Permit `. C I T 1 OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00590
III DEVELOPMENT SERVICES DATE ISSUED: 10/18/2006
A- °: 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 1S133CD
SITE ADDRESS: 13669 SW FEIRING LN ZONING: R - 25
SUBDIVISION: COTSWALD MEADOWS LOT : 047 JURISDICTION: TIG
Project Description: (3) branch circuits. Job No. 443
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: SIGNALJPANEL:
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: 2 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:
RYAN VAN DUSEN WILLAMETTE ELECTRIC INC
13669 SW FEIRING LN PO BOX 230547
TIGARD, OR 97223 TIGARD, OR 97281
Phone: Contact #: PRI 503 - 624 - 3631
FAX 503 - 624 -2938
FEES
Description Date Amount Reg #: ELE 34 - 283C
[ELPRMT] ELC Permit 10/18/200( $60.15 L[C 75059
[TAX] 8% State Surcharge 10/18/200( $4.81 SUP 1965S
Total $64.96 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 s , t - forth in \ OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these r or direct questions to OUNC at
503-246-6699 or 1 -800 '32-f . • 4.
Issued y: k !s wUL2� Permittee Signature,-
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
RE OF PR. ELEC'N - i �� O /1( /x 6 '
SIGNATURE SUPR. � DATE: l
- -_
LICENSE NO: l
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.
nc 2008 9:38AM WILLAMETTE ELECTRIC 5038242938 p.2
1 .s
Electr ` Permit A •• �r'61-4 A F OFFICE USE ONLY LI'
City of � 1 �E� Date/B ived
: / 0 /g b . O PermitNo.. E.
g
13125 SW Nall Blvd., Tigard, OR 97223 ',,A ° 4 Phone: 503.639.4171 Fax: 503.598.1960 ' { 201 A i y, I 1 Clii) Pta n Review ®�� ��other Permit. Inspection Line: 503.639.4175 � Date
„ Date Ready/By: J�uris 121 See Page 2 for
Internet: www.ci.tigard.or.us CITY OF 'Wit Notified/Method: .-7 le.,. Supplemental information
T 1
... .. ,, T 1"
{ «. : t1 Y 'I�ililt...._, TO- .ii', .1 . 1 4-''.1 L ^'. Yl :� •''
❑ New construction ,r- Addition /alteration /replacement - Please check all that apply:
❑ emol ition ❑Service over 225 amps, comm'i ❑Hazardous location
D ❑O ther:
: _ : d ;• e:,___ --.� f ❑Service o ver 320 amps - rating Buildn over t •
_ _ _ - _:
, . 17 p' g g 0,000 sq. fl.,
�' :
. - ,'.-. :.:;_.: .__ ::: �::: ���'' ��t-, �iZ'`+ T. �d--'--'- �-----..._.. �_-- 1 .'_._. , :: j:; :_• :; :�. : :�wA >='��= :. : < :i i` " of dwellings ,.- _.,., :. = r ._ ....... ...........<. s, _...__ ., ��� ,, : : : : : :L,..;, : :.:.,. ! f
Y e ngs 4 or more new residential
Vii./1- and 2-family dwelling ❑ Commercial/industrial ID Accessory building ['System over 600 volts nominal units in one structure
•
•
Multi -famil ['Building over three stories ['Feeders, 400 amps or more
❑ _ y ❑ Master builder ❑ Other:
1�• "'2 �-- - - ^ .- ld�' i '�'�t•t - 'd" ; r � ",v� � 'li••i - Y' ^- ;,;� " --� - t � p• ❑Occupant load over 99 persons ❑Manufactured structures or
LiS:f: _ M. ::1tt/ d EY3'1tR3#df `' �! ': x ,� "' ia ay,.' .. - L f ._=a:
Iii :..._._._._..�_.__. - Ea.:,,,: —�� =;. -r - - .... - _1�.. ''•�� : :a, :>_... -'..- 'r E plan RV
' `. _ -� ;;., .�-� : : :•;, . -' :._ zest{ mtl��� s.�;,,t...�. = :t � €E; -` ='t ;err ❑ Egress/lighting park
p
Job no.: "! 3 Job site address: ! 3 t'G y 6 L , r r - 1 _� ./� ❑ -care facility ❑Other:
I 1601 Subm 2 sets of plans w any of the above.
City/State /ZIP: / - + j if r1 �z i7 9�J 3 The above are not applicable to temporary constuction service.
Suite/bldg./apt. no.: } 469/o . t i.G[_ `;i ^;I T <7 :•4 ` 'J')40,W -r';: µ `.a 1 ...
Project name: Y/�h 1/1
Drscrlptlan f Qty. I Fee. Total "
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: Lot no.: Ea. add') 500 sq. ft. or portion _ 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
"zl.s :fr, °'' i ,a.. :_ t . I: , f !t; _ Limited energy, non- residential 75.00 2
> _ .. tG;�l..l. (� . .. 'L1i^ ..,......... -- ......,_ .- .__.. -�. :' ,.,:. "'
•-,-...: : . . ......:...... :- ' : :,,;• :, ,�J ._ �,:,_.... v- : : :.rn,a� --• ,_ „. t d; ��:.::: :s;l......_.... „......_._ Eachmanufacwred or modular
�T J / �{ i ; �eG y G�e dwelling, service and /or feeder 90 90 2
` �L t Services or feeders installation, alteration, and/or relocation
/'] t , f- ,he 200 amps or less 80.30 2
::, a _ . „' , - = -t om k 2 01 aril's to 40
= ��` 'S - - = M'�:a• ?r.: --- =1, „.,,.: mp O amps 106.85 2
i,, 4' 311._ 9 .,.- „ - ; ;Ke•%. n :d. - _.
,...., .. � %liv; ki :2� . ,' "rSlftii� "ildk':t'littt.flS� 'r t�Ndt9'I..a�._ _. - -.: ilii��1�'i4E` {� - ,{�;;_ �,s_ -• ��
` t ''" °� ,r_ _. ,,, . 1 N,r.._._ ,,, 401 amps to 600 amp s
160.60 2
Name: 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
Ciry/State /ZIP: Temporary services or feeders installation, alteration, and /or
Phone: ( ) I F ax; ( ) _ relocation
200 amps or less 66.85 I
Owner 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 600 amps 133.75 2
Owner signature: Date: Branch circuits -
._, 1 .. Y......a ,,. > �., aes ::.\;,ii > ;W u:t M" r”' ° A. Fee for branch v, alteration, r extension,
.......,
.. ...... ..�t : :��'� : _� _._....__- __— .._.... I(ijli^h :r • �''":i�� circuits with
per panel
,' � r --- A h circ
service or feeder fee, each
Business name: branch circuit 6.65 2
Contact name:
B. Fee for branch circuits
without service or feeder fee, �// •
Address: • first branch circuit ` 46'85 HG -y5 2
Each add'l branch circuit 1. , 6.65 1 - b,5.0 2
City /State /ZIP: Miscellaneous (service nr feeder not included)
Phone: ( ) I Fax: ; ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: _
.,,a _.. ° :_'' :. f ,i. iLt- .___c._ It1 . L".-3 =�r i :,. •litifif i _' Lis= 5'' =j ° lgll:
rgna circuit (s) or limited-
�'q } y �� �,? 7 , crr.�. ��Iw � one Panel, al
,-- _...._- -- ---'_- t<.,_:!:1 • aaFiiiii.. -- — Q.... 4., V� . , '.t:?'. , . ,..,, , _ - , - "%`?. --, -,end c :.:. rgY P Describe:
or
@ extension. Describe: Page 2 2
Business name:
a e/-I- L /ectr.t. r ... •t.
Address: P p 8.0”. 2..m 0 S” i) Each additional inspection over allowable in any of the above
Per inspection 62.50
City/State /ZIP: T i of c1 0 v et 2Z 8 J
Investigation per hour (i 62.50
Industrial plant per hour 73.75
Phone: (S�) 624f- 3 t 3. i Fax: (,5 �J ) 62 ti �- Z. 7 3 e e'ss :� - �._ °_? :s�
::c. = -_ - :' ) lit ?. i ':;+± �: �r. A_, ��.�,�'��kt�+. :I6 ' = . : .; :. :' -'
CCB Lic.: 75 9 Electrical Lic.: 3 -ze., C Suprv. Lie.: �Z Z 6 's' Subtotal �g
1- E
Suprv. Electrician signature, required ✓ _.- _..._...•• - -••- ^- - "" "' " Plan review (25% of permit fee)
Print name: 0 a ; , f ,; re Date
State surcharge (8% of permit fee) L-1 s .. I •
- TOTAL PERMIT FEE ,G l , q
Authorized signature:
This permit application e xpir es if a permit is not obtained Lrithin 180
days after it has been accepted so complete
Print name: Date: * Fee methodology set by Tri -County Building Industry Service Board
** Number of inspections per pemlit a llowed.
is \Boi Idin \ Permits \E LC- PermitApp. doe 12/03 440- 4615T(10/02/COM /WEB
CITY OF TIGARD
BUILDING DIVISION `' PERMIT #: ELC2005•00590
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 .14-
INSPECTION WORKSHEET FOR DATE: 10/31/2006 TIME: 7 :01AM PAGE: 27
SITE ADDRESS: 13669 SW FEIRING LW CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS LOT #: 047 TYPE OF USE:
PROJECT NAME: VANDUSEN
DESCRIPTION: (3) branch circuits. Job No. 443
OWNER: VANDUSEN, RYAN PHONE #:
CONTRACTOR: WiLLAMMMETTE ELECTRIC INC PHONE #: 503 - 624 - 3631
Inspection Request Scheduled For: Date: 10/3112006 Pour Time:
Cod- nspection • - ; . '.tion Confirm # Contact # Message
120 Electrical rough -in 039070 -01 503- 624 -3631 N
Corrections /Commen s /Instructions:
X PASS ❑ PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
, 068L
Inspector: Date. 16 I ('D Phone #: (503) 718144;
CITY OF TIGARD
BUILDING DIVISION �' PERMIT #: ELC2006 -00590
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/18/2006
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 N,
INSPECTION WORKSHEET FOR DATE: 10/3€/2006 TIME: 7 ;05Am PAGE: 75
SITE ADDRESS: 13669 SW FEIRING LN CLASS OF WORK:
SUBDIVISION:. COTSWALD MEADOWS LOT #: 047 TYPE OF USE:
PROJECT NAME: VANDUSEN
DESCRIPTION: (3) branch circuits. Job No. 443
OWNER: VANDUSEN, RYAN PHONE #:
CONTRACTOR: WILLAMETTE i'E ELECTRIC INC PHONE #: 503.624 - 3631
Inspection Request Scheduled For: Date: 10/30/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 036948 -01 603.624 -3631 N
Corrections /Comments /Instructions:
❑ PASS PARTIAL APPROVAL ❑ CANCEL !1 NO ACCESS
'FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: G" • Ni d e t_e Date: Phone #: (503) 718- 2-4
— 1°
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