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Permit C ITY OF TIGARD ELECTRICAL PERMIT PERMIT #: ELC2008 -00545 COMMUNITY DEVELOPMENT DATE ISSUED: 9/25/2008 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S135CA-90205 SITE ADDRESS: 11040 SW GREENBURG RD 205 ZONING: R -12 SUBDIVISION: ASH CREEK PARK CONDO LOT : JURISDICTION: TIG PROJECT: DAVIS Project Description: Installing 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: SIGNAUPANEL: MANF HMI SVC/ FDR: 601 +amps - 1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: 1 W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 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: EUGENE & VIVIAN DAVIS ADVANCED ELECTRICAL CONCEPTS, INC. 11040 SW GREENBURG RD A.K.A MR. ELECTRIC TIGARD, OR 97223 14300 NE 20TH AVE. D102 -313 VANCOUVER, WA 98686 Phone: 503 - 246 - 5862 Contact #: PRI 503 - 296 -8555 FAX 360- 546 -2158 FEES Description Date Amount Reg #: ELE C136 [ELPRMT] ELC Permit 9/25/2008 $80.30 LIC 168324 [TAX] 12% State Surchar 9/25/2008 $9.64 SUP 45885 Total $89.94 REQUIRED ITEMS AND REPORTS This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC at 503.246.6699 or 1.800.332.2344. Issued By: . „ - `_ Permittee Signature: - / " OWNER INSTALLATION ONLY The installation is being made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR. ELEC'N: DATE: LICENSE NO: Call 503.639.4175 by 7:00 a.m. for an inspection that business day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. .. • ., .. Sep. 24. 2008 2:41PM No. 9071 P. 1 .1,7 � Electrical Permit Application �+ �� FOR oErl('11 USE ONLY City of Tigard G D�� , O VA - •` _ I/5 13125 SW Hall Blvd., Ti gard, OR 97 , rl GQ+� t n Review • . Other Permit: " Phone: 501639.4171 Fur.: 503 59$.1960 :� .` � �� Datc/By_ runs: m See Pope z Cr o Inspection Line: 503.639.4175 �\ Date Ready/BY: "11(3 AR❑ `G Notified/Method: Supple mental Information interact' www tigard -or goy t „ j „ r :, " i t „• r -: r r+1 ' ±: !t, i ,!; t , , 't • �i .E } ' ; 4' r ' i' - , 1} t ' i i F E e t 1 ' I l ' ir;lx ., (t'" (, s + l-,r i . ;14.i .;; . .i tltl:il E , ,, : ; i , l l�. t " II P i7 � i`i J �dj 1 14!m�,' ! '`i.1 jiri �tdF j.,!� trt tf i �I 1 a ° . ft4, it '� :`: fil(: R E t:i =ii l!? 1 t::( ?;t: . (3 ,111 f ?i tl, 13...1 ' .. }�{ ( {;f „uc . , 1 -. :a t.,� 1 'r,:: • '7tl�,', d# t • . ' ,.. I .: •' ” ! ❑ New construction ►�lAddition /al[eration/rep •cemetlt Please check all that apply (submit 2 sets Of plans w /items checked below): ❑ Service or feeder 400 amps or more ❑ Building over three stories. ❑ Demolition ❑ Other: where the avnilablc Fault currant ❑ Marinas and boatyards. ff {{`` t ji; ■ at ' i , e exceeds 10,000 amps at ] SD volts or ❑ Floating buildings. ii it.t! i,(f IE` ,r " Rr> t d i1 d 1 I i (1t� 1 1, . f i i4,11112 ; , r t a ii i, - d f ihdti i §! tl'i? "iii ii ' f�"� less to ground, a exceeds t volts ❑Commercial oating agricultural Ig I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building amps for all other installations. :,i buildings. in of Ts KVA or Master builder ❑ Other; ❑ Fire pump ❑ il ❑ Multi f ❑ ❑ Emergency System. larger separately derived System. ` }i4 iii I f r t t� +! (EE aii u t E� 1 E>tm�, " �� & : t u tn, 1j .f f� , S }i •.,.I „ ;t } t 1 } t ❑ Addition of new motor load of ❑ "A . •E „ ,. 1 -Z „ 1.3 r � �ar 'I # , 1000 or more. occupancy Job no.: • Li C\ (.4 Job site address: 1 6 , ' • I I ` ,,. ❑ Six or more residential units. ❑ Recreational vehicle parks. ` f 7 ❑ Health -cats faei s. ❑ Supply voltage for more than liti City /State/ZIP: i C Cpl O 1. Z(,— ❑ Hazardous locations, 600 volts nommsl. �bS Project flame: ❑ Service or feeder 600 amps or more Suite/btdg /Apt no.: v J / U , }t , j # !1 , l� „ Sru,.,, t s� l r} .r r .�°.48 i E s i I ���i , r; , d�i n ' 1. �� ,' t .h < , ��� Cross street/directions to job site: i / At r • Desert ,(too iFVE Bee. 1 -s New residential single or multi - family dwelling unit. Includes attached garage. Lot no: 1,000 sq. ft, or less 145.15 4 , Subdivision: 2a. add'I 500 sq. ft. or portion 33,40 • Tax map /parcel no.: Limited energy, residential 75.00 II ei ut}t r t ` ..u.. 0 1lt . , ai jf�� !�4ft ,. rit with above s.. ' ft. } j,it j' d 1, i .tea, >81i1f11 i`l.fEtt0i ,11r�il�� Ei "1�J Ufl il+�n' "•'wt ` Limited energy, multi - family l 75, 00 2 r b ./7 �r , `' residential (with above sq. ft.) ( ,A Services or feeders installation, alteration, and /or relocation • 200 amps or less 80.30 ' ! 2 { �� y #I l lSTifi nl ".d i latii$I .0 , z,1 • l 201 amps to 400 amps 106.85 2 401 amps to 600 amps II 160.60 i M a 601 amps to 1,000 amps 240.60 II Address: \ p I ■ 0 4 Over 1,000 amps or volts 454.65 � Temporary services or feeders installation, alteration, gad /or City /State /ZIP: -- c - 7).. r 6, it 0 1 Z � relocation Fax; ( ) 200 amps or less 66.85 Phone: (SO • 100.30 2 01 a m ps to 400 amps Owner installation: This installation is being made on property that I own which is not 401 amps to 599 amps 133.75 intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. Branch circuits — new. alteration or extension, ter .auel Owner signature: ` { r � � Date: �r f A. Fee for branch circuits with ■ �,�1 L 4 1\ . ,,>wt t ' ' .. r l i P : r t re'r i j above service or f ee d er f e e , 6.65 h.a t } q 2 each branch circuit is r A ! A ._" / I0 i� u if 1. 1 i B.. Fcc for branch circuits without service or feeder fee, 46.85 2 Contact name: ( 1, o , first branch circuit Each add'l branch circuit 6 .65 2 Address 1� to • 1(� /l n ( Miscellaneous service or feeder not included City /State /ZIP: , y\ oL. .J Q.. q e7 • D 0 Each manufactured or modular 90,90 2 dwelling service and/or feeder Phone: ( t, ) IP , (65-5-5 Fax: •D) , — Reconnect only 66.85 2 lbw Pump or irrigation circle 53,40 2_ tc�7`!11 t lao l � 1 ,B „ t118liYT�ltlld m9 and ' F lfittllfttr i�itti3ir1t1 1d1. fit di or outline lighting 2 , y1 53,40 mop t f t i., a, t Signal circuit(s) or limited- Business name j . • e -1 iC f ( C A ) ' Vr f 0 'r/ energy panel, alteration, or extension. Describe: Page 2 2 Address: f L( 0 t� . i. _ i o 4 ' 1 0 Each additional inspection over allowable in an of the above i. 6 i • 4• A i Per inspection 1 62.50 Phone: (c 3) 2 CI (D - t 5-E Fax; ( ,b) 5 - l' investigation per hour (1 hr min) 62.50 • r Suprv. Lic.: �' ' Industnal plant per hour 73.75 • Electrical Lic.: i • • • • P t• . rr ; % ,. i f , i' ''ilgi S`� SuprV, Electrician signature, required: Pik AI., C i$ Subtotal: W aili /� Plan review (25% of permit fee): IMMIMMIM • Date: • 0 J State surcharge (12% of permit fee): =Mil Authorized signature: TOTAL PERMIT FEE: S! • , q This permit application expires if a permit is not obtaine within 18' Print name; Date: days after it bas been accepted as complete. ' Number of inspections allowed per permit. A 7 CITY OF TIGARD ;i BUILDING DIVISION PERMIT #: _, (:2000;;.: 1; 0 ; 13125 SW Hall Blvd=; Tigard, OR 97223 DATE ISSUED: ,,, Phone: (503) 639=4171 It ulii Inspection Requests (24 Hrs.): (503) 639 -4175 «i' ,_ 1' INSPECTION WORKSHEET FOR ,`� DATE: .Ifsi'!(1 0:001i TIME: 7:00. I PAGE: (i:S SITE.ADDRESS: 1 loit1 :rv' �.ii•� �.1_NE - ) .: }Zc, ` .`tsi! CLASS OF WORK: SUBDIVISION: a,-.7,i i ,— - is v pARK { .. LOT #: TYPE OF USE: PROJECT NAME: j . ".,.l,3? • DESCRIPTION: ia' • --": };ire. OWNER: j( . ( PHONE #: } / < (} I�iv,i; :, 1_ f3i.it{i Ct •�!! i..[ CONTRACTOR: • I r • r 7 c �� a PHONE #: y: .��•',`{�I -�'�:? � t.i:C?'i - �! �:'� . `.:.�i,.l - T tr, .I`e[. .�•.s tii5f;5 Inspection Request Scheduled For: Date: ,0/1;3'00.ci Pour Time: Code # Inspection Description Confirm # - Contact # Message .1 9 c .; ;=1 rt'ii. final 4Y -01 ( Y Corrections /Comments /Instructions: ,., // 1 \ \Jz • 1 © ' / 0 r ' . , , . _ . . , , , ki , , , , , - PASS I I PARTIAL APPROVAL n CANCEL n NO ACCESS � p 6:(1 n CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED Inspector: J-1 Q Date: / 0 ` 19 - 2 Phone-#: (503) 718 - 4r !