Permit • CITY OF TIGARD ELECTRICAL PERMIT
II
PERMIT #: ELC2008 -00077
COMMUNITY DEVELOPMENT DATE ISSUED: 2/12/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S 103CA -01100
SITE ADDRESS: 13260 SW HOWARD DR ZONING: R -4.5
SUBDIVISION: WOODCREST LOT : 010 JURISDICTION: TIG
PROJECT: JORDAN
Project Description: bathroom remodel. installing (2) branch circuits.
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 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: 1 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:
MICHAEL & JENNIFER JORDAN FISHBACK ELECTRIC LLC.
13260 SW HOWARD DR PO BOX 810
TIGARD, OR 97223 NORTH PLAINS, OR 97133
Phone: Contact #: PRI 503 - 430 -8800
FAX 888 - 700 -0130
FEES
Description Date Amount Reg #: ELE 34 -563C
IELPRMT] ELC Permit 2/12/2008 $53.50 LAC 147186
[TAX] 12% State Surchar 2/12/2008 $6.42 SUP 4561 S
Total $59.92 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: /M ..� Permittee Signature: COQ ��2
___/ -
/ 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.
. - q� ui( ' s�3 --
2/12/2008 7:55 AM FROM: 503 - 430- 8800Fishbac TO: 503. 9 1960 PAGE: 002 OF 003
Electrical Permit Application FOR OFFICE USE ONLY
City Vv' of Ti a EC V E -r, eived n
A' /1 (fg 'etmi[ No.: �GC tL.�,Q' _
` 13125 SW Hall Blvd., Tigard, OR 97 L3 Plan Review Or/VO
Phone: 503.639.4171 Fax: 503.598.1960 p -p ' 2608 Date/By: oulerPermit:
TIGARD Inspection Line: 503.639.4175 FEB 1 DateReady /By: 7uris 0 See Page 2[or
Internet: www.tigard- or.gov {+ �, otified/Method Supplemental Information
TYPE - OF_:Wals34l TIGQ PLAN REVIEW
❑ New construction ®Adclitionralter A ICp Cement Please check all that apply (submit 2 sets of plans se/items checked below):
❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Demolition ❑ Other: where the available fault current ❑ Marinas and boatyards.
S CATEGORY OF CONSTRUCTION - - - exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
' . � � �� � "' � � - less to p'otmd, or exceeds 14,000 ❑Commercial -use agsiculhual
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ hastanation of 75 KVA or
Em ergency system larger separately derived system
JOB.'. SITE INFORMATION AND ;LOCATION.:` ❑ Addition of new motor load of ❑ "A" "F" "1 - 2^ "1 -3
10013 or mare. occupancy.
Job no.: Job site address: 13260 SW Howard Drive
❑ Six or more residential units. ❑ Recreational vehicle parks
City /State /ZIP' Tigard, OR 97223 ❑ Health -case facilities. ❑ Supply voltage for more than
❑ Hazardous locations. 600 volts nominal.
Stute/bldg. /apt. no.: PIoject name' ❑ Service or feeder 600 amps os more.
. FEE : SCHEDULE".,
Cross street/directions to ob site: Cross streets: SW 121st and Howard Drive
� Description . Qty. Fee. ! Total I '
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: Lot no 1,000 sq. ft. or less 145.15 4
Tax map /parcel no.: Ea. add') 500 sq. 11. or portion 33.40 1
gy
Limited energy, residential 75 00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
bathroom remodel residential (with above sq. ft.)
Services or feeders installation, alteration, anti /or relocation
200 amps or less 80.30 2
®;PROPERTY: OWNER ❑ : 201 amps to 400 amps 106.85 2
Name: Jennifer Jordan 401 amps to 600 amps 160.60 2
ff\L�•rva t�..1..1Y.12rmr 949.60 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
ralnrafinn
Phone: ( ) Fax: ( ) 200 amps or less 66.85 1
a.sVIIrl' utatauauuu: 11105 uWidltui Lu! to ucutg UTAILC sill pi 01)01 ulnt t siwu wuwii its urn , ^' ' —, '� ^^ " —,
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Branch circuits - new, alteration, or extension, per panel
Owner signature Date
A. Fee for branch circuits min bu
❑ APPLICANT., iL CONTACT PERSON abov .sefane ferderfee, 665
encIlhrpflch,I1liI I 2
Business name: Fishback Electric LLC B. Fee for branch circuits l �
am tvi/ /told service or feeder fee, 1 46.85 /
Contact name: Alan Fishback 46
first bran .85 2 branch circuit NY
City /State /ZIP: Each manufactured or modular 90.90 2
dwelling, service antl /or fzetler /J lw"
Phone: (503) 805 -9983 cell Fax:: ( ) Reconnect only 66.85 2 JJ
F_msil Pn mp nr irrtentinn rirrle. 9340 7
CONTRACTOR Sign or outline lighting 53.40 2
Business name: Fishback Electric LLC Signal circui[(s) or limited
energy panel, alteration, or
Address: PO BOY 810 J extension. Describe: Page 2 2
City /State /ZIP: 97133 j l � y �'c , a/J' / O1_. Ech additional inspection over allowable in any of the above
V ` � k v Pe a r inspection 63.50
Phone: (503) 430 -8800 Fax: (888) 700 -0130
Investigation per hour (I hr min) 62.50
CCB Lic.: 147186 Electrical Lic.: ?4 Suprv. Lic.: 4561 Incusbr al plant per hour 73.75
- - ty ELECTRICAL PERA'lIT ,FEES . - , :'.
Sup . Elec a ician signature, required: tj� Subtotal 53.50
Print name: Alan Fishback Date: 2 /11)2008 Plan review (25% of permit feel:
State surcharge (12 %of permit fee): 6.42
Authorized signature: , t .,G,2i_. TOTAL PERMIT FEE: 59.92
Print name: Alan Fishback Date: 2/11/2008 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete,
` Number of inspections allowed per permit. r
I7Building\Pemrits\ELC- PenmtApp dcc 05/23/)6 440 .d615T(1 L05 /COM'WEB T
CITY �~��� ��8�������� ' '
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BUILDING K�U��U��U��0� ' '
=~~~.~~~°""~~� ~~"°"~~"~~"~ PERMIT #: ELC2008'00077
| 13126SVV Hall B|vd,llgund.OR07223 DATE ISSUED: 2112/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 A. -' Ails
INSPECTION WORKSHEET FOR DATE: 3/7/20O0 TIME: 7:00ANi PAGE: C4
SITE ADDRESS: 13260 SW HOWARD DR CLASS OF WORK:
SUBDIVISION: WOODCREST LOT #: 010 TYPE OF USE:
PROJECT NAME: JORDAN
DESCRIPTION: bathroom remode instlliri (2) branch circuits.
OWNER: JORDAN, MICHAEL & JENNIFER PHONE #:
CONTRACTOR: F|SHBACK ELECTRIC LLC. PHONE #: 503
Inspection Request Scheduled For: Date: Pour Time: V.
iv
Code # Inspection Description Confirm # Conta(t# K8eoaage �� '
199 Electrical final 066209-0 50:�B05'9963 Y
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,
Corrections/Comments/Instructions:
__
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.
2n 5 _CDASS PAR �� �� CANCEl NOACCESS
�� FAIL LL FOR | | | ADDITIX FEES ASSESSED
. 41r ' ��
Inspector: ����� i
^ ~� Date: ���r �~ ~ Phone #: (503)
- . - ' . ' . '
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC2008 -00077
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/12/2008
Phone: (503) 639 -4171 4 Pftawtvil I ll
A
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 2/19/2008 TIME: 7 :01AM PAGE: 7
SITE ADDRESS: 13260 SW HOWARD DR CLASS OF WORK:
SUBDIVISION: WOODCREST LOT #: 810 TYPE OF USE:
PROJECT NAME: JORDAN
DESCRIPTION: bathroom remodel. installing (2) branch circuits.
OWNER: JORDAN, MICHAEL_ & JENNIFER PHONE #:
CONTRACTOR: FISIIBACK ELECTRIC LI_C. - Li PHONE #: 50: 430.8800
Inspection Request Scheduled For: Date: 2110008 Pour Time:
Code # Inspection Description Confirm # o f Message
120 Electrical rough-in 5213 - 01`503 - 805 -8983 \ Y
g n 0 6 t
Corrections /Comments /Instructions:
e
PASS n PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ` 1v (Al-. Date: )- ' c Phone #: (503) 718- .
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