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Permit ` CITY OF TIGARD ELECTRICAL PERMIT ,. PERMIT #: ELC2006 - 10102 DEVELOPMENT SERVICES DATE ISSUED: 6/14/2006 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S 103DA - 01800 SITE ADDRESS: 10815 SW DERRY DELL CT ZONING: R -3.5 SUBDIVISION: DERRY DELL PLAT 2 LOT : 018 JURISDICTION: TIG Project Description: (1) 60 amp sub panel, (6) branch circuits. 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: 6 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: DOUG SAWKINS FARWELL PERRY ELECTRIC 10815 SW DERRY DELL CT 2536 NE 10TH AVE TIGARD, OR 97223 PORTLAND, OR 97212 Phone: 503 - 620 -5043 Contact #: PRI 503- 890 -2352 FEES Description Date Amount Reg #: ELE 26 -855C [ELPRMT] ELC Permit 6/14/2006 $120.20 LIC 91733 [TAX] 8% State Surcharge 6/14/2006 $9.62 SUP 4067S Total $129.82 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: - j Permittee Signature: - 5"/ .a OWNER INSTALLATION ONLY v 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. :Elect rical Permit Application f ... • „FOR 01 Ic[. ONLi s J "City of Tigard ��`v QU Received .1 Permit No r_ id d • } 1 ; . � j . .. 13125 SW Hall Blvd., Tigard, O §�' t C Review Plan v Permit. Other Pent. Phone: 503.639.4171 Fax: 503. t9:. 60 4 V Date/By 41 A•KD Inspection Line: 503.639.4175 v`` O Date Ready/By 10 See Page 2 for Internet: www.tigard- or.gov o .� %GP S � N Notifi Supplemental Information TYPE OF W ag G� PLAN REVIEW acement Please check all that apply (submit 2 sets of plans w /items checked below): ❑ New construction ('ddition/alterakl repl ❑ Service or feeder 400 amps or more ❑ Building over three stones ❑ 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 agncultural and 2- family dwelling El Commercial /industrial El Accessory building amps for all other installations buildings Multi- family 0 Master builder El ❑ Fire pump ❑ Installation of 75 KVA or JOB SITE INFORMATION AND LOCATION ❑Emergency system. larger separately denved system ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ", Job no.: Job site address: i I l n I i00HP or more occupancy. \ D (g w Deaf?, t ( pf' [ ` U ' ❑ Six or more residential units ❑Recreational vehicle parks. City /State /ZIP: t //�� - 2:2 - 3 I ❑ Health -care facilities ❑ Supply voltage for more than 1� ©a — "I ['Hazardous locations 600 volts nominal . Suite/bldg. /apt. no.: Project name: ea, iv iv K I iuS ❑ Service or feeder 600 amps or more FEE SCHEDULE. Cross street/directions to job site: Description i Qty. I Fee. I Total i * 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 75.00 2 ` DESCRIPTION OF WORK (with above sq. ft.) Limited energy, multi - family 75.00 2 residential (with above sq. ft.) 0 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 • cy h ✓` I 401 amps to 600 amps 160.60 2 Name: 3 C 1( L�1 � ' 1Z1 � 601 amps to 1,000 amps 240.60 2 Address: ` p \ S + io 1� c-- C am; Over 1,000 amps or volts 454.65 2 City /State /ZIP: ''V \ P' 12_0 t b (2 — Q 2-2- Temporary services or feeders installation, alteration, and /or l relocation Phone: ( ) 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 Branch circuits — new, alteration, or extension, per panel Owner signature: Date: A. Fee for branch circuits with A PPLICANT , 0 CONTACT PERSON above service or feeder fee, (n each branch circuit CC 6 65 2 Business n e: �4� �iy� �� B. Fee for branch circuits . Contact name: without service or feeder fee 46 85 2 first branch circuit Address: 2-,G �� 4 1 -1-h Its-v&- Each add'I branch circuit 6 65 2 Miscellaneous (service or feeder not included) City /State /ZIP: Porz -i l�O...., 0 r 172 R' Z ( 2_ Each manufactured or modular 90.90 2 ) G Fax: ( ) dwelling, service and/or feeder Phone: ( 03 l t) � Reconnect only 66.85 2 • E - mail: Pump or irrigation circle 53.40 2 . CO TRACTOR Sign or outline lighting 53.40 2 Business name: �(� Signal circuit(s) or limited - f "T energy panel, alteration, or Address: extension Describe: Page 2 2 City /State /ZIP: Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: ( ) , , e ` , 0 2 574 Fax: ( ) investigation per hour (1 hr min) 62.50 CCB Lie.: q, ( 5, Electrical Lie.: Suprv. Lie.: industrial plant per hour 73.75 ELECTRICAL PERMIT FEES Suprv. Electrician signature, required: Subtotal: Plan review (25% of permit fee): Print name: Date: • State surcharge (8% of permit fee): Authorized signature: TOTAL PERMIT FEE: (el 9 V Print name: Date: This permit application expires if a permit is not obtarired within 180 days after it has been accepted as complete. • Number of inspections allowed per permit \ Building \Pemiits\ELC- PermitApp.doc 05/23/06 440-4615T(1 I /05 /COM/WEB Electrical Permit Application - City of Tigard Page 2 - Supplemental Information • LIMITED ENERGY PERMIT FEES: - RESIDENTIAL WORK ONLY: Fee for all residential systems combined .. $75.00 Check Type of Work Involved: ❑ Audio and Stereo Systems* I T Burglar Alarm ❑ Garage Door Opener* ❑ Heating, Ventilation and Air Conditioning System* ❑ Vacuum Systems* ❑ Other: COMMERCIAL 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* • n 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 \Permits\ELC - PermitApp.doc 03/23/06 - ' CITY ������N�������� ��mm m ��n mm�mm=umn�� . ^ ° ' BUILDING DIVISION PERMIT #: ELC2006-10102 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/1412000 Phone: (503) 639-4171 Inspection Requests (24Hm.):(5O3)83Q'4175 .4W11- NIii. INSPECTION WORKSHEET FOR DATE: 9/14/2007 TIME: 7:00Ak8 PAGE: 56 SITE ADDRESS: 10816 SW DERRY DELL CT CLASS OF WORK: SUBDIVISION: DERRY DELL PLAT 2 LOT #: 018 TYPE OF USE: PROJECT NAME: SAWKINS DESCRIPTION: (1) 60 amp sub panel, (6) branch circuits. OWNER: SAWKINS, DOUG PHONE #: 501620'5043 CONTRACTOR: FARWELL PERRY ELECTRIC PHONE #: 603-890`2352 . Inspection Request Scheduled For: Date: 9/14/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message � 0N// [^ 7 _1 199 Electrical final 066533-01 503-620-5042 V /7 ~ / ~- Corrections/Comments/Instructions: . ,„--- - - --- "Th : ... ,...___.__ c: ., / /''--- 17 C • PASS [ I PARTIAL APPROVAL n CANCEL 0 NO ACCESS I I FAIL 0 CA FOR INSPECTION | I ADDITIONAL FEES ASSESSED ALP" Inspector: P � ' ^ Date: I f i V /07 Phone #: 8508> 718- ` `` , • ~ . CITY OF TIGARD C am. BUILDING DIVISION PERMIT #:ad96e IQ /e) 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639-4171 Requests (24 Hrs.): (503) 639- 4175!si INSPECTION WORKSHEET FOR DATE: TIME: PAGE: SITE ADDRESS: / U g l 42,e_AA w CLASS OF WORK: SUBDIVISION: � OT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: 6 -- /5 o( Pour Time: ode # Inspection Description Confirm # Contact # Message 1 S° -- 6 •rre• ions /Comments /Instructions: / �' Z °Th cbik y 40,3Se V cr (C) P 0 PASS PARTIAL APPROVAL ❑ CANCEL n NO ACCESS ❑ FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 6 Date: 6 -6 " Phone #: (503) 718 - E-6 CITY OF TIGARD BUILDING DIVISION , PERMIT #: ELC2006-10102 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2006 Phone: (503) 639-4171 po Tit\ Inspection Requests (24 Hrs.): (503) 639-4175 ■ .. t ja I 1.. ■ ■ ■ . . 1 1 INSPECTION WORKSHEET FOR DATE: log6/7 TIME: 7:03AlvI PAGE: 55 SITE ADDRESS: 10815 SW DERRY DELL CT CLASS OF WORK: SUBDIVISION: DERRY DELL PLAT 2 LOT #: 0.18 TYPE OF USE: PROJECT NAME: sAwKiNs DESCRIPTION: (1) 60 amp sub panel, (6) branch circuits. OWNER: SAWKINS, DOUG PHONE #: 503-620-5043 CONTRACTOR: FARWELL PERRY ELECTRIC PHONE #: 503-890-2352 • Inspection Request Scheduled For: Date: 10/6/2006 Pour Time: Code : .- .. - ::, istion Confirm # Contact # Message 120 Electrical rough-in 037772-01 503-807-0165 Y Corrections/Comments/Instructions: `. '(\\ R- jY 1j 1-- \`•R . ila?ac (INAA Ir...E.J9. RtO.N1(4 s FL 105 pECITION toN)0 The electrical installation defects noted on this report shall be corrected and an inspection request made within 20 calendar days per OAR 918-271-0030 ill 2101 PASS fl PARTIAL APPROVAL n CANCEL I I NO ACCESS I FAIL I I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: Cr , w oe LE Date: I 016IN) Phone #: (503) 718- 2.14410 CITY OF TIGARD 4 . _ BUILDING DIVISION gp e S PERMIT #: ELC2006- 10102 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/14/2006 Phone: (503) 639 -4171 L ��� U °Nu� Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 9/4/2007 TIME: 7:01A1M1 PAGE: 31 t SITE ADDRESS: 10815 SW DERRY DELL CT CLASS OF WORK: SUBDIVISION: DERRY DELL PLAT 2 LOT #: 018 TYPE OF USE: PROJECT NAME: SAWKINS DESCRIPTION: (1) 60 amp sub panel, (6) branch circuits. OWNER: SAWKINS, DOUG PHONE #: 5U3- 620 -5043 CONTRACTOR: FARWELL PERRY ELECTRIC PHONE #: 503°890"2352 Inspection Request Scheduled For: Date: 9/4/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 055056-01 503 -807 -0165 N Corrections /Comments /Instructions: ) E re Ceitkide # S WI-a i atit-V i./4 4e-4 �� reu,p6tti @ 1,e kaki, NAsJ'� -- ke lethdd (y■ 1,vol? t - v To uovt-N ak-ctuif t +14 0 tov-e- 012_ - , 2 t •5 t > /YYDV je - 6 g PASS PARTIAL APPROVAL I I CANCEL I I NO ACCESS n FAIL I'W CALL FIR INSPECTION I I ADDITIONAL FEES ASSESSED PO i Inspector: Date:q 5 / 07 a Phone #: (503) 718- 0