Permit CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2008 -00238
COMMUNITY DEVELOPMENT DATE ISSUED: 4/29/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1S134AC-00700
SITE ADDRESS: 11398 SW IRONWOOD LP ZONING: R - 4.5
SUBDIVISION: ENGLEWOOD LOT : 035 JURISDICTION: TIG
PROJECT: WILLIAMS
Project Description: 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: 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: 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:
BILLY JEAN WILLIAMS T & T ELECTRIC
11398 SW IRONWOOD LOOP 4120 SE INTERNATIONAL WAY #F
TIGARD, OR 97223 MILWAUKIE, OR 97222
Phone: 503 - 590 -0453 Contact #: PRI 503 - 652 -7610
FAX 503 - 652 -7612
FEES
Description Date Amount Reg #: ELE 3 -605C
[ELPRMT] ELC Permit 4/29/2008 $53.50 LIC 161187
[TAX] 12% State Surchar 4/29/2008 $6.42 SUP 5176S
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: /; � � - Permittee Signature: 77//- � ��i
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.
i
riee,tr*ical Permit Applicatic -3 i
' �� C ity of Tigard � ,�p �r�
� ' , , Received / ,
` g Phone: 503.639.4171 Fax: 503.598.1960 �'" 13125 SW HaII Blvd., Tigard, OR 97223 Q � DateB : "! / t , (, g PermrtNo.: � , P 1 \G , at e B ew • Other Permit: 12_,C y.�
Z h A `n Inspection Line: 503.639.4175 ` p ._ <u +
Internet: Line and -or. ov .r� �, N4 ` Dat fie Reedy/By: brit: 63 see Information
or
B U C\ .., S " Notified/Method: ied/Method.
Supplemental
.;�„ "' �-�. a 4 . z -�rsE a r "' Y m
Sr. N er';�.n�t. s 2�0 :fi' <'.:J1`xrxi'� ' s._. - Y >. F' �'. 1 Wf A _ 9 4 � '''` c ` A1�P `Q91, `� � FaY6 l �, t. vitt ; .
❑ New construction j Addition/alteration/replacement Please check all that apply (submit e: sets of plans w /items checked below):
❑ Demolition ❑ Service or feeder 400 amps or more ❑ Building over three stories.
❑ Other
� ] where the available fault 5 0 Y O 1 ❑ Marinas and boatyards.
° t ,,z, " l £7 r . r s, e' t x 7' Htt y'6 n rep P q exceeds 1[),p00 amps at i5 volts or ❑ Floating buildings
t a a _ , tn< i a�% o1,Vax`.I,�). 1.et' 1 -tnt _ o.tntu`r i 1151 ' ... � 8 tIs
less to gra or meccas 14,000
❑Comm -use agricnitwal
:4 1- and 2- family dwelling ❑ Commerciallindustrial ❑ Accessory building Fires for m all other installations.' bud
❑ Multi family ❑ Master builder installation Other: ❑ Fire pump. ❑ installation of 75 KVA or
` :r a w s `r v ` �" wn , . z •, el separately derived
.0 Ai it1 1 X lfiL ,_ "Y °ngiliv ri,° re ; r`r1 tar.4sfcmc r ' «' t .: ❑ Addition of new motor load of ❑ Emergency system. 'e r8 P� Y system
, ❑ Six
Job no.:fa �- Q 3 3 Job site address; / 3 9 S iv .2 o ( o I x OP or more, occupancy.
or more residential units. ❑ Recreational vehicle parks.
City /State /ZIP: /; f � �ie ❑ Healthcare facilities. CI Supply voltage for more than
J ❑ Hazardous locations. 600 volts nominal
Suite/bldg. /apt. no.: Project name: 73..'4- 0 Service or feeder G00 amps or more
-
F •
Cross street/directions to job site: ` 1 tam'"
,s err. -0sa t�?: <+
Description Qty. Fee. Toed •
New residential single or multi - family dwelling unit.
Includes attached garage.
Subdivision: 1 Lot no.: 1,000 sq. R. or less 145.15 4
Tax map /pence] no.: Ea. add'I 500 sq. ft. or portion _ 33.40 1
' t� �, ' r + Limited energy, residential
x 4 3 :£ t t ' m 1 � % l p r � « � 75.00 2
a < . 4 1 4 ii sa "1` ztA,Al� u k ti .. ' w1 k 1 4 Ay ( a s ft.)
Limited energy, multi- family
residential (with above sq. @) 75.00 2
Services or feeders installation, alteration, and/or relocation
t w j •
° 1 r X° x }fix r • 200 amps or less 80.30 2
:`.'aaul� `;., , . r g v °Tat 2q,a 201 amps to 400 amps 106.85 2
Name: /j y JLa w= 1 / ;A e m 5 401 amps to 600 amps 160.60 2
�
601 amps to 1,000 amps 240.60 2
Address: / j 3 f e sit" Ivor 4...-or.� 7 Over 1,000 amps or volts 454.65 2
City /State/ZIP: - � , a Temporary services or feeders installation, alteration, and/or
relocation
Phone: (ds 3 ) y giy _ / S 3 [ Fax: ( ) 200 amps or less 66.85 1 i 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
1 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
1 , a x sg r� 3t A. Fee for branch circuits with
ry ' .,i_. " ;sa_..rv'. ;i ti ... t.: _ • s ss a sa ` Ra a.M J.. � above service or feeder fee, Z 6.65 1 /1 3b
Business name:
each branch circuit 2
B. Fee for branch circuits N
Contact name:
without service or feeder fee, 46.85 i,„44•6
/ 2 1 �'
first branch circuit _ ti
'FA Address: Each add'] branch circuit ( t 6.65 (p, ) 2 \ �tFT
City/State/ZIP: Miscellaneous (service or feeder nbt included) if te
Each manufactured or modular 90.90 2
Phone: ( ) Fax: : ( ) dwelling, service and/or feeder
Reconnect only 66.85 2 rf
E r_ Pump or irrigation circle 53.40 3-&'t.. '5 � � :.' ..: t &tf�"IMI I - r t t - r . r or uu tline lighting 2
,. � �,.. .��... .: � ��i�� _,. a Si ._ 1� � 8 53.40 2
Business name: ?'�jf Signal circuit(s)orlimited-
e c ./ r,'c.a ( / 4 f _ energy panel, alteration, or
Address: r/i2 p .Si :7ep lie rn fb,rat/ 4/47 , 5 f4 f tensian.Describe: Paget 2
City /State/ZIP. t
/ sr,z 9? Z I < Each additional inspection over allowable in any of the above
Phone: (S 5 ) _5 Z - 7 Fax: ( ) l0 52. Per inspection 62.50
Investigation per hour(' hr min) 62.50
CCB Lie.: /G / 7 I Electrical Lie.: 3 -65 e• I Suprv. Lie.: 57 76 S Industrial plant per hour 73.75
Suprv. Electrician signature, required: '' �'+ § . '` "^ � r 3 ? 31
Subtotal: 30 • 3'Sz
Print name: Date: Plan review (25% of permit fee):
State surcharge (12% of permit fee): t
Authorized signature: - D 6. 4 d�
TOTAL PERMIT FEE: f p /7t
Print name: Date: This permit application expires If a permit is not ob Ined winds 180 e 1
days after it has been accepted as complete.
* Number of inspections allowed per permit
r.1BuildingTemliU .<..PennItApp. 05/23/06 440- 4615T(I ]105 /COM/Wna
a - d a T 9L aS9 60S XFJ3 13C?I36FJ1 dH 817:0I 800Z ea .add
CITY OF TIGARD
BUILDING DIVISION PERMIT #: ELC200B- 00238
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/29/2008
Phone: (503) 639- 4171-,u'ghM °IhNldj�l�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/13/2008 TIME: 7 :02AM PAGE: 36
SITE ADDRESS: 11398 SW IRONWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD LOT #: 035 TYPE OF USE:
PROJECT NAME: WILLIAMS
DESCRIPTION: Ind ailing (2) branch circuits
OWNER: WILLIAMS, BILLY JEAN PHONE #: 503 - 590-0463
CONTRACTOR: T & T ELECTRIC PHONE #: 603 -652 -7610
Inspection Request Scheduled For: Date: 5/13/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
199 Electrical final 06976 8-01 603- 652 -7610 N
Corrections /Comments /Instructions:
\Ppi
l
N
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: • N t6 LEK Date: 611 3I di Phone #: (503) 718 - 7-441)