Permit C ITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2005 -00483 A r i t DEVELOPMENT SERVICES DATE ISSUED: 7/6/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL. 1S133DB-06500
SITE ADDRESS• 11103 SW ESCHMAN WAY ZONING. R -12
SUBDIVISION CASTLES AT BRITTANY LOT 011 JURISDICTION' TIG
•
Project Description (10) branch circuits for bathroom 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 9 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:
ZIENHNERT, MICHAEL & BROOKE GAW ELECTRIC INC
11103 SWESCHMAN WAY PO BOX3414
TIGARD, OR 97223 TUALATIN, OR 97062
Phone: 503 - 519 -9235 Phone: 503- 692 -3540
FEES Reg #• LIC 150495
ELE 34 -586C
Description Date Amount SUP 49955
[ELPRMT] ELC Penult 7/6/2005 $106 70
[TAX] 8% State Surcharge 7/6/2005 $8 53 REQUIRED ITEMS AND REPORTS
Total $115.23
This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Speaalty Codes and all other applicable laws
All work I- bSdohe in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is
suspe ed for more than 180 days ATTENTION Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center Those
rule re set forth in OAR 95 -101 -0010 through OAR 952- 001 -0100 You may obtain copies of these r or direct questions OUNC at
503 246 -6699 or 1- 800 -33 st 44
Iss ed By. ", Permittee Sig atp e:
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:
ONTRACTOR INSTALLATION ONLY
—
SIGNATURE OF SUPR. ELEC'N• : ;/1 � a. d �–1 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.
Electrical' Permit.M n FOR OFFICE e SE ONI
City ofTigard ��. ieeaved I aside y�3
Q, 1.‘#) DateBv ,r1Na_/ Pint N
13125 SW Hall Blvd , Tigard, OR 97223 Plan Res mw -
Phone 503.639.4171 Fax 503.598 , ATOM ° I Date /o3 Other Permit,
Inspection Line 503 639.4175 ,,. 0? S ,, ie\O -1 •• .e:a lie Daze keudyBy tutu ® See Pace 2 for
Internet, aww ci tigard.or.us GA . CA notdied/Method � Supplemental Informahon
BVTI OF WORK PLAN REVIEW
❑ New construction ® Addition/alteranon/replacement Please check all that apply
❑ Demolition [] Other ❑Service over 225 amps, comm'l ❑Hazardous location
❑Semce over 320 amps - rating ❑Buddng over 10,000 sq ft ,
CATEGORY OF CONSTRUCTION of 1- and 2-family dwellings 4 or more new residential
E I and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ❑System over 600 volts nominal units in one structure
['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
Job no.: Job site address: 11103 SW Eschman SL ❑Health - care facility ID Other
Submit 2 sets of plans with any of the above
City /State/ZIP' Tigard, Or The above are not applicable to temporary construction service.
Suite/Wig no. Project name: SLS Zien hart Residence FEE* SCHEDULE
Deamplron Qty I Pre. I Tout I "
Cross street/directions to job site' New residential single- or multi - family dwelling unit.
Includes attached garage.
1,000 sq. ft or less 145 15 4
Subdivision l Lot no. Ea add'l 500 sq ft or portion 3340 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
Rom Addition - New bathroom dwelling, service and/or feeder 90 90 2
Services or feeders installation, alteration, and/or relocation
200 amps or less 80 30 2
❑ PROPERTY OWNER I ❑TENANT 201 amps to 400 amps 106 85 2
Name: 401 amps to 600 amps 16060 2
Z. f�r� 601 amps to 1,000 amps 240 60 2
Address. Over 1,000 amps or volts 454 65 2
Reconnect only 66 85 2
CirylStateJZIP Temporary services or feeders installation. alteration, and /or
Phone: (COI) ! 1 9 • � ?35 Fax. ( )
relocation amps 200 amps or less 66 SS l
wrier installation: This installation is being made on property that J 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 emps to 600 amps 133 75 2
Owner signature Date: Branch circuits- new, alteration, or extension, per panel
❑ APPLICANT I ❑ cONTACT PERSON A Fee for branch circuits trtth
service or feeder fee, each 6 65
branch circuit 2
B usmess name
Contact name:
B Fee for branch circuits
without service or feeder fee,
Address: each branch circuit 4685 g6,1(5" 2
Each add', branch circuit 6.65 5 • g5 2
City /State /ZIP: Miscellaneous (service or feeder not included) i
Phone Pump or imgation circle 53 40 2
( ) Fax. ( ) Sign or outline l 53 40 2
E -mail Signal orcuit(s) or limited-
CONTRACTOR energy panel, alteration, or
extension Describe' Page 2 2
Business name. GAW Electric Inc ,1
'sal Addresses �¢�
1 `tom 11`��,�n' p 184 F 14 Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State/ZJP Tigard Or _`1 I~ ca CAA 2/w O 2 ' ) 0 (o D- Investigation per hour (1 hr min) 62.50
Phone (503) 603 -0810 Fax (503) 2174236 Industrial plant per hour 73.75 I
ELECTRICAL PERMIT FEES'
CCB Luc . I50495 Electrical Li�e 34 -586c Suprv. Lic COIN 4 z? Subtotal /0 b - - !/
Supry Electrician signature, required !L /lye l 11�„ _ Plan review (25% of permit feel
Print mime
.1-1/.4.- :2 - '> �I � v e � f ) "y / Dat
e::Q
J �/ � State surcharge (8 %ofpermit fee) Is S
� / ! / ) T TOTAL PERMIT FEE / /C, / , 3
Authorized signature, yr 4 is permit application expires if a permit it not obtained within ISO
i w , [� O - � doss after tr hag ores accepted as complete
Pnnt nerve: / _ • Hate' Fee methodology set by To- County Budding Industry m Se Seance Bonnt
•• Number of iospecnons per permit allowed
1 'd PennaApp doe 12/63 440f615T[I0/37/COM/WEB
L d 9EZ9 LZ (£09) ONI OI211O313 MVO e17911. L 90 90 In
CITY OF TIGARD ,
BUILDING DIVISION t. PERMIT # ELC2005 -00483
13125 SW Hall Blvd , Tigard, OR 97223 DATE ISSUED 71612005
Phone. (503) 639 -4171 '^ lit Requests (24 Hrs ). (503) 639 -4175 a__
INSPECTION WORKSHEET FOR DATE 8/24/7005 TIME 7:08AM PAGE 53
SITE ADDRESS 11103 SW ESCHMAN WAY CLASS OF WORK
SUBDIVISION' CASTLES AT BRITTANY LOT # 0i1 TYPE OF USE
PROJECT NAME ZIENHERT
DESCRIPTION (10) branch circuits for bathroom remodel
OWNER ZIENHNERT, MICHAEL & BROOKE, PHONE # 503- 519.9235
CONTRACTOR CAW ELECTRIC INC PHONE # 503-692-3540
Inspection Request Scheduled For Date: 8/24/2005 Pour Time: < _Th
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 014186.01 503- 519 -9235 Y
Corrections /Comments /Instructions:
/O: c
-1
aIMMIM
0 FASS a PARTIAL APPRO' • CANCEL ❑ NO ACCESS
FAIL %CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
L
Inspector a Date: 2 /o Phone #: (503) 718 -
r