Permit CIT QF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00316
Alof � DEVELOPMENT SERVICES DATE ISSUED: 6/2/2006
- '- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 104AC - 03900
SITE ADDRESS: 12647 SW 133RD AVE ZONING: R -25
SUBDIVISION: MORNING HILL NO. 8 LOT : 183 JURISDICTION: TIG
Project Description: Circuit to 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:
STEFFEN, MICHAEL J OWNER
12647 SW 133RD AVE
TIGARD, OR 97223
Phone: 503 - 521 -1906 Contact #:
FEES
Description Date Amount Reg #:
[ELPRMT] ELC Permit 6/2/2006 $46.85
[TAX] 8% State Surcharge 6/2/2006 $3.75
Total $50.60 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: f 4 4_ f1 -� Permittee Signature: AP d r
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.
Elect *ical Permit A 1i �ti o Li ng FOR OFFICE USE ONLY .
City of Tigai p I As _ :j. Received e i 't
'� / Pe rmit No C a, , - '3a/c,
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi w
" 13 ' ' Phone: 503.639.4171 Fax: 50 ' S 8.1960 Date/By: Other Permit:
T I CA R D Inspection Line: 503.639.4175 JUN 2 2006 Date Ready/By: 'lids: ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: ��5( Supplemental Information
1 ,� . (�
T O YYORK I L I ri Ali PLAN REVIEW .
�� y t e Please check all that apply:
❑ New construction �rtto u rteZ "aio'nJrepla/ cet�iter�t ! Pl h t
❑ Demolition Other: ❑Service over 225 amps, comm'l ❑Hazardous location
❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION oft- and 2- family dwellings 4 or more new residential
X I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
Master builder Other:
['Building over three stories ❑Feeders, 400 amps or more
Multi - famil
❑ Multi-family ❑ ❑
❑Occupant load over 99 persons ❑Manufactured structures or
JOB SITE INFORMATION AND LOCATION . ❑Egress/lighting plan RV park
Job no.: Job site address: f L6 1. f7 SvJ 133 AO E ❑Health -care facility ❑Other:
r� Submit • 2 sets of plans with any of the above.
City /State/ZIP: TI G Ai` 7 o O O T 7 223 The above are not applicable to temporary construction service.
Suite/bldg. /apt. no.: Project name: -fp C� FEE* SCHEDULE (
Description I Qty. I Fee. I Total I "
Cross street/directions to job site: 1 -s V --O Nu E 5 r3 EPJ (S VI New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: M 0 K l NG HILL Lot no.: i g3 Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map parcel no.: RZ i 3 C Limited energy, non i 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK Each manufactured or modular
R Q j P 0\N.1 ER_ 7o HOT -� c e u t C K dwelling, service and/or feeder 90.90 2
f ,/ HOT V Services or feeders installation, alteration, and /or relocation
pi C U (� co M N ECT ' o t?) 0 t 1 &R.G.A K � 201 amps o 400 amps I 106.85 WQZO 2
PROPERTY OWNER . ❑ TENANT
r _ 401 amps to 600 amps 160.60 2
Name: M I (i _ L �� � ' 601 amps to 1,000 amps 240.60 2
Address: i'. 6 i.4. 7 S 1 '3 (W A \JL Over 1,000 amps or volts 454.65 2
�
Reconnect only 66.85 2
City / State/ZIP: `T C R.D �� � 72 Temporary services or feeders installation, alteration, and /or
( S 5 Z ` - (a (5 ) S 2 19 . C relocation
Phone: D J 1 D Fax: 3 �b 200 amps or less 66.85 I
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 ent, or e ange, according to ORS 447, 449, 670, and 701.
i r 401 amps to 600 amps 133.75 2
Owner signature: - Date: G-1-0 6 Branch circuits - new, alteration, or extension, per panel
❑ APPLIC T ❑ CONTACT PERSON A. Fee for branch circuits with
service or feeder fee, each 6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
first branch circuit / 46.85 2 .
Address: 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 .
extension. Describe: Page 2 2
Business name: (--t il - 1 U\--
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City / State/ZIP: Investigation per hour (1 hr min) 62.50
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES*
CCB Lie.: Electrical Lie.: Suprv. Lic.: Subtotal: 216, S
Suprv. Electrician signature, required: Plan review (25% of permit fee):
Print name: Date: State surcharge (8% of permit fee): 3 _ 1 S
TOTAL PERMIT FEE S, 0
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.
l:\ Building \Pennits\ELC- PermitApp.doc 03/23/06 440- 4615T(1 I/05 /COM/WEB
Electrical Permit Application - City of Tigard '
. Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTNAI 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: RO1 TJ B
COMMERCIAL WORK "ONLY: .____._____
Fee for each commercial $75.00
system
(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 LighOng*
❑ Protective Signaling
D. Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building \Permits\ELC- PennitApp.doc 03/23/06
CITY OF TIGARD
BUILDING DIVISION A • PERMIT #: ELC2006-00316
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/2006
Phone: (503) 639-4171 .hfolltiiiI\
Inspection Requests (24 Hrs.): (503) 639-4175 ..,Jill■ -....
7 INSPECTION WORKSHEET FOR DATE: 7/7i2006 TIME: 7: PAGE: 15
SITE ADDRESS: 12647 SW 133RD AVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 8 LOT #: 183 TYPE OF USE:
PROJECT NAME: STEFFEN •
DESCRIPTION: Circuit to hot tub.
OWNER: STEFFEN, MICHAEL J, PHONE #: 503-521-1906
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 717/2006 Pour Time: .
Kle . Inspection Description Confirm # Contact # Message
199 Electrical final 032819-01 503-521.1906 N
I IIIIIb ,
we - ctions/Comments/Instructions:
Q
----........ _ Q._
PARTIAL APPROVAL El CANCEL 0 NO ACCESS
fl FAIL fl CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
•
Inspector: 1\)qe) L: Date: r) 9 01) Phone #: (503) 718- 2 •
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200 -(0316
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/2/2006
Phone: (503) 639 -4171 �m�» i�
Inspection Requests (24 Hrs.): (503) 639 -4175 4 .3 `�'L
INSPECTION WORKSHEET FOR DATE:; 715/2006 TIME: 7: 00AM PAGE: 10
SITE ADDRESS: 12047 SW 133RD AVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 8 LOT #: 183 TYPE OF USE:
PROJECT NAME: S1 EFFEN
DESCRIPTION: Circuit to hot. tub.
OWNER: S1'EFFEN, MICHAEL J, PHONE #: 503 -521 -1900
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 7/5/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 032665-01 503-521-1906 N
Corrections/Comments/Instructions:
O 1,--A (- E - k-- E-L C (L C.L 'PANEL. SAoi i ri di
ciDME '30 \- v•)1%► 1 cts01 a-IA- 1\ 10 es_
t&_ 4ttt 4
P asy.11 c.)1._G u f k.:03 ( 6 \-64- c (
, p t..1 -t EEigkt.. C__Zk) -&-. 4. (CiAZ c t 1 \\ 1 . --1 )
)J
yikaSD
PASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS
X I FAIL 4 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: _ 0- _Pi N be L.,' Date: 11 3/O 1) Phone #: (503) 718- ALA •