Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: E1-C2008 00588
COMMUNITY DEVELOPMENT DATE ISSUED: 10/15/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 110 B B -04200
SITE ADDRESS: 12244 SW AMES LN ZONING: R - 3.5
SUBDIVISION: ARLINGTON RIDGE LOT : 019 JURISDICTION: TIG
PROJECT: OTIS
Project Description: (3) branch circuits for oven and dishwasher.
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:
BRIAN & LORRAINE OTIS GOT POWER
12244 SW AMES LN 17990 MONTICELLO DR.
TIGARD, OR 97224 GLADSTONE, OR 97027
Phone: Contact #: PRI 503 - 722 -1295
FEES
Description Date Amount Reg #: ELE 3 -589C
[ELPRMT] ELC Permit 10/15/2001 $60.15 LIC 158067
[TAX] 12% State Surchar 10/15/2001 $7.22 SUP 4678S
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 •AR 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:
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.
10/15/2008 08:37 FAX 5037221592 Got Power Electric l ]001
;Electrical Permit Application 01)
Received FOR OFFICE 1 SSE ONO
8 1 25 of BI v d d Qt� Date/By: I(� � Permit No.: 1 c 9w �, � 3r
iii
0 13125 SW Hall Blvd, Tigard, OR 9 Plan Review
f -'0
Phone: 503.639.4171 Fax: 503.598.1960 r '\ D Other Permit:
T t C '_ R D Inspection Lime: 503.639.4175 01� G` r SO • Re /By: ' 1a Sec Page 2 for
Internet: vtww.tigard- or_gov O g 15 out ethod: f ie 77(1 Supplemental information i
❑ New construction ® Addition/alteratilacement Please check all that apply (submit 2 sets of plans w /items checked below):
Q Service or feeder 400 amps or more Q Budding over Thine stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
._.,-=- = ...._..__..:. - - .-. -: R-. --- _- exceeds 10000 at 130 volts or Floatin buildings.
_ - - __.. CAT VOR O fjNSTR[IQ ION .,,_._.^ - - amps _ less to ground, or exceeds 14,000 ❑ Commenciat -use agricultural
® 1- and 2- family dwelling ❑ Commercial /industrial 9 Accessory building for for all other installations. buildings.
0 Mufti- family [] Master builder i] Other: I]Fizc 0 1nyallatirw of 75 K VA or
- _ ' - -' - -_ _ -_ ency system. larger separately derived system
,__,:_ -_ == _ >_ _- ____:,. - . SOS SITE_INFURM___A I03 GATQ4�i =_'' -- _-- _ = =-'-
- ' - � . - -__ -- _ --- ` -- ' 141N
:,- -_ _ --__ "•- - - • - - -- - -� - o new motor d of - 1 - -
_ . _ -' -- - : --- _ -- -'- _ - Addition f r loot °A ^ ^, "L" °1 2r •: 3'•
Job no.: Job site address: 12244 SW Ames Lane 1 ootit' or more. occupancy.
❑ Six or more residential units- Q Recreational vehicle parks_
City /State /ZIP: Tigard, Oregon 97224 ❑ Ec'ahh -care facilities. Q Supply voltage for more than
ED Hazardous locations. 600 volts nominal.
Suite/bldg. /apt.no.: + Project name: Add o circuit V 0Senice feeder 600anapA
-_ - - _ FEE-SHH €DUCE - _
Cross street/directions to job site: 121" Ave Descnptloo 1 Qty. I Fee Total ►
New residential single- or nanite -f». JJy dwelling unit
Includes attached garage.
Subdivision: Lot no.: 1 = 000 sq. ft. or less 145.15 4
La add'! 500 sq. tL or portion 33.4() I
Tax map /parcel no.: Limited residential
. _ =. ___ -. : - _ ; ; _ - totted energy, resid 75. 2
- - =- :...._ ., - - --- = - DESiL7i1J O OEl 0.111K _ _- _ :_ _._. __-_.:,_;:: ;_ (with above sq. ft.)
limited energy, multi -family
Add oven circuit and extend dishwasher ckt residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 2
Q PitQPERFFY OW FER . - __ 11a.jrYNABIT _ = 201 amps to 400 amps 106.85 2
Name: 401 amps to 600 amps 160.60 2 ,
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: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I on 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
Branch circuits - new, alteration, or extension, per panel
Owner signature: Date: A. Fee for branch circuits with
- - - - -- - -- - - =TOT - - - =- -- - - -- - - - feeder feu
._ : __ ._ - � IGAAiT = .,;..:: = COIYTAGT PENS(3N
r- - ;' - above service or d
6.65 2
Business name: Got Power Electric, LLC each branch circuit
B. Fee for branch circuits
Contact name: Timothy Schmidt without service or feeder fee 1 46.85 L-((, IF 2
first branch circuit
Address: 17990 Monticello Drive Each adds branch circuit 2 6.65 f 2
Miscellaneous (service or feeder not included)
City / State/ZIP: Gladstone, Oregon 97027 Each manufactured or modular 90.90 2
dwelling, econnect t only
Phone: (503) 722.1295 Far :: (503) 722.1592 Reconnect and/or feeder
Recon 66.85 2
E -mail: got.power @comcast.net Pump or irrigation circle 53.40 2
- CON-T1tACI OR = �_ _= Sign or outline lighting 53.40 2
Business name: Got Power Electric, LLC Signal circuit(s) or Limited -
energy panel, alteration, or
Address: 17990 Monticello Drive extension. Describe: Page 2 2
City/ State/ZIP: Gladstone, Oregon 97027 Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone; (503) 722.1295 Fax: (503) 722.1592 Investigation per hour (I hr min) 62.50
CCB Lie.: 158067 Electrical Lie, 3589C Suprv. Lic.: 4678S ' Industrial plant per hour 73.75
. --- - - -- -- - -'- _ :-_ ___- 1,. 1 41- :EERMITI_PEPS'-_ _- _ - -_
Suprv. Electrician signature, required , /� / / G � - _ Subtotal: 60.15
Print name: Richard Poudrier Date: /V l, /
Plan review (25% of permit fee):
State surcharge (12% of permit fee): 7.22
Authorized signature: i
A V C TOTAL PERMIT FEE: 67.37
-
This permit application expires if a permit is not obtained within 180
Print name: Timothy Schmidt Date : /g/ /-67n ,Q� days after it has been accepted as complete.
!� Y ' Number of inspections allowed per permit.
I: \Etuildii Weemirs\ELC -P rmii pp not 05/23r06 440- 16.15T(i1/05)COMfWt_lt
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC20t)B -00588
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/15/20118
Phone: (503) 639 -4171 �48414111'
�� 1 "jij r J
Inspection Requests (24 Hrs.): (503) 639 -4175 !�i :! l.
INSPECTION WORKSHEET FOR DATE: 12/18/2 t+' TIME: 7 :01AM PAGE: 10
SITE ADDRESS: 12244 SW AMES LN CLASS OF WORK:
SUBDIVISION: ARLINGTON RIDGE LOT #: 019 TYPE OF USE:
PROJECT NAME: OTIS
DESCRIPTION: (3) branch circuits for oven and dishwasher_
OWNER: OTIS, BRIAN & LORRAINE PHONE #:
CONTRACTOR: GOT POWER PHONE #: 503. 722-1.295
Inspection Request Scheduled For: Date: 12110/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final • 079108 -01 503- 753.9362 N
Corrections /Comments /Instructions:
C i
PASS 'ARTIAL APPROVAL ❑ CANCEL n NO ACCESS
id ' IL % CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 1. ___ — Date: 46/ Phone #: (503) 718- Z_C-Y
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: f 605 - REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date By If Code Inspection Description PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
- 410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing x 120 Electrical rough -in
805 MFG- Structure grading /footing , 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
- 220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors x 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG - Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab
PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I. \ Building \ Forms \InspCard -AOP -Blank doc 02/02/07
ELECTRICAL PERMIT
'`
CITY OF TIGARD
PERMIT #: ELC2008-00588
COMMUNITY DEVELOPMENT
DATE ISSUED: 10/15/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2 S 110 B B -04200
SITE ADDRESS: 12244 SW AMES LN ZONING: R -3.5
SUBDIVISION: ARLINGTON RIDGE LOT : 019 JURISDICTION: TIG
PROJECT: OTIS
Project Description: (3) branch circuits for oven and dishwasher.
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:
BRIAN & LORRAINE OTIS GOT POWER
12244 SW AMES LN 17990 MONTICELLO DR.
TIGARD, OR 97224 GLADSTONE, OR 97027
Phone: Contact #: PRI 503 - 722 - 1295
Wi
•
FEES P
Description Date Amount Reg #: ELE 3 -589C O
[ELPRI IT] ELC Permit 10/15/2001 $60.15 LIC 158067 Q®
[TAX] 12% State Surchar 10/15/2001 $7.22 SUP 4678S 1J
Total $67.37 REQUIRED ITEMS AND REPORTS 0
0
UD
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 AR 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 .
- !' —"
Y �,y �'-- .__/-- Permittee S i /'% \ �^ s ue- ,
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.