Permit ` CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2006 -00083
DEVELOPMENT SERVICES DATE ISSUED: 2/2/2006
-- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S110DD -11400
SITE ADDRESS: 10875 SW HIGHLAND DR ZONING: R -
SUBDIVISION: SUMMERFIELD NO.13 LOT : 684 JURISDICTION: TIG
Project Description: Service upgrade.
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: 1 W /SERVICE OR FEEDER: 4 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:
GENI EVE ROBB AMPHERE ELECTRIC
10875 SW H IGH LAND DRIVE 1350 SE 122ND AVE.
TIGARD, OR 97224 PORTLAND, OR 97233
Phone: Contact #: PRI 503 - 775 - 5311
FAX na
FEES
Description Date Amount Reg #: ELE 26 - 788C
[TAX] 8% State Surcharge 2/2/2006 $8.55 LIC 82102
[ELPRMT] ELC Permit 2/2/2006 $106.90 SUP 41055
Total $115.45 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 OUN ' :t
503 - 246 -6699 or 1 -8!, - 32 -2. A4. , -
Issued By: Permittee Signature: -�i� r .,r4, , �
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.
Electrical' Perit it A FOR or FlcE u ONLY
City of Tigard Date i '•e � �' I ' PennitNo ?U(7 —o 7o23
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revi-
Phone: 503.639.4171 Fax: 503.598.196 F EB 0 2 2006 , 1 �'¢�
fl Da[e By: Other Permit:
v`
Inspection Line: 503.639.4175► Date Ready/By: turfs. ® See Page 2 for
Internet: www.ci.tigard.or.us CITY OF 'T' a uJ A c Notified/Method: ^ / Supplemental Information
�WR1�4� I I t � ,111 91�t PLAN R EVIEW
❑ New construction ® Addition /alteration/replacement Please check all that apply:
❑ Demolition ❑Other: ❑Service over 225 amps, comm'l ❑Hazardous location
['Service over 320 amps - rating ❑ Buildng over 10,000 sq. ft.,
CATEGORY OF CONSTRUCTION of 1- and 2- family dwellings 4 or more new residential
® 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building ['System over 600 volts nominal units in one structure .
❑ Multi: family ❑ Master builder ❑ Other: ['Building over three stories ❑Feeders, 400 amps or more
❑Occupant load over 99 persons ['Manufactured structures or
. JOB SITE INFORMATION' AND LOCATION ❑Egress /lighting plan RV park
❑Health -care facility ['Other: Job no.: 23 Job site address: 10875 SW Highland Drive
Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, Oregon 97224 The above are not applicable to temporary construction service.
Suite /bldg. /apt. no.: Project name: Highland Drive FEE* .SCHEDULE
Description Qty. Fee. Total I **
Cross street/directions to job site: SW 109 Avenue 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'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
Limited energy, non - residential 75.00 2
DESCRIPTION OF WORK. Each manufactured or modular
Panel Upgrade dwelling, service and /or feeder 90.90 2
Services or feeders installation, alteration, and /or relocation
Additional circuits 200 amps or less I 80.30 'O.30 2
❑ PROPERTY OWNER 201 amps to 400 amps 106.85 2
0
401 amps to 600 amps 160.60- 2
I
Name: �` 1'�.O t ti 601- amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 66.85 2
City /State /ZIP: Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that l 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- new, alteration, or extension, per panel
" , ® APPLICANT ❑ CONTACT PERSON„ A. Fee for branch circuits with
• service or feeder fee, each ICJ
Business name: Ampere Electric branch circuit i.-/ 6.65 V` 2
B. Fee for branch circuits
Contact name: Ed Wilson without service or feeder fee,
first branch circuit 46.85 2
Address: 1350 SE 122 Avenue
Each add'l branch circuit 6.65 2
City /State /ZIP: Portland, Oregon 97233 Miscellaneous (service or feeder not included)
I
Phone: (503) 775 - 5311 Fax:: ( ) Pump or irrigation circle 53.40 2
Sign or outline lighting 53.40 2
E -mail: Signal circuit(s) or limited-
,
. CONTRACTOR energy panel, alteration, or .
extension. Describe: Page 2 2
Business name: Ampere Electric
Address: 1350 SE 122 Avenue Each additional inspection over allowable in any of the above
Per inspection 62.50
City /State /ZIP: Portland, Oregon 97233 Investigation per hour (1 hr ruin) 62.50
Phone: (503) 775 -5311 Fax: ( ) Industrial plant per hour 73.75
EL ECTRICAL PERMIT FEES **
CCB Lic.: 82102 Electrical Lic.:. 26 -7:: " -- Suprv. Lie.: 4105 Subtotal /dG yd
Suprv. - Electrician signature, required: ' / Plan review (25% of permit fee)
Print name: ,, - Date: 2_110 ` Sta surcharge (8% of permit fee) 9. S
' TOTAL PERMIT FEE /45 ''
Authorized signature: / /11FoG This permit application expires if a permit is not obtained within 180
days after ithas-been accepted as complete
Print name: F G f / Date: * Fee methodology set by -Tri- County Building Industry Service Board
ti ** Number of inspections per permit allowed.
' ii\ Building \ Permits \ELC- PermitApp.doc 12103 440 -46t 5T(10/02/COM/WEB
CITY OF TIGARD
BUILDING DIVISION PERMIT #: Re:2006-0003
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/20006
Phone: (503) 639-4171 14
,.... 110
Inspection Requests (24 Hrs.): (503) 639-4175 — !I.
INSPECTION WORKSHEET FOR DATE: 2/6/2006 TIME: 7:02AM PAGE: 32
SITE ADDRESS: 10875 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.13 LOT #: 684 TYPE OF USE:
PROJECT NAME: R01313
DESCRIPTION: Sol** upgrade.
OWNER: ROBB, GENEVE PHONE #:
CONTRACTOR: AMPHERE ELECTRIC PHONE #: 503.775.63:11 -
Inspection Request Scheduled For: Date: 2/6/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough-in 026322-01 603-267-2081
Corrections/Comments/Instructions:
C--7\ 16.7----7;_)Z:
•
p "ASS 11 *A: IAL APPROVAL 0 CANCEL El NO ACCESS
I FAIL 1/4 C L FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Z 6 •
Date: - (--) Phone #: (503) 718-
CITY OF TIGARD el- (-
BUILDING DIVISION PERMIT #: ‘ 2400‘ - 600?)
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 +
Inspection Requests (24 Hrs.): (503) 639 -4175 .J' `:_.,
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
S�rcr SIC P/6-2-ct5
�7
SITE ADDRESS: U Q / 5 / CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 / S — b (a Pour Time: •('
Code # Ins ection escription Confirm # Contact # Message
Corrections /Comments /Instructions: •
•
rr� PASS • ARTI. E-A ROVAL El CANCEL ❑ NO ACCESS
I I l
FAIL VC9SPECTION I I ADDITIONAL FEES ASSESSED
Inspector. :. `V e26
p Phone #: (503) 718 -
s