Permit CITY OF TIGARD ELECTRICAL PERMIT
° PERMIT #: ELC2009 -00042
_ COMMUNITY DEVELOPMENT DATE ISSUED: 1/29/2009
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S133CD
SITE ADDRESS: 13887 SW CRIST CT ZONING: R -
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT : 110 JURISDICTION: TIG
PROJECT: PORRAS
Project Description: Grounding for new water service.
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: 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:
MARTIN PORRAS METROS BEST ELECTRIC
13887 SW CRIST CT P.O. BOX 30075
TIGARD, OR 97223 PORTLAND, OR 97294
Phone: Contact #: PRI 971 - 563 - 9418
FAX 503 - 262 -8251
FEES
Description Date Amount Reg #: ELE C430
[ELPRMT] ELC Permit 1/29/2009 $46.85 LIC 147298
[TAX] 12% State Surchar 1/29/2009 $5.62 SUP 4619S
Total $52.47 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 By: [,y\ Permittee Signature: pp 'I � 1Q 6V1
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.
. Jan 29 09 04:32p Case-h.. 5032628251 p.1
Electrical Permit Ap licatio FOR OFFICE USE ONO1
City of Tigard 1 ^ A N 2 ° .°9 Received
�+ J Date/13v: • q . 0 • _', Permit No.: C `C • ` _ Q so
a 13125 SW Hall Blvd., Tigard, OR 97223 iew Other . Phone: 503.639.4171 Fax lr� 503.598.196Q OF TtGARD DatPlan Rev Other Pent»!: 'Lm Q • . 0 4 O
T k A1tD Inspection Line: 503.639.4175 ptVtSION Date Readyn3y: 0 See Paget for
.. Internet: www.tigard or.gov BUILD ING Notified/Method: Supplemental Information
TYPE OF WORK PLAN REVIEW
- eW construction ❑ Addition/alteration /replacement Please check all that apply (submit 2 sets of plans w.titents checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
• Demolition ❑ 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
and 2- family dwelling ❑ Commercial /industrial ['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- 1 3
Job no.: Job site address: ` 3$'" y r t Sri or or more. occupancy.
C lt(,[.✓"t' ❑ $ix or more residential units. ❑ Recreational vehicle parks.
City/State /ZIP: - — " CI I Health -cart facilities.
0 Supply voltage for more than
C c C 42 �� �o� t'] ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project thee: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: Description I Qty. I Fee. I Total i
New residential single_ or multi- family dwelling unit.
(C;'• Ce e_-1- pry's C&.) t lTVr1 Aue.— Includes attached garage.
Subdivision: Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
• y C: (..r\ i ia residential (with above sq. ft.)
_Services or feeders installation, alteration, and/or relocation
200 amps or less 80.30 , 2
PROPERTY OWNER ❑ TENANT 201 amps to 400 amps 106.85 2
Name: fAc�Y 1 n �� _�S 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: VDD (5S S(-A--) C ham - Over 1,000 amps or volts 454.65 2
City/State /ZIP: l Y at--iaQ?-) Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( s 3t , '3(3,2.L� Fax: ( ) 200 amps or less I 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits - new, alteration, or extension, per panel
with
A. Fee for branch circui
APPLICANT ❑ CONTACT PERSON above service or feeder fee, 6.65 2
each branch circuit
Business name: '- Qesi- B. Fee for branch circuits
Contact name: � g�j �� without service or feeder fee, l
first branch circuit 46.85 2
W� L
Address :$ L . ' Each add'1 branch circuit 6.65 2
r Miscellaneous (service or feeder not included)
City/State /ZIP: Ch -}-.C. (.la ae_ Ci 1 2Ci d Each manufactured or modular 90.90 2
I , f / �� dwelling, service and/or feeder
Phone: ('C'1I) S�3 . Li i b Fax : : (51)9 Cal L02_- � 2__(.3--i Reconnect only 66.85 2
E - mail: C..s::1't.i -� e, C.ase.As Ql (,k_(,' or- (;\ .. cry, Pump or irrigation circle 53.40 2
CO RACTOR J Sign or outline lighting 53.40 2
c Signal circuit(s) or limited-
Business name:
�g' -S � 5,k GAe.G f; energy panel, alteration, or
Address: P)OX extension, Describe: Page 2 2
City/State/ZIP: } an
"At (yO o . 'T Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ,gi11,) S - GL L , Fax: (c ) 0 ) ip a _( ( ,, a S . 1 Investigation per hour (1 hr min) 62.50
CCB Lie.: 1 �clzci S 1 Electrical Lie.: CA ':) Suprv. Lie.: 4-16' ! C Industrial plant per hour 73.75
y J ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: _ f, 2 Subtotal:
Print name: "1✓0, Date: Plan review (25% of permit fee): i F., . ( 'Z
v,, l LC � f State surcharge (12% of permit fee):
Authorized signature: tu, `�r� 1 r r � TOTAL PERMIT FEE: - �
�t l J, t This permit application expires if a permit is not obtained r,
Print name: +` �` / r ) � �'�i I ��� �7 // K � , Date: t z G� '��Ol days after it has been accepted as complete. 2 . 4,
I t 1 l ( t • Number of inspections allowed per permit.
11.lBuildineerrnits dot 05123(06 44046157(11 /05 /COMAVEB
. ,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2009- 00042
13125 SW Hall Blvd., Tigard, OR 97223
Aohjimpeeil\ DATE ISSUED: 1/2912009
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 61-
INSPECTION WORKSHEET FOR DATE: 2/2'2009 TIME: 7:00Atvl PAGE: 12
SITE ADDRESS: 131387 SW GRIST CT CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS N0,3 LOT #: 110 TYPE OF USE:
PROJECT NAME: PORRAS
DESCRIPTION: Grounding for new waiter service.
•
OWNER: PORRAS, MARTIN PHONE #:
CONTRACTOR: METROS BEST ELECTRIC PHONE #: 971-563-9418
Inspection Request Scheduled For: Date: 2/2/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
. 199 Electrical final 0l30172-01 503.253-0030
Corrections/Comments/Instructions:
\
4 PASS [7 PARTIAL APPROVAL fl CANCEL LII NO ACCESS
FAIL E] CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: r1/41\)3 LE Date: 2.2 Phone #: (503) 718- Vii6