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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2006 -00441 DEVELOPMENT SERVICES DATE ISSUED: 8/8/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111 CC -05400 SITE ADDRESS: 10080 SW CENTURY OAK DR ZONING: R -7 SUBDIVISION: SUMMERFIELD LOT : 077 JURISDICTION: TIG Project Description: (2) branch circuits for NC installation. 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: PAT WOODCOCK HARVEY ROSE ELECTRIC SERVICES 10080 SW CENTURY OAK PO BOX 128 TIGARD, OR 97224 NORTH PLAINS, OR 97133 Phone: 503 - 956 -4604 Contact #: FAX 503 -648 -8254 PRI 503 - 789 -3284 FEES Description Date Amount Reg #: ELE 34 -130C [ELPRMT] ELC Permit 8/8/2006 $53.50 LIC 43084 [TAX] 8% State Surcharge 8/8/2006 $4.28 SUP 2767S 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: AK. / 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. „. . EG Eiu , _ , ,Electrical Permit Application FOR.OFFICE USE . - ' City of Tigard Received 1 .1 Permit No.: v(.l i(9lF O6 y y7 IN '� 13125 SW Hall Blvd., Tigard, OR 97223 t J Ian Review � ' : Phone: 503.639.4171 Fax: 503.598.1960 AUG 201E.: Ian Other Permit: T I G AR l- Inspection Line: 503.639.4175 : t Da eadyBy: Suds: El See Page 2 for Internet: www.tigard - or.gov L�.9, Y.!' .h -3 � `. .1med/Method: . / (r Supplemental Information TYPE OF Wq ', 3 , I” .. PLAN REVIEW ❑ New construction ❑ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ® Other: where the available fault current ❑ Marinas and boatyards. CATEGORY OF CONSTRUCTION exceeds 10,000 amps at 150 volts or ❑ Floating buildings. less to ground, or exceeds 14,000 ❑ Commercial -use agricultural (n I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildingrs. ❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or • ❑ Emergency system. larger separately derived system. JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 - ", Job no.: Job site address: (� / �- t 10014P or more. occupancy. C7 ) S w Ci-/ / ✓7J ©7 t ❑ Six or more residential units. ❑ Recreational vehicle parks. City/State/ZIP: �j C / ❑ Health -care facilities. ❑ Supply voltage for more than ' ` I i1 7 pZ c/ ❑ Hazardous locations. 600 volts nominal. Suite/bldg. /apt. no.: f Project name: ❑ Service or feeder 600 amps or more. FEE SC HEDULE Cross street/directions to job site: 1:) v La Wl 6_ C a l V� 014. Description I Qty. I Fee. I Total I • Y � New residential single- or multi - family dwelling unit. Includes attached garage. Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4 Ea. add'I 500 sq. ft. or portion 33.40 1 Tax map /parcel no.: Limited energy, residential . . DESCRIPTION OF WORK ' (with above sq. ft.) 75.00 2 Limited energy, multi - family 75.00 2 t/\> k 4 I C o "l A c residential (with above sq. ft.) Services or feeders installation, alteration, and /or relocation 200 amps or less 80.30 2 ❑ PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2 Name: p (AJd ®af Cc, 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: (ca3 ) 9 5-6— 1 CP C( Fax: ( ) 200 amps or less 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 599 amps 133.75 2 Owner signature: Date: Branch circuits - new, alteration, or extension, per panel A. Fee for branch circuits with ❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 O 6s 2 each branch circuit f Business name: B. Fee for branch circuits Contact name: without service or feeder fee / 46.85 w 2 first branch circuit / Y Address: i Each add'l branch circuit 6.65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Each manufactured or modular dwelling, service and/or feeder 90.90 2 Phone: ( ) Fax: : ( ) Reconnect only 66.85 _ 2 E -mail: Pump or irrigation circle 53.40 2 ' CONTRACTOR, , Sign or outline lighting 53.40 2 � I Signal circuit(s) or limited - Business name: /c f� C p e 5 c 17 w 1 G ✓c 6 -, energy panel, alteration, or Address: �U , (O/ t extension. Describe: Page 2 2 City /State/ZIP: A/ ° ril4`,,S /Cf ' , ( ? 3 Each additional inspection over allowable in any of the above -Z 76' r Per inspection 62.50 Phone: (SD J ) — ! Fax: a x: ( ) ��� 7� Investigation per hour (1 hr min) 62.50 CCB Lie.: /oe26 Electrical Lie.: 3 c4 /3vc..._ Suprv. Lie.:? 26 ' S Industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: � � - Subtotal: 63 , 5) Print name: 2d 9 A� f Date: 6 Plan review (25 % of permit fee): �� / �' State surcharge (8% of permit fee): 9 , 0 Authorized signature: TOTAL PERMIT FEE: 1-7, 7) This permit application expires if a permit is not obtained within 180 Print name: Date: days after it has been accepted as complete. ' Number of inspections allowed per permit. C\ Building \Permits\ELC- PermitApp.doc 05/23/06 440- 4615T(11/05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information LIMITED ENERGY PERMIT FEES: RESIDENTIAL"WO.RICONLI': "m__ ,. „ Fee for all residential systems combined $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* ❑ BurgIar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: ' COMMERCI 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 Lighting* ❑ Protective Signaling ❑ Other Total number of commercial systems: *No licenses are required. Licenses are required for all other installations 1: \Building\Pennits\ELC- PermitApp doc 03/23/06 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006 -00441 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2006 Phone: (503) 639 -4171 Ai % �� ib Inspection Requests (24 Hrs.): (503) 639 -4175 s' `__ . INSPECTION WORKSHEET FOR DATE: 8/22/2006 TIME: 7:03AM PAGE: 3 SITE ADDRESS: 10080 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 077 TYPE OF USE: PROJECT NAME: WOODCOCK DESCRIPTION: (2) branch circuits for NC installation. OWNER: WOODCOCK, PAT PHONE #: 503-956-4604 CONTRACTOR: HARVEY ROSE ELECTRIC SERVICES PHONE #: 503-7(19 -3284 Inspection Request Scheduled For: Date: 8/22/2006 Pour Time: Cod- • • . -: 1 Description Confirm # Contact # Message 135 A/C or he, ° circuit 035396 -01 503- 720 -9938 N Corrections /Comments /Instruc s: • ■ (PASS I I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: - 'y W �� Date: %• 2- Phone #: (503) 718 - iiipic _____ CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006-00441 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 8/21/2006 TIME: 6:58AM PAGE: SITE ADDRESS: 10080 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 0 TYPE OF USE: PROJECT NAME: WOODCOCK DESCRIPTION: (2) branch circuits for NC installation. OWNER: WOODCOCK, PAT PHONE #: 503-956-4604 CONTRACTOR: HARVEY ROSE ELECTRIC SERVICES PHONE #: 503-789-32134 Inspection Request Scheduled For: Date: 8/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 145 A/C or heating unit circuit 035325•01 503-720-9938 Corrections /Comments/ Instructions: (M kP\AT ) V \ ' a- o 0.44,0 df\rf C.A(CC...OrTS 1\4 V•ig 4-111 CtOaSZL 10 l iO v e • I I PASS n PARTIAL APPROVAL El CANCEL NO ACCESS FAIL 4 1K CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED Inspector: Date: t 2.1 O (b Phone #: (503) 718- 2-00.0 CITY OF TIGARD BUILDING DIVISION PERMIT #: ELC2006-00441 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/8/2006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 8/21/2006 TIME: 6:68AM PAGE: SITE ADDRESS: 10080 SW CENTURY OAK DR CLASS OF WORK: SUBDIVISION: SUMMERFIELD LOT #: 077 TYPE OF USE: PROJECT NAME: WOODCOCK DESCRIPTION: (2) branch circuits for A/C installation. OWNER: WOODCOCK, PAT PHONE #: 503-956.4604 CONTRACTOR: HARVEY ROSE ELECTRIC SERVICES PHONE #: 503-7993284 Inspection Request Scheduled For: Date: 8/21/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 035292-01 503-789-3284 Corrections/Comments/Instructions: Yaib\itU t1/41.a_. 1)e F2a, Ltuldf n PASS 0 PARTIAL APPROVAL 0 CANCEL II NO ACCESS 0 FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED Inspector: G" • Date:"g.2i 6 Phone #: (503) 718- VILA