Permit CITY OF `TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 00109
COMMUNITY DEVELOPMENT DATE ISSUED: 2/27/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S112CA-11300
SITE ADDRESS: 07755 SW ASHFORD ST ZONING: R -4.5
SUBDIVISION: RENAISSANCE WOODS LOT : 039 JURISDICTION: TIG
PROJECT: JENSON
Project Description: Adding (5) branch circuits for kitchen.
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: 4 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:
DARYL & BARBARA JENSON BEAR ELECTRIC
7755 SW ASHFORD ST P.O. BOX 389
TIGARD, OR 97224 DONALD, OR 97020
Phone: 503 - 639 - 7241 Contact #: PRI 503 -678 -1355
FAX 503 - 678 -1108
FEES
Description Date Amount Reg #: ELE 24 -107C
FELPRMT1 ELC Permit 2/27/2008 $73.45 LIC 20919
[TAX] 12% State Surchar 2/27/2008 $8.81 SUP 4902S
Total $82.26 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. Yu ma obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: / ✓ Permittee Signature: Q 4� 3y�
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.
02/27/2008 WED 13:20 FAX 5036781108 Bear Electric, Inc. 2001 /002
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Electrical Permit Application i t '�
FOR OFFICE
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City of Tigard R.. " Receive ...... . •
Date/By: / ermit No.. p
(J C.0 }UrfO 00 10 13125 SW Hall Bird., Tigard, OR 97223 L Plan Review
Phone: 503.639.4171 Pax: 503.598.1960 /i- Other Permit:
Inspection Line: 503.639.4175 �. I ater
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Al„,,!, i;,,, ;'Dzte. Ready/By: furls El See Pager for .
ct.ugard.
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Internet: vrwo/ s
o � % Notified/Method: Supplemental lnforma[wn
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o ED New construction Addition / alteratio � V ement Please check all that apply: •
0 Demolition ❑ Other: ❑Service over 225 amps, comm ❑Hazardous location
�Y Vie' h•. _,fir - 4,::>.- :'rr „:;�:. - >,::� �.,Y �.��, - ❑Service over 320 as - rating ❑ Buildng over 10,000 sq. ft.,
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�r,,;; . :.�s�'- Y-- 4.�4rxr .Y.:�t ..v.,_��ao; ,�,., � '��;,"� �; of 1 -and 2-family dwellings 4 or more new residential
1 and 2 family dwelling ❑ ConunerciaUindustrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
❑Building over three stones ❑Feeders, 400 amps or more
I1] Multi - family ❑ Master builder ❑ Other:
r• _ �_ -� , ;. ,:
: ❑Occupant load over 99 persons ❑Manufactured structures or
M1 ri; .- JDBrthRORr11TlO1iTI�Tt =r;A 1 YQ�r -� z ; psi o
, , tfrfi -O: ;T ..:. � ;.,�.r. z r e :_: ,•y,r„ :...:.,,.. .: '.sr. :.>.r:� '°�>� s a; i ❑Egress/li plan RV park
Job no.: I Job site address: --/ 1 S5 Si. ( oS S4 ❑Health -care facility ❑Other:
Vim` Submit 2 sets of plans with any of the above.
- City /State /ZIP: ''7' 42c t 7 qr? 2 Z if The above are not applicable to temporary construction service.
Suite /bid /apt no: I Project name: �( ,. , .._wf. ..:..
..•_...:...._. ti.- �,_Tx ... :. ... :...:
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�� ' ° "Nk$N Description { Qty. Fee. I Total I "`
Cross street/directions to job site: a f' .5%03 , ) New residential single - or multi- family dwelling unit.
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J l `� Includes attached garage.
1,000 sq. ft. or less 145.15 I I 4
... Subdivision: [ Lot no.: Ea aad'r 500 sq. ft: or p ortion 33 1
Tau map /parcel no.: l Limited energy, residential 1 l 75.00 [ 2 i
,v.; .r {r t . �„ r r Limited energy, non - residential 75.00 2
K ,5 „GI?SP7F3f 03? � x 1 Y OI:T .a' , zr t::2 A . il.>-,l
„ •- 44 :r"`�`s lra`- v � s,:•�..,.. �..�,�.
. ..,,_ .. : - �.,f.. � . ° h : r• aa • ! .1.;7; f ' E ach manu factured or TM ut
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t} A 7 � S t ��t L , j' >J rL i V dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation . •
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r C u k g l ) S S f IV A ' q-( lq.{ 200 amps or less 80.30 I 2 •
;?xt; ru.�:: N.�.1 •c;s . ,Xi c - t-:�.,,, li ,.;;., .. _.. 201 amps to 400 a
a - _. �� ;<'�Y��.�Z'rf9i �r,;.� . Yx,.:,- �.:�;i r -`",{_ _, �';� mp amps 106.85 2 '
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�--(( a ”' ” "`"'' ='`' "" 401 amps to 600 a trtps 160.60 2
Name: TAre- daC!✓ i 601 amps to 1,000 amps I I 240.60 I.
2
Address: 5 A L Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 I 2
City /State/ZIP: Temporary services or feeders installation, alteration, and/or
Phone: (563) 4C-1 —72 S� 1 Fax: ( ) relocation
L ` _ 200 amps or less 66.85 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 12
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 I 2
Owner signature: Date: circuits - alteration, or extension, � Branch cite its new, alterafi n, o 'on, per pa nel
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= '-'b'` Y • •'kr x _L._ +:c': "z''''t,- l Y 5 ':v;'tom W".3 v = -•n "- '.:.\p' -:-^" - - _
' .- , ,ct t .r:, : ' t gi T '� t4'4, �:c ; ;MM t_ '•:CIJ iBi .. T_ 10 %'= K A. Fee . ' branch circuits x ith I
_. _x,:.�r. _ „ ._ r x:. ;. � �. ��':: ��.. t�... a'` �4G” 5-,_:, c: �., ,:;�,:.Px:.rt.,.- �.r.::i:rat.�.. '.�.-:t•e.yr. W ?a: nxY
Business name: se rvice or f eeder fee, each
6.65 I 2 '
branch circuit
Contact name: B. Fee for branch circuits
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without service or feeder fee, t 46.85 4 b > D5 2
Address: - each branch circui •
Each add'l branch circuit I q I 6.65 gt .4 2
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) Fax: : ( ) • Pump or irrigation circle 53.40 I . I 2 .
Sign or outline lighting I 53.40 2
E - mail:
Signal circuit(s) or limited -
rM K ' 1 .,3.` . X11-= ^ _ Ot ` R' <a r:w:. , :.I 8 °::z �.f. ener an el alterati on or
Business name: El -�; c..- n extension. Describe: Page 2 2
Address: P -0 �D>L C+l Each additional inspection over allowable in any of the above
City /State /ZIP: t a r Per inspection 62.50
p` l l es tS� 01 "7 0 'Z•-_ D Investigation per hour (I hr nun) 62.50
Phone: (S7} � ) ( f�� ) ' '- 35 Fax: (53) 6,7 s„.._ i i 0 3/ Industrial plant per hour ( t f� { } 7�3..75(�NV ,
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COB Lic.:`Lpc c Electrical Lic.:24.4 5 -1 L 1 Suprv. Lic.: 3 I(,.,Z 5 Subtotal 'n ,M5
Suprv. Electrician signature, require.. If �� ��` � � r . _ . Plan review (25% of permit fee)
Print name: - 0 0 ------ State surcharge /o 1f rmit fee) ! `i ' q 't
v �ll� t�t!v�o z Dale: — IA. —5 S TOTAL PERMIT FEE CD, .28
Authorized signature:
This permit application expires if a permit is not obtained withi I SO
I days after it has been accepted as complete
I Print name: ( Date:
` Fee methodology set by Tti- County Building industry Service Board
' ' Number of inspections per permit allowed.
CITY OF TIGARD-.,
BUILDING DIVISION PERMIT #: ELL200t3-00109
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2127/20013
Phone: (503) 639 -4171 :relit i
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' — 1.1.
INSPECTION WORKSHEET FOR DATE: 6126/2008 TIME: 7:00A1v1 PAGE: 12
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SITE ADDRESS: 0775 SW ASHFORD ST CLASS OF WORK:
SUBDIVISION: RENAISSANCE WOODS LOT #: 039 TYPE OF USE:
PROJECT NAME: JENSON
DESCRIPTION: Adding (6) branch circuits for kitchen.
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OWNER: JENSON, DARYL, & BARBARA PHONE #: 503 - 639-7241
CONTRACTOR: BEAR ELECTRIC PHONE #: 603 - 678 -1366
Inspection Request Scheduled For: Date: 6/2612008 Pour Time:
Code # Inspection Description • flrm-# Contact # Message
'199 Electrical final 071882- 1 603 -678 -1355 N Y
Corrections /Comments /Instructions: 219 332,5 6 ` ,7c)
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F , PASS ❑ PARTIAL APPROVAL n CANCEL n NO ACCESS
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FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: G WALL Date: ` ?a61* Phone #: (503) 718- 1)4 1 110 J