Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00460
�� DEVELOPMENT SERVICES DATE ISSUED: 8/16/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1 S125DB -10900
SITE ADDRESS: 07465 SW ELMWOOD ST ZONING: R -4.5
SUBDIVISION:- ELMWOOD PARK LOT : 006 JURISDICTION: TIG
Project Description: (2) branch circuits for a/c install. Job No. 24649
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:
DUANNE DEHAAN OREGON ELECTRIC GROUP
7465 SW ELMWOOD 1010 SE 11TH AVE
TIGARD, OR 97223 PORTLAND, OR 97214
Phone: 503 - 977 -6084 Contact #: FAX 503 - 535 -2763
PRI 503 - 234 -9900
FEES
Description Date Amount Reg #: ELE 26 - 95C
[ELPRMT] ELC Permit 8/16/2006 $53.50 LIC 203
[TAX] 8% State Surcharge 8/16/2006 $4.28 SUP 4460S
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 -fort' h in OAR 95 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rul or direct questions to OUNC at
503 - 246 -6699 or 1 -800; 2 -2 `
Issued By: �� I , _ /� Permittee Signature( . I
( r r
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 •
._— ? /er-: �L DATE:
SIGNATURE OF SUPR. ELEC'N:
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.
AUG- 16-2006 02:33PM FROM -OR ELECTRIC SVC 5035352763 T -748 P.001 /002 F-324
Liegrta! rermit AppueNr
i
City of Tigard EIVE ! p.te/ti; b / 6 ' 66, 117 Permit No.: £4C.j2 CPS
13125 SW Hall Blvd., Tigard, OR 97223 plan Review
Phone: 503.639.4171 Fax: 503.598.1960 AUG 1 6 2 L.a,�`' I +�i• Date/By. Other Permit:
Inspection Line: 503.639.4175 ,1 � Q ,,, '''s i,, Date R°�ylBY � �� 'ss . E3 $ M t'aSo 2 for
Internet www.ci.tigatdorms +�j eITY OF TI - r - Notified/Method , in • Supplemental Information
11
B DINt; DIVISION .
TYPE OF WORK • '. • PLAN REVIEW
❑ New construction ❑ Addition /alteration /replacement Please check all that apply:
0 Service over 225 amps, comm'I ❑Hazardous location
❑ Demolition ❑ Other: ['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft,
• • CATEGORY OF CONSTRUCTION of 1- and 2- ltmily dwellings 4 or more new residential
® 1- and 2-family dwelling 0 System over 600 volts nominal units in one structure
y g ❑ CommerciaUindusvial 0 building []Building over three stories ❑Feeders, 400 amps or more
❑ Multi-family ❑ Master builder ❑ Other: ❑Occupant load over 99 persons ❑Manufactured structures or
• JOB SITE INFORMATION AND LOCATION ❑ Egress/lighting plan RV park
❑IIealth -care facility ❑ Od1°-
Job no.: 24649 Job site address: 7465 SW ELMWOOD ST Submit? sea of plans with any of the above,
City/State/ZIP: TIGARD, OR 97223 The above are not applicable to temporary construction service_
FEE" SCHEDULE
Suite/bldg./apt. no.:
p /a t Project name: DUANE DEEHAN Qt.' I Description I Qty Fee. 1 Total ••
Cross street/directions to job site: New residential single- or multi- family dwelling unit.
• Includes attached garage.
1,000 sq_ fl, or less 145.15 , 4
Subdivision: 1 Lot no.: Ea. add'I 500 sq. R or portion 33,40 1
Limited energy, residential 75.00 2
Tax map/parcel no.: _ Limited energy, non - residential — 75.00 2
DESCRIPTION OF WORK . _ Each manufactured or modular
OUTDOOR A/C UNIT dwelling, service and/or feeder 90.90 2
• Services or feeders installation, alteration, and/or relocation
200 amps or less 8030 2
201 amps to 400 amps 106.85 2 • ❑ PROPERTY OWNFJi I ❑ TENANT _- 401 amps to 600 amps 160.60 2
Name: DUANE DEEHAN . 601 amps to 1,000 amps 240.60 _ 2
Address: 7465 SW ELMWOOD ST Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City/State/ZIP: TIGARD, OR 97223 Temporary services or feeders installation, alteration, and/or
relocation
Phone: ( ) I Fax: ( ) 200 amps or less 66 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 extension_, per panel
❑ APPLICANT 1 ❑ CONTACT PERSON A, Fcc for branch circuits with
service or feeder fee, each 6.65 2
Business name: brunch circuit
- B. Fee for branch circuits
Contact name: without service or feeder fee, I 46.85 %a $ 5 2
each branch circuit
Address: Each add'I branch circuit I _ 6.65 • lo t 1 2
City/ State/ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( ) '
_Signor outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
. .
. CONTRACTOR . • energy panel, alteation, or
. extension, Describe: Page 2 2
Business name: Oregon Electric Group .. ,
Address: 1010 SE 11th Ave Each additional Inspection over allowable in any of the above
Per inspection 62.50
City/State/ZIP: Portland, OR 97214 Investigation per hour (1 hr min) 62.50
Phone: (503) 234 Fax: (503) 535-2763 Industrial n>ant per hour 73.75
ELECTRICAL PERMIT FEES*
COB Lie.: 203 Electrical Lie.: 26 -95C I Suprv. Lic.: 45495 Subtotal 53 , 5o
a � Plan review (25% of permit fee)
Suprv. Electrician signature, _
State surcharge (8% of permit fee) 1.4. 2Z
Print name: M L Date: 08/16/06 -.
Tt C� 1 a �`� c E I 1 0 }7 TOTAL PERMIT FEE
v
Authorized signature : v ( � S. Thie permit application expires Ira permit 1s not obtained within 180
days after it has been accepted as complete
Print name: R , C ‘„, A, y-c.) M [, l I l Date: 08/16/06 • Fee methodology het by Tti- County Building Industry Service nosn!
• •• Number of i,tapactions per penolt allowed_ (^
i;\ B, Meinawenaiaustc- rrr,j,itnrp.dac 12/03 4404 ` J \
615T(10/02JCOM/WEB
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200& 00460
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/16/2006
Phone: (503) 639 -4171 d ip �
Inspection Requests (24 Hrs.): (503) 639 -4175 J .. `' !
INSPECTION WORKSHEET FOR DATE: 9/1512006 TIME: 7:06Am PAGE: 25
SITE ADDRESS: 07465 SW ELMWOOD ST CLASS OF WORK:
SUBDIVISION: ELMWOOD PARK LOT #: 006 TYPE OF USE:
PROJECT NAME: DEHAAN
DESCRIPTION: (2) branch circuits for alc install. Job No. 24649
OWNER: DEHAAN, DUANNE PHONE #: 603 977 - 6004
CONTRACTOR: OREGON ELECTRIC GROUP PHONE #: 503 - 234 -9900
Inspection Request Scheduled For: Date: 9/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 036611 -01 503 - 849`4013 ¥
Corrections /Comments /Instructions: c ,
\4 .
I1 PASS n PARTIAL APPROVAL n CANCEL I I NO ACCESS
❑ • CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: A C/8 `—E Date: 9118 c316 Phone #: (503) 718- 1.44