Permit .,CITY OF TIGARD ELECTRICAL PERMIT
• • COMMUNITY DEVELOPMENT
PERMIT ISSUED ELC2007
DATE ISSUED: 8/13/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102DC -00200
SITE ADDRESS: 09325 SW EDGEWOOD ST ZONING: R -4.5
SUBDIVISION: EDGEWOOD LOT : 016 JURISDICTION: TIG
PROJECT: HAWKINS
Project Description: Temporary electrical power for new addition construction.
RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS
1000 SF OR LESS: 0 - 200 amp: 1 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: 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:
TODD HAWKINS P B ELECTRIC INC
9325 SW EDGEWOOD 1108 SE DOGWOOD LN
TIGARD, OR 97223 OAK GROVE, OR 97267
Phone: 503- 807 -2065 Contact #: PRI (503)786 -4499
FAX 503- 786 -6005
FEES
Description Date Amount Reg #: ELE 3 -428C
[ELPRMT] ELC Permit 8/13/2007 $66.85 LIC 85896
[TAX] 8% State Surcharge 8/13/2007 $5.35 SUP 454IS
Total $72.20 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 da s. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in
OAR 952- -0010 thr• •h OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions - NC at 503.246.6699 or 1.800.332.2344.
Issu By: , � // Permittee Signat . �� i Ji m /
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:
,QNTRACTOR INSTALL • TIDN ONLY
SIGNATURE OF SUPR. ELEC'N: 4111111111 c , , � / s / ��_�i l Amor. DATE: g 7
LICENSE NO: `'7�' /
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.
• • Electrical Permit Application FOR O I ICE,IISI ONLY
• '
=' Received Q /
1 �� �
City of Tigard Date/B . V I 0 Permit Na. �`.', �S
U PI l
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Ill ' Phone: 503.639.4171 Fax: 503.598.1960 Date/B : Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: El See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
' T)PE OF WORK PLAN REVIEW
❑ New construction I, L — f f Addition /alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stones.
❑ 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
li 1 - and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
JOB SITE INFORMATION AND LOCATION- • • ❑ Emergency system. larger separately derived system.
• . . ❑ Addition of new motor load of ❑ "A ", "E ", "1 -2 ", "1 -3 ",
Job no.: Job site address: Q t 1001-IP or more. occupancy.
1 Z 35 S: L,) C j t�(''t x' ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: ,/ C, ❑ Health-care facilities ❑ Supply voltage for more than
y �� �d OA 4 2� ❑Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: /lat. Service or feeder 600 amps or more.
, t i7 .S S ' - FEE SCHEDULE
Cross street/directions to job site: Description p I Qty. I Fee. I Total
New residential single- or multi - family dwelling unit.
Includes attached garage. _
Subdivision: Lot no.: a.33 1,000 sq. ft. or less 145.15 > 4
Tax map /parcel no.: ,\ Ea. add'I 500 sq. ft. or portion 33.40 c 1
70 2. I ( 0 Z Limited energy, residential
DESCRIPTION OF WORK • . - (with above sq. ft.) 75.00 2
Limited energy, multi - family
7L 3 7.5 43 ,4d 1 ' bi residential (with above sq. ft.) 75.00 2
Services or feeders installation, alteration, and /or ralncation
200 amps or less 80.30 _ 2
. 'PROPERTY- OWNER . ' ❑ -.TENANT . - 201 amps to 400 amps 106.85 2
. Name: - A 4. - S 401 amps to 600 amps 160.60 2
_ 601 amps to 1,000 amps 240.60 2
Address: '723 5 x,1..1 * �'d J
�. l.rle;� � '!� . Over 1,000 amps or volts 454.65 2
City /State /ZIP: t 1 G% )12 ' Temporary services or feeders installation, alteration, and /or
J c ' 1 re ! relocation
Phone: (St}.1) go? - 2065 I Fax: 60 ) '152 -_ MI 200 amps or less ( 66.85 66- yS 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
. ❑ APPLICANT . • , : • • •❑ •CONTACT PERSON above service or feeder fee, -
each branch circuit 6.65 4 2
Business name: B. Fee for branch circuits
without service or feeder fee,
Contact name: 46.85 2
first branch circuit
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service and/or feeder
Phone:
( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
CONTRACTOR - - . • • ' Sign or outline lighting 53.40 2
,a Signal circuit(s) or limited -
Business name: �3 L l� G / 11 1ZL energy panel, alteration, or
Address: i(V S .5 E ,) e j t.,t ' LI extension. Describe: Page 2 2
City /State /ZIP: Oc 6�✓i: c, oe . `-17 . 7 Each additional inspection over allowable in any of the above
Per inspection 62.50
. Phone: 6f.1 ) el 3 6 -5 Z2,(, ,- Fax: (5"S ) 286 -- 6 Ot= S Investigation per hour (1 hr min) 62.50
CCB Lic.: 425 b?`((;., Electrical Lie.: & -1,2 g e_ Suprv. Lie.: 115 -1( 5 Industrial plant per hour " "-
'ELE N ' ERMIT ,FEES
Suprv. Electrician signature, required: Subtotal: 40( .
Print name: Date: Plan review (25% of permit fee): -�- --
State surcharge (8% of permit fee): 5 5‹
Authorized signature: /S TOTAL PERMIT FEE: 79, .
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.
I:\ Building \Permits\ELC- PermitApp.doc 0523/06_ 440- 4615T(I I /05 /COM /WFB
' CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2007 -00566 7
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/13/2007
Phone: (503) 639 -4171 " A �I
Inspection Requests (24 Hrs.): (503) 639 -4175 � I
::INSPECTION WORKSHEET FOR DATE: 8/31/2007 TIME: 7 :00AM PAGE: 9
0 el itg Pr
SITE ADDRESS: 08325 SW EDCEWOOD ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: 016 TYPE OF USE:
PROJECT NAME: HAWKINS
DESCRIPTION: Temporary electrical power for new addition construction.
OWNER: HAWKINS, TODD PHONE #: 503 - 807 -2065
CONTRACTOR: 1 ''D ELECTRIC INC PHONE #: (503)786-M99
Inspection Request Scheduled For: Date: 8/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
'110 Temporary electrical service 054989-01 503 -807 -2065 N
Corrections/Comments/Instructions:
R---FO A S /2_ 4 71C , 7 (GA./
•
.___________ 2.....4:1
i = PASS • •Ar IAL APPROVAL ❑ CANCEL El NO ACCESS
IL FOR INSPECTION I , ADDITIONAL FEES ASSESSED
Inspector: �'„ . Date: g4,//07 Phone #: (503) 718 - c�CY1
7 _
CITY OF TIGARD
BUILDING DIVISION , PERMIT #: ELC2007 -00566
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0311112007
Phone: (503) 639 -4171411 i,ii 1 +
Inspection Requests (24 Hrs.): (503) 639 -4175 l �I
INSPECTION WORKSHEET FOR DATE: 8/24/2007 TIME: 7:00AM PAGE: 73
SITE ADDRESS: 00325 SW EDGEWOOD ST CLASS OF WORK:
SUBDIVISION: EDGEWOOD LOT #: 016 TYPE OF USE: - z ;
PROJECT NAME: HAWKINS
DESCRIPTION: Temporary electrical power for new addition construction.
OWNER: HAWKINS, TODD PHONE #: 503.807 -2065
CONTRACTOR: P B ELECTRIC INC PHONE #: (503)7N-4499
Inspection Request Scheduled For: Date: 8/24/2007 Pour Time:
Code # Inspection Description Srar41' • • Contact # Message
110 Temporary electrical service 054571 -01 503- 807 -2065 N
Corrections /Comments /Instructions: '
6D Two G v IJ 0 5 A(__1 ((.G a. v ► Pte. f aT 2so .
Wo2v.i N . ..v-- Efa-B1 c_C "IN FRocs17 0E V' A1O i(.. is
P - 8 Ati`G' i zb 3 F fiti To E(.o;► -
❑ PASS n PARTIAL APPROVAL I I CANCEL I I NO ACCESS
FAIL I I CALL FOR INSPECTION 1 ADDITIONAL FEES ASSESSED
Inspector: 0.- , (0 ) Date: ' 2 '&1 Phone #: (503) 718- 249