Permit CITY OF TIGARD ELECTRICAL PERMIT
I V PERMIT #: ELC2005 -00044
� W DEVELOPMENT SERVICES DATE ISSUED: 1/27/2005
� �' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S111 DD -01400
SITE ADDRESS: 08820 SW AVON CT
SUBDIVISION: STRATFORD ZONING: R
BLOCK: LOT : 044 JURISDICTION: TIG
Project Description: (1) branch circuit for new gas furnace.
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:
BEKOOY, CHRIS & KARA W OWNER
8820 SW AVON CT
TIGARD, OR 97224
Phone: 503 - 968 - 5433 Phone:
Reg #:
FEES
Description Date Amount
Required Inspections
[ELPRMT] ELC Permit 1/27/2005 $46.85
[TAX] 8% State Surcharge 1/27/2005 $3.75 Rough -in
Elect'I Final
Total $50.60
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Uti'. : o . cation Center. Those
rules a re c ...._____ - f5fth - in.OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direr -st ns to OUNC at (503)
246 -669 1 -800 -332- • 44:
Issued : K___i / 4 Permit Signature: y
OWNER INSTALLATION ONLY
The installation is being made on property I Q� which is not intended for sale, lease, or rent.
//9-7/js
OWNER'S SIGNATURE: /C DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 639 -4175 by 7:00pm for an inspection the next business day
Electrical Permit - FOR OFFICE usE ONLY
City of Tigard DateBy: , WPM Permit No.:ELZ 5;^ COO
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 bw mt,.mP I �r� Date/8 Other Permit:
Inspection Line: 503.639.4175 _Ai ` � W Date ReadyBy: Illr.�� 10 See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: CO. Supplemental Information
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• �� #afro ,� }.�
� - Syz. `�" F � Y ''O�,`'.`4. rQ 'k�,�"�£%�r�s1 - •s .. ^ ? n f° 'i,� ;��,y�' y ,..; 5 '�.'`, y { �, a..: ; ..
x. :p'y.: tee~ 0 4 )e. °. P L�Y+ RI ; .
❑ New construction 53-Addition/alteration/replacement Please check all that apply:
▪ Service over 225 amps, comm'l ❑Hazardous location
❑ Demolition III Other: ❑Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
�_�>� -z�, 4§ " ^`�, -�" „ �, . �.��- �- w�. , �m •.;��- �� ±�- s�€;:�?�<k ms's �•a -. "*aC
?s ,�SfATEd® R IO) CO$" R• O7 Ol�l ° i' „?� : k ' ;')' , of 1- and 2-family dwellings 4 or more new residential
:`ts ».. ' -' al ge r i.: ?r.`. -A .r * ..,;,,-4, , r:^ao.tw laz a:d itz .s: �, Y g
[1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ❑Feeders, 400 amps or more
❑ Multi - family El Master builder
❑ Other:
['Occupant load over 99 persons ❑Manufactured structures or
MM „` ><?V „S� .. � IJOV f& 4 ❑E gress /lightingplan RV. park
.art; a L 1 .� s� , s s` m..,4.:. sm14 ,,, ,,i Wi n . 13 . 12:6,„u a
❑ Health -care facility ❑Other:
Job no.: Job site address: .543 : 6 rt — `r Submit 2 sets of plans with any of the above.
City/State /ZIP: R 1 7 a 4 The above are not applicable to temporary construction service.
/ . ,..,.sci„ .fli wa "'=tom 4 £ ":ka.l.' ?:'`��';�:.�.
Suite/bldg. /apt. no.: Project name: _ ':. RM SEE. ,SGOt 'E : zt s • . . ,
Description I Qty. Fee. Total
Cross street/directions to job site: Cg• e g r t. j__ • S L,,.,,: New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: Lot no.: Ea. add'1500 sq. ft. or portion 33.40 1
Limited energy, residential • 75.00 2
Tax map /parcel no.: .
r` w ` ". ;aa ti , - i , ys ,,,,, r ,1s �.s „me,, :.t-_, : r, r a.� ,: ;,3. ;x;e f `:` i ,,,, `, ' „. °: ' Limited energy, non - residential 75.00 • 2
rr t .,t ` li eW, �RTtP,,Te Q . O K� � ' lit” Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
^ , ", > s. � K. . RE . .._.. { ,,. , •,,: "r 3s ar. , o 400 amps 106.85 2
�" 201 amps t
. b �� x P l2QI? ER� OWNsE R a ` { . N .x ; ' ® „1) ^O x m� 4r 401 amps to 600 amps 160.60 2
..4., r - : -a «amr a ".. 1 . , � t, " _ .,an,., ... IU. ,X,
Name: / I 601 amps to 1,000 amps 240.60 2
1.Vt rt - S &G liuyc� 1
Address: 47g •- n S 1-0 .4,/ :�r , l Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: D C2 °l 7 - a- 4 E Temporary services or feeders installation, alteration, and /or
, ---- 1--c '3 3 Fax: ( ) 2 00 am p
Phone: amps ( � °1 - 200 amps or less 66.85 1
Owner installation: This installation is • - ing made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent or/ e • ge, a ording to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 ' 2
Owner signature: .■ i Date: / - a ? - 47 5 Branch circuits - new, alteration, or extension, per panel
A. Fee for branch circuits with
ai ;' a ' `^ r t ° " {' :i , 4 A ,,f ' ;=.1 ; . : t e :. s: � , ,_ f: "
4 :' � ❑ A APP C •; . - •t . V.A 1°4t„ c� D 1 A , ,,,, GT k 2,S - ,, � 3,,„, :
service or feeder fee, each 6.65 2
Business name: branch circuit
B
Contact name: w service or feeder fee /
each branch circuit / 46.85 �! /_ 4,5"
2
Address: / tttPPP
Each add'I 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- .
r• "° ' . ' , �,::2 . , . . : �t:' :. it t o , r ,: ,; ry .'at`"� energy :!����"•"� ' - 'a` ���'. -?'� . , �'` ;�Ql1t,9T,�ACT(il��i�;;;�,5' �����.�r�!z� �w..�.�,'�:�i���.;xq P anel, alteration, or
extension. Describe: Page 2 2
Business name: COLO (` 0 �K—
Address: Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Investigation per hour (1 hr nun) 62.50
-
Phone: ( ) Fax: ( ) Industrial plant per hour 73.75 ,
ri " 2_ .: `• ; 1 'I:E, GTKTG.A ' t- ltat ttsT ::s IATi f.i: :
CCB Lic.: Electrical Lic.: Suprv. Lic.: Subtotal
• Suprv. Electrician signature, required: Plan review (25% of permit fee) 6/6. • r S�
Print name: Date: State surcharge (8% of permit fee) 3 • 7S
TOTAL PERMIT FEE 5 /GO
Authorized signature: This permit application expires if a permit is not obtained within ISO
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.
is\ Building \Permits\ELC- PermitApp.doc 12/03 440- 4615T(10 /02 /COM/WEB 6 7' 5 e /6
Electrical Permit Application - City of Tigard j .,
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
Fee for all residential systems combined ... $75.00
Check Type of Work Involved: •
❑ A udio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
❑ Heating, Ventilation and Air Conditioning
System*
❑ Vacuum Systems*
❑ Other:
MiQWW:(1 ANA
Fee for each commercial system $75.00
(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*
❑ M edical
❑ Nurse Calls
n O utdoor Landscape Lighting*
❑ Protective Signaling
❑ Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
is\ Building \Perrtuu\ELC- PermitApp.doc 04/03
CITY OF TIGARD 24 -Hour
BUILDING " . a Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Liner (503) 39 -4171 MST
rP P
Received Date Requested PM
Location • V i►.jL Suite MEC H su t'
Contact Person 0.4/2-e Ph ( ) 6 g 5 X33 PLM
Contractor Ph ( ) SWR tiff
BUILDING Tenant/Owner
Footing d� " ELC � i
Foundation � ELC
Ftg Drain Access: � /'`) / , / ` / ELR
Crawl Drain v12 r�a'i
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath /Shear a) �D j
Framing Aillib _ -
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post .& Beam
Smoke Dampers
aka
PART FAIL
ELECTRICAL
Service
Rough -In elk
UG/Slab e to
Low Voltage
Fire Alarm
4'`' El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date r � Inspector Ext
Other:
Final DO NOT REMOVE this inspection record •I om t e job site.
PASS PART FAIL