Permit C ITY OF TIGARD , ELECTRICAL PERMIT
PERMIT #: ELC2006 -00336
l DEVELOPMENT SERVICES • DATE ISSUED: 6/19/2006
°''I - 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S112CC -13300
SITE ADDRESS: 08493 SW BONAVENTURE LN ZONING: R -12
SUBDIVISION: TANIA PARK LOT : 008 JURISDICTION: TIG
Project Description: 2 branch circuits AC and GFI
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: 1 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:
KRIS SCHULTZ HILLSBORO ELECTRIC
8493 SW BONAVENTURE LN 21185 NW EVERGREEN PKWY #110
TIGARD, OR 97224 HILLSBORO, OR 97124
Phone: 621 -8602 Contact #: PRI 503- 439 -9666
FAX 503 - 601 -3680
•
FEES
Description Date Amount Reg #: ELE 34 -4399C
[ELPRMT] ELC Permit 6/19/2006 $53.50 LIC 134481
[TAX] 8% State Surcharge 6/19/2006 $4.28 SUP 4941S
Total $57.78 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended
for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503 - 246 -6699 or
1- 800 - 332 -2344.
Issued By: Permittee Signature: ei �
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
06- 15 -'06 18:06 FROM- Hillsboro Electric 503 - 601 -3680 T -664 P002/002 F -950
,.= Electrical Permit Application 1'()r; OErlc l': [s F: ()NIA
•
},� of f Tigard
Received
• City Date/By: /9 f/067 Permit Noac,... p 0 3
13125 SW Hall Blvd., Tigard, OR 97223 RECEIVE I.V E ,r, Plan Review l
Phone: 503,639.4171 Fax: 503.598.196 '' ° DateBy: Other Permit:
Inspection Line: 503.639,4175 D Ready/ By: 7uris: til See Page 2 for
Internet; www.ci,tigard.or.us JUN 1 6 20i 1 Nod fred/Method: Supplemental Information
. ...
TYl'
' °r1 yes °. . :. :.. ..:: .. W
❑ New construction ['I Adaii.HUIthielatIVINIONnent please check all that apply:
❑Demolition El Other: ['Service over 225 amps, comm'l ['Hazardous location
.. :. :. . . , ., : U1(!>'j$ ,,TRV,YCI'I0 of 1- and 2-family dwellings ❑Bu
' . ; :: ':.GA'FECrrOI!'Y.: pt? . !G, N;' `r ';
.:...: :.:.. t nb* over ,
s ,
.:::::::.i...;: � ° � � - Y g or more new residential
111- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
El Multi - family 0 Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
"'r "^ + "i persons sons d structures o r
,:.,:.,,:,....., ;
:::,::• ;. ,.• ccupant load over er anu actors
: ,: ,, ..... .. 't�JFUk�IATIOI�I , ULNA :a1(a4�Cj!4T �) i � :: ' : :! •�i :'= i :' :i : : : : : � :.. :' i g kV park
. .. ........� :., : , .
; .: ,.,. .:......, gressRighting plan P
Job no.: ,7/3 Yob site address :7 I 1 , , o , [11-care facility ❑Other;
L r v Submit 2 sets of plans with any of the above.
City /State /ZIP: \ j, ON (A 'W 011 f fi t+ The above are not applicable to temporary construction service.
4(hw
SuiteJbld /a t. n � , ...,. .. . ' *4 F.' '1: „ ,.. . ,
g. /apt. o.: � f o�ect name: Q , I Fee. I Toad
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
Includes attached garage.
1,000 sq. ft. or less 145.15 4
Subdivision: I Lot no.: Ea, add'l 500 sq. ft. or portion 33,40 1
Tax map /parcel no.:
Limited energy, residential 75.00 2
— Limited „
�A�n�G'�pTY�N..!'t�F "WORD`; :' :!' ' ' ;;: ; ,, :� :;
. , ' •. energy, non - residential 75 00 2
: . Bach manufactured or modular
4/ (" l dwelling, service and /or feeder 90.90 2
�— _ r� Services or feeders installation, alteration, and/or relocation
c
200 amps or less
80.30 2
READ
201 amps to 400
amps 1 06 5 2
F 8
P
401 amps to 600 amps 160.60 2
Name: ,i Lh .�
V .... AC 601 amps to 1,000 amps 240.60 2
Address: .) Over 1,000 amps or volts 454,65 agg idlL2
Reconnect only 66.85 2
City /State/ZIP; Temporary services or feeders installation, alteration, and/or
Phone: (C919 174 -- ( � I Fax: ( ) relocation
" t U `c 200 amps or less I 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 600 amps 133.75 2
Owner signature: Date: Branch circuits -- new, alteration, or eytension
,. ;<,, , , �P�1G •• .t ;i_ ,. ... . :.:;:;: . : ;: .: . Fee forbtanchcircuits
.,.• ....... . ........ t� ,.,,..,...... ' :.:...........: .... :•. :............ :.......... 1 . c a `r i n
A
service or feeder fee, each
Business name: A • branch circuit 6,65 2
J B. Fee for branch circuits
Contact name: 1
without service or feeder fee, •
first branch circuit 46.85 2
Address: Each add'l branch circuit 6.65 •(OS -
City /State/ZIP: Miscellaneous (service or feeder not included)
Phone: ( ) I Fax:: ( ) Pump or irrigation circle 53,40 2 -
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
.. ;...
� :CflNTBA energy a. Describe; c or
extension.
l �> 7 , tension. Dcribe: Page 2 2
Business name: � ..1 � V
Address l'Q0 \ 1 ) e i �� ��� - 1 b Each additional inspection over allowable in any of the above
v D� Ll t ! Per inspection 1 62,50
City /State /ZIP: ' • tU51/�l� Vu 1
9 "1 �t ' , U Investigation per hour (1 hr min) 62.50
Phone: ( )149 " l K "�J ir .�� J . i F ax: (C -tc14 ( _�� Industrial'plant per hour
: 73.75
t I .::.::.
� `, . : :. : : ::: '. : :. : :. , : :: .: EI EG'I 104.: :PERMIT ' :, FE wi °r . r f
CC13 I ic. `' `�� Electrica � Supr Z ie,: U q i , I Subtotal : 5
Suprv. Electrician signature, required: � - _ E J 1-'" , Plan review (25% of permit fee)
Print name: ' Date: l 0 1 ( C
State surcharge (8% of permit fee)
( `7 TOTAL PERMIT FEE 5 1
Authorized signature. This permit application expires if a permit is not obtained within I80
Print name: I Date: days after it has been accepted as complete
Pee methodology set by Tri•County Building Industry Service Board
" Number of inspections per permit allowed.
i:1 BuildinglPermits 'ELC.PeneitApp.doc 12/03 44 0. 4 6157(10 /02/COM, EB
CITY OF TIGARD EZ
BUILDING DIVISION PERMIT #: ( 940 , --" C/ 6" —0 3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 �n�u4��n��
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
t -P ,-seii
SITE ADDRESS: 0 (i 3 c i CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspe tion Request Scheduled For: Date: 6 " 2 8-- c$ Pour Time / ,
Code # Inspection Description Confirm # Contact # Message
I t om - ff -a9.s3
6a/ Co rrections /Comments /Instructions:
- 860D_ r
F' PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: € •'f Date: ' Zeg' dc, Phone #: (503) 718-