ Corrections/Comments/Instructions: . IQ, 3, 9i AL,: is6A POit easfy. Niq t\ tkist6 6cls $ckl. fl PASS 1 PARTIAL APPROVAL LII CANCEL fl NO ACCESS 0( FAIL XCALL FOR INSPECTION El ADDITIONAL FEES ASSESSED . Inspector: Cr/ N(3 LC Date: . 5 .1 1 1 )1) Phone #: (503) 718- 144k