Permit CITY OF TIGARD ELECTRICAL PERMIT
" PERMIT #: ELC2007 00024
711
: COMMUNITY DEVELOPMENT DATE ISSUED: 1/10/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S126DC -03700
SITE ADDRESS: 09375 SW CORAL ST ZONING: R -
SUBDIVISION: LEHMANN ACRE TRACT LOT : 002 JURISDICTION: TIG
Project Description: (1) 200 amp service. Convert overhead metered service to underground.
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: 1 W /SERVICE OR FEEDER: PER INSPECTION:
201 - 400 amp: 1st W/O SRVC OR FDR: 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:
KEN RASMUSSEN LIGHTWORKS ELECTRIC CO
19290 SW CONZELMANN RD
SHERWOOD, OR 97140
Phone: 503 - 749 -4949 Contact #: PRI 503 - 625 -1953
FAX 503 - 625 -2890
FEES
Description Date Amount Reg #: ELF 34 -673C
[ELPRMT] ELC Permit 1/10/2007 $80.30 LIC 158595
[TAX] 8% State Surcharge 1/10/2007 $6.42 SUP 3044S
Total $86.72 REQUIRED ITEMS AND REPORTS
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All
work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for
more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued B y : - - !) /, l �f� iO Permittee Signature: b s i .tZ.~e.. e, p.
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale, lease, or rent.
OWNER'S SIGNATURE: DATE:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR. ELEC'N: DATE:
LICENSE NO:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
01/10/2007 09: 5t l " ~$. LIGHTWORKS ELECTRIC PAGE 02!03
El iritcal Permit Ap1i ca FOR OFFICE USE ONLY I
City of Tigard r i- 1 A ��,' 1 Re / q
13125 SW Ha11 Blvd„ Tigard, OR 97223 ,!F ily 0 2 O° ° D ake B y , (vad / / 0 permit xo:t�(� 9 /10 1 ' /�wJ f]��(l
Phone: 503.639.4171 Fax: 503.598.1960 4.11P4:- r Pfau 3Levicw �" {�C (� v `t/`
( l f i , Date/Bv; Mot Permit;
Inspection t.tne: 503.639,4175 6 tA f ' 1t. 1I
Internet www.ci.tigard,or.us VLL f y a l B S See Paget for
Y y runs:
_ NDat otiCieod/tvlcthod:
I "Iv �iU �a rt+l'¢ ri a<: _��� Supplemental
M1 kf 'I?4 R 7��'y` ( ll� l 1'; Ir +'t yry!ry "� °'F 1��7.1SJTitrIN� 1 /iJ1}44CC�If`i i•,�1dV 1 � r t,� ` � . iAy y� A-, ' l ltl��� 9 � ( 1 V 1 N"I r� t{q ` , f
UaW'r lli,l lira el� ;LYtla � l,l�lllU`�i ll7 n r3 Y, fiii'j {'t'1'1 T17. �RSY1 �(��il {1 1, I r�ihl '1' FIff 1' qq I 1 I I` � �,I, �� y , ;{ S i �V�1 f " i= i'ISt� V' . E� A�. Ni +ary�71 " . ..
.�tJ�,. ift �11� iiI�li1� fit i �'1 a i, a , ,.'•� ;b
New construction a �� apply:
�+ .'
�� Addition/al Please check all that apply;
amps, cnmm'I ❑Service over 225 em
P ❑Hazardous location
El Demolition 0 Other:
t e '` 1 ,4 "` !'�' L' I•*Jr�IJ t dot' " + 1' , t a. Rlar4[ 5 { . yI �±r y I ., , ❑Service over 320 amps -rating
1 �� I:x `h�lc W'ii:Yl�iiuti �[`i? +� ;�r�iQAi I P .� are e, a y' i I, of 1- and 2-family dwellings 8 ❑d mo e c residential � s m r. , a n r ' i�r w ,W, �.�, •�� PI Y 4 or
g ^
4 1 - and 2- family dwelling 0 Commercial /i.ndttstriai. Q Accessory building. ['System over 600 volts nominal units in one structure
❑ Multi fatmly [] blaster builder 0 Other; ❑Building over three stories ❑Feeders, 400 amps or more
v rs ti fa ! 4 { l 1 F " " ' 'f�1 ' L q�t +, t{ jq;w r t . l , ❑Occupant load over 99 persons ❑Manufactured structures or
4 ; ''t '�,r, `Ikl����Ctlst 9 i �i lli ;°' � �i EN re i ll,7 t +{ P o
I. n .tt atP r .�s, t�lm v<i . t r l . tl�P .o ,a, �, l �t ;r<L 1; ❑ Egress/lighting plan RV. park
Job no.: Job site address: /- Oliealth - care facility ❑Other;
3 7 5 Sw 60re � u- e &V— Submit 2 sets of plans with any of the above,
City /State /ZIP: T, ,, Q K` ( b� The above arc not applicable to temporary construction service.
Suite/bldg./apt. t. n Project r} T 4 1 t ..
P r eject name: U
Dexcrlptlee Qty. Pon, Ta
.J 1 l 1 ' tiI '1 1 77;: r: •::, ' r '
ta "
Cross street /directions to job site: s , ,, i . RQa 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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel rho Limited energy, residential 75.00 2 ^
J
�' .map/ parcel
I ce ! no tj� . yt� "�}( 1' r `w rr` i afQuy^ . , . m r r. 6 y� Limited ener non - residential 75.00 • 2
I, �illp: . ��tlt'lU+s'1' y� f1 41'' 1, I , - t ' -�ti rah rl i' ,.� rt 3�i ai { 13 �( p 'ir r ' .jj1 E --71. 0 - 1 - 1 manufactured or mod _"`
odular
e. _ dwelling service and /or feeder 90.90 2
d , s , ���• • 0 Services or fe lustnlla alteration, and /or relocation
. •41 in) • H 4 ' ' a , ed ..e. cz 200 amps or less _ / 80.30 ' 3J 2
I? 11 , •w • ';iN C lr/ $k , f f i! + Y; G , y�T�j p g I � p
Ig 'Il<cV �A llrlc '•? erti i i, ��� ' S k il,' ,' 'v��'�� a {{ 1"It{�rq$$p�i I xi'"l 201 amps to 400 amps 106,85 2
r N y 1t5, I IJ t e)1 Iil4! t I�'nilli.„I ^d
Name: 401 amps to 600 amps 160.60 2
' - ` t - --1, ~ 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454,65 2
City /StatclZIP: Reconnect only 66.85 2
— Temporary services or feeders installation, alteration, and /or
Phone: (5Z3) 7 y Q v 9 v 9 P'ax: ( ) _ relocation
Owner installation: This installation is being made on zo 200 amps or lcsa 66.85 1
attended for salt, lease, rent, or exchange, according to ORS 44 , 449, 670, and 701. aaot 201 amps to 400 amps 100 7,
Owner signature: 401 amps to 600 amps 13333.75 75 2
1'6Et ++ ! Taw t bate: Branch tit r,
li zl ^ rrw ;axr� rl s - new, alteration, or extension, per panel
,, I � , 4 �,� � � �l rr 1 1.• r•1 � ��„ I +p� t r r ��/ r , ` 1
A. Fee for branch circuits with
'l i� ° �'d 14r c�}'�{ ss' a'w�` '"m'r th
�lri� l� . �.. � ��,, , rf6�>l'k��;l t l ,��(1H'�r� I � � �Rh1��� � el; isTd11;1�� ��1i�Fxlr7�iYgi�a�a��mz6il�i ,§�" S ,'�r���l
:13USiness name: service or feeder fcc, each 6.65 2
branch circuit
Contact name: B.tee for branch circuits
without service or feeder fee, 46,85 2
Address: each branch circuit
?teach add'! branch circuit _ 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not Included)
Phone: ( p er; : ( Pump or inigation circle 53.40 2
E -mail: Sign or outline lighting 53.40 2
NM S t i t " lfi + 9 r ( p t ar+ :s ° r., }} ',.1119111101211 Signal circuit(s) � ion, or
imited-
k!G I [��li �dU�t624 �dl, lit e JL° i 1 , a� 1a 11.121111 S e _�, _ —
1 {•t�f' ��ii "�1 � �h1 V t'' I' ene rgy Panel, alter
l3usiness name: extcna Describe: page 2 2
/, I. I ..S T / I ”/ / _
Address: Z Lt�,r'�, -, / /zA ltaeh additional inspection over allowable in any nftbe above
City/State/ZIP: _ Per inspection 62,50
g P - 00 Ole 7 I <4 0 Investigation per hour (1 hr min) 62.50
Phone: ( J0) 197_5 1 453 Fax; (5' /_/�25 2199D Industrial plant per hour y 73,75
CC33 Lie. /5 fi5 5 Electrical r io. J V L c b
! 1O7�uprv, Lie.: 3 1 "' E�Yt a `�to a" r ""�Y N .V Subtt o t al f�'i`�':!, st 3-
Suprv. Electrician signature, required: /' / --19-- ,,, .,�: (>� f plan review (25% of permit foee) )
Print name: '� a I 49 Date: / - / 0 D w St s u rchar g e ( 8 "/° if o perm t fc ( p . y
a _
Authorized signature:
TA
I I')ERMI )C Lr d� 7 G-
Le /�/,
This permit appatixptra a rrmlt It neta
Print name: /� ) e G 1 a c e Date: ttnya lic solar on it e it>as ba accepted as no complete
within t80
L ^� " Fee methodology set by Tri County Building Industry Service Board
i:�8u {(din 1p `* Number of inspections per permit silowed.
R mar!lc1IILC-PertniNpp.doc 17107 440.451 'T(10/02/CQMJWaa
CITY OF TICARD
BUILDING DIVISION
PERMIT #: ELC2007-00024
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/10/2007
Phone: (503) 639-4171 J ,' L L .
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/11/2007 TIME: 7:03AM PAGE: 15
. SITE ADDRESS: 09375 SW CORAL ST CLASS OF WORK:
SUBDIVISION: LEHMANN ACRE TRACT LOT #: 002 TYPE OF USE:
PROJECT NAME: RASIvIUSSEN
DESCRIPTION: (1) 200 amp service. Convert overhead metered service to underground.
OWNER: RASIVIUSSEN, KEN PHONE #: 503-749-4949
CONTRACTOR: LIGHTWORKS ELECTRIC CO PHONE #: 503 ,
Inspection Request Scheduled For: Date: 1/11/2007 Pour Time:
Code # Inspection Description Confirm # Contact #
115 Electrical seivice 04202401 503 ,f2:).(:)
Corrections/Comments/Instructions:
(I f'.. K)
• it c - I - ) k... Lsi IS. 06..fliK) (- 7 ‘-1 OZ-.0Q K
. .
0
/ ASS El PARTIAL APPROVAL 0 CANCEL NO ACCESS
FAIL Li CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: iii4P Date: /////J 7 Phone #: (503) 718- Zggr
— .