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Permit CITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2008 -00302 COMMUNITY DEVELOPMENT DATE ISSUED: 6/3/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S 134AC -02646 SITE ADDRESS: 11040 SW COTTONWOOD LN ZONING: R-4.5 SUBDIVISION: ENGLEWOOD NO.3 LOT : 212 JURISDICTION: TIG PROJECT: SWEARINGEN Project Description: Installing (7) branch circuits for kitchen and dining room remodel. 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: 6 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: LARRY & ROBERTA SWEARINGEN 205 ELECTRIC ROBERTA 7831 SE JOHNSON CK BLVD 11040 SW COTTONWOOD LN PORTLAND, OR 97206 TIGARD, OR 97223 Phone: 503 - 590 -3655 Contact #: PRI 503 - 771 -5491 FAX 503 - 771 -5491 same as above. • FEES Description Date Amount Reg #: ELE 3 -452C [ELPRMT] ELC Permit 6/3/2008 $86.75 LIC 34255 [TAX] 12% State Surchar 6/3/2008 $10.41 SUP 3805S Total $97.16 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 Permittee Signature: 2517/2Ge./V-PN/ `' 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. May -29 -2008 10:59 AM Walker Interior Remodel.'IFl,1 503 - 244 -4667 4/4 'Electrical Permit Application FORQFFI.EUSEONLY 5 eaeive p �L►{ �{1 City of Tigard Vi**ate/13 : u` , t . hermit No. �aTic `�i✓- .444 . . Ph one: SU3.639 171 Pas. 503.598.19 '0 �pp \ m r r 13125 SW flail Blvd.. Tigard. OR 9722S g� P ;� g - � +h( J y' ' ■ Other Perna( �^ { & V % nu+ifro.�tip Inspection Line: 503 6394175 \\ 4,ii a „ 11 t y. 3uris a : ec Page 2 for Milk. Th 1. 6fi sN Internet: www.tigard- or.gov ®i //�� /Method: Supplemental Information ; C7 TYPE OF WORK 0, ®� PLAN REVIEW Neu Please chuck all that apply (submit' sets of plans w /items checked below): ❑ 'xr.++ construction [�'Adtlitiott /altcralion /rcpt ❑ Service or feeder 400 amps or shore ❑ 13ttildinn over three stories ❑ Demolition 0 Other: where the available limit current ❑ Marinas and boatyards CATEGORY OF cos 'ERUCT[ON '' •'.t.:" ` , 0:, " , - •' . -h . .,�, , t,, :.. ,,. , �, z_ ,.,„ exceeds 10,000 aryls at ISO volts or Floating buildings , °'r" .■ less to ground, or exceeris 14,000 ❑ Commercial-use agnculwrd gj I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. buildings ❑Multi- lbmily fl Master builder ❑Other: ❑ Fire pump. ❑ Installation of75KVA e , ❑ Gntergeney system , larger separately derived system JOB SITE INFORMATION AND ; LOCrVUON'ij . . i. f.= . . rr-' ❑ Addition of new motor load of ❑ - A" - E" "I - "I -r" Job no.: Job site address: I00NPormore. occupancy 1 lri i� S t r1 �Ory+h�CXxL 4 t9 hP ❑ Six or more residential mulls. ❑ Recreational vehicle parks. Cit) /Stale /ZIP: ❑ Health-care facilities. ❑Supply voltage for store than 1 \t d ' C (') k q ZZ� ❑Hazardous locations. 000 volts nominal Suite /blue. /apt. no.: - Project name: S W ea in I nO.er) ❑ Service or feeder 000 amps or more. t t "f FEC;SCHEDULE Cross street /tliieeiions to job site: 4ri'' \" Cl �N 1 Description I Qty. I Fee. I Total I • 1 Now residential single or multi - family dwelling trail. Includes attached garage. Subdivision: Unknown Lot no,: ? 1,000 sq. IL or less 145.15 4 Ea. add'I 500 sq. R. or portion 33,40 I l`ax map/parcel no.: Unknown Limited energy, residential DESCRIPTION OF WORK . ' N. '''. +''- (with above sq. 0.) 75.00 2 Limited energy. multi- family 75.00 2 i Wrl e.-1" ( b 1)n i In 4 M r w-,, n � e_ e residential (with above sq. II.) Services or feeders installation, alteration, and /or relocation -) 200 amps or less 80.30 2 i ® PROPERTY OWNER 0 TENAN I' li ` ,.. 1 / 201 snips to 400 amps 106.85 2 Nautc: 401 amps to 600 amps 160.6(1 2 . ` col >e Y l ,0.r try L 5 ear it P,Y, 601 amps to 1,000 :maps 240.60 2 Address: 12 ' SCE YVl P p Over 1,000 amps or volts 454.65 ('its /Brute / /..II': Temporary services or feeders installation, alteration, and /or V _ relocation ('hone: ( ) Fax: ( )None 200 amps or less 66.85 I 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 9 '''1{` 3f>Af. :CONea.'" l -.BERSON..' ' , a above service or feeder fcc, . , each branch circuit 6.65 2 Business name: Walker Interior Remodeling, Inc. B. Fee for branch circuits Contact name: Gary Burkhart first br service or feeder fee, 1 46.85 LItp C 2 tirst branch circuit Address: 6775 SW I I I' Avenue, Suite 201 Each add'I branch circuit Cs I 6.65 3 2 Miscellaneous (service or feeder not included) City /State /ZIP: Beaverton, Oregon 97008 Each manufactured or modular 90.90 7 dwelling, service and /or feeder Plume: (503) 452.1383 Fax: : (503) 244.4667 . Reconnect only 66.85 2 E-mail: None Pump or irrigation circle 53.40 2 CONTRACTOR. •• r '^ ` ++ ; {i :M f�.' ;'_L+ ' ;ir ,7, Sign or outline lighting 53.40 2 Business name: 205 Electric Signal circuit(s) or limiled- energy panel, alteration, or extension. Describe: Page 2 2 Address: 7831 SE Johnson Creek Blvd. City/State/ZIP: Portland, 0 regon 97206 Each additional inspection over allowable in any of the above Per inspection 62.50 Phone: (503) 771.5491 Fax: (503) 771.5491 Investigation per hour (1 hrwnin) 62.50 CCB Lie.: 34255 Electrical Lie.: 3 -452C Suptv. Lie.: 38055 Industrial plant per hour I 73.75 S . :".q4 :4!.K. .. ELEC ICAL PERMIT FEES Supt. Electrician signature, required: - %� ,''. -'a ------" Subtotal: ck Print name: Robert Caron Date: Plan review (25% of permit fee): .00 7 State surcharge (}ct /o of permit fee): > n L4 t Authorized signature y e. TOTAL PERMIT FEE: q-4-,1 Le This permit application expires if a permit is nut obtained iiithin 130 Print ant name: Robert Caron Date: days after it has been accepted as complete. • Number of inspections allowed per permit. t \fluddinpns,,nitstlit.C•I'c, nmApp Juc 05/lim6 440- 45t5T(I I /a5 /COMAVEn CITY OF TIGARD BUILDING DIVISION A PERMIT #: Et {� r0U8 Ot)30 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/3/2008 Phone: (503) 639 -4171 u� In��ul �I Inspection Requests (24 Hrs.): (503) 639 -4175 „_,W0- ''L INSPECTION WORKSHEET FOR DATE: 8/8/2008 TIME: 7:00AM PAGE: 40 SITE ADDRESS: 11040 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO .3 LOT #: 212 TYPE OF USE: PROJECT NAME: SWEARINGEN DESCRIPTION: Installing (7) branch circuits for kitchen and dining room remodel. OWNER: SWEARINGEN, LARRY & ROBERTA PHONE #: 0y390 CONTRACTOR: X05 ELECTRIC PHONE #: 503-771 -5491 Inspection Request Scheduled For: Date: 8/8/2808 Pour Time: Code # Inspection Description Confirm # Contact # Message 199 Electrical final 073889 -01 503 -452 -1383 N Corrections/Comments/Instructions: 0 I ,f (i 1 ' NW • 6ait , OK- - ,. .'2- • I -5 v (-/ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL ❑ CA ; L FOR INSPECTION ❑ ADDITION' L F ES ASSESSED , 1' I 2 1 1 VO Inspector: Date: 0 d . V Phone #: (503) 718- . CITY ��U�U� �*mu n ��o mwn�o��un�� BUILDING DIVISION ,. - ~,~°"=~~=""~~= ~,"°"~,"=~.. PERMIT #: 00502 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 613/20O8 ~ Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 5/4/2008 TIME: 7:01AM PAGE: 20 SITE ADDRESS: 11040 SW COTTONWOOD LN CLASS OF WORK: SUBDIVISION: ENGLEWOOD NO.3 LOT #: 212 TYPE OF USE: PROJECT NAME: SWEAR|MGEN DESCRIPTION: Installing (7) brarick circuits or kitchen and dining i'oom rmode!. OWNER: SWE-AR|NGEM. LARRY & ROBERTA PHONE #: 503-530-3555 CONTRACTOR: 205 ELECTRIC PHONE #: 503-771-5491 Inspection Request Scheduled For: Date: 6/4/2008 Pour Time: Code # Inspection Description o • "o # Contact # Message 120 E]wcthmal[oug+in 070838'01 503-840~2293 N C}ornocdona/Connnnenta/|nStruct|ono: • FA PAS8 RA�OALAPPROVAL CANCEL NO ACCESS 1 FAIL 7 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED � � �� ~° ^ � Inspector: «��--� ��m� L�� Date: _ "* ^ ~ % ' �� Phone #: (503) 718- t�- / & ��