Permit CITY OF TIGARD ELECTRICAL PERMIT
F' .,--i. COMMUNITY DEVELOPMENT PERMIT #: ELC2008-00106
DATE ISSUED: 2/26/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 110BC -00800
SITE ADDRESS: 12380 SW CORYLUS CT ZONING: R -1
SUBDIVISION: AMES ORCHARD LOT : 005 JURISDICTION: TIG
PROJECT: NAIDA
Project Description: Installing (2) branch circuits for furnace and A/C.
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:
MAHAN NAIDA T & T ELECTRIC
12380 SW CORYLUS CT. 4287 SE INTERNATIONAL WAY #F
TIGARD, OR 97223 MILWAUKIE, OR 97222
Phone: 503 - 598 -9547 Contact #: PRI 503 - 652 -7610
FAX 503 - 652 -7612
FEES
Description Date Amount Reg #: ELE 3 -605C
FELPRMT1 ELC Permit 2/26/2008 $53.50 LIC 161187
[TAX" 12% State Surchar 2/26/2008 $6.42 SUP 5176S
Total $59.92 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. Yo •• +/:.tain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344.
Issued By: _ _/ //, �r� - ermittee Signature C ��/
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.
, 4 , Et-Mr /cal Permit Application . fOR OFFICE USE ONLY .
(,. City of Tigard — Received
Received c r
/ DaterBy' J/_ Pennil No.: j L , / fc ,
13125 SW Hall Blvd.. Tigard, OR 97223 plan Review (/ " VV w
. , , 7 , . Phone: 503.639.4171 Fax: 503. • : v60 0\1 Datealy Other Permit:
Inspection Line: 503439.4175 Ready /By: ® Sec Page 2 For
Ti G:ARD Date Read r6 texts
Internet: vvww.tigard or.gov ‘11 � Notified/Method: Supplemental Information
�.GC�
TYPE OF WORI{ o i r t��' ctrfI PLAN REVIEW
,i�{�
❑ New construction Addition/alteratio ti ce40 - Please check all that apply (submit 2 sets of plans wlitems checked below):
❑ Demolition ❑ Other:
)3" CI Service or feeder 400 amps or more ❑ Building over three stories.
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
1- and 2- family dwelling ❑ Cummercial/industrial ❑ Accessory building
g amps for all other installations. buildings.
Multi- family ❑Master builder pump. ❑ Installation of 75 KVA or
0 ❑ Fire pum .
JOB SITE INFORMATION AND LOCATION ❑ Emergency system, larger separately derived system.
❑ Addition ot' new motor load of ❑"A `'E ", "1- 2 ", "I -3 ",
Job no.: 'O „al WI Job site address: I a'� 51,0 �n ++ / ICOFIP or more occupancy.
4.d.'f �t�� S f .�- ❑ Six or more residential units. ❑ Recreational vehicle parks.
City/State/ZIP: "� /1 f ❑ Health -care facilities. ID Supply voltage for more than
,j1 L! "' ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
Cross street/directions to job site:
FEE SCHEDULE
newriptien I Qty. I Fee 1 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'l 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential
DESCRIPTION OF WORK (with above sq. 11.) 75.00 2
r Limited energy, multi - family • 75.00 2
{ n ya_et �J 5 ,`t c residential (with above sq. a,)
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: Nets Yo'i 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
CitytState /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Own er installation: This installation is being made on property that 1 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 brunch circuits with
❑ APPLICANT ❑ CONTACT PERSON above service or feeder fee,
each branch circuit 6.65 2
Business name: B. Fee for branch circuits
Contact name: without service or feeder fee 46 /�� 2
first branch circuit 1 "6: TS
Address: Each addi branch circuit / 6 65 ip 6;6 2
CityiState /SIP: Miscellaneous (service or feeder not included)
Each manufactured or modular 90.90 1 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
Business name: f ' a ` m �L /. Signal energy panelt(s)oriimited-
l� panel, alteration, or
Address: it, t�?,Y1 5 1 . J 4 ` .i A.(
i
extension. Describe: Paget 2
CityiState/ZIP: � w K a ! l 72 , .2 r Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( (ct q to iO Fax: (505) 1 5 2 • I &) f Investigation per hour (I hr min) 62.50
CCB Lic.: ii,ii g �► Electrical Lic.: Or %.) Suprv. Lie.: - "
r 7 & t' Industrial plant per hour 73.75
Suprv. Electrician signature, required: /0 1 ELECTRICAL PERMIT FEES
w Subtot �.
�` Plan review 2 5% of ermit fee
Print name: I t'L e 1„ ,, ti Date: ,-1;?. 3 (25% p )
�L L.e-t' ! �! State surcharge (12% of permit fee): t :.4''
Authorized signatu TOTAL PERMIT FEE: 5q, `jam
Print name: This permit application expires if a permit is riot obtained within 180
Date: days after it has been accepted as complete.
Z'd Z 69L (£09) Jlegsu t of j e L17: i, 6 90 9Z qed
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008-00106
13125 SW Hall Blvd., Tigard, OR 97223
4,41: DATE ISSUED: 2/2€J2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 pl ..tqF IN •
INSPECTION WORKSHEET FOR DATE: 3/12/2008 TIME: 7:00AM PAGE: 65
SITE ADDRESS: 12380 SW CORYLUS CT CLASS OF WORK:
SUBDIVISION: AMES ORCHARD LOT #: 005 TYPE OF USE:
PROJECT NAME: NAIDA
DESCRIPTION: Installing (2) branch circuits for furnace and NC.
OWNER: NAIDA, MAHAN PHONE #: 503-598-9617
CONTRACTOR: T & T ELECTRIC PHONE #: 503-652-7610
Inspection Request Scheduled For: Date: 3/12/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 06E442-01 503-579-2250
Corrections/Comments/Instructions:
4 - 9t) P
b e 54.-0
/ 3
•
ICe) 1111ARTIAL APPROVAL fl CANCEL 1 1 NO ACCESS
FAIL 2111CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector:
Is
Date: agg Phone #: (503) 718-