Permit rip CITY OF TIGARD ELECTRICAL PERMIT
PERMIT #: ELC2007 -00113
COMMUNITY DEVELOPMENT ., DATE ISSUED: 2/21/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102BA -02100
" SITE ADDRESS: 09935 SW JOHNSON ST ZONING: R -4.5
SUBDIVISION: NO. TIGARDVILLE ADDITION AMEND LOT : 020 JURISDICTION: TIG
PROJECT: BORSCH
Project Description: (2) branch circuits to reconnect gas furnace.
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:
JOE BORSCH BOB'S ACTION ELECTRIC INC
9935 SW JOHNSON ST 2700 NE BURTON ROAD #A
TIGARD, OR 97223 VANCOUVER, WA 98662
Phone: 503 - 484 - 4024 Contact #: PRI 360 254 - 7200
FAX 360- 254 -8219
FEES
Description Date Amount Reg #: ELE 37-431C
[ELPRMT] ELC Permit 2/21/2007 $53.50 LIC 53136
[TAX] 8% State Surcharge 2/21/2007 $4.28 SUP 4322S
Total $57.78 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: / `Gj 1 ��(� Permittee Signature: _ -C.. Cj , �'
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.
V
Electrical .Permit Application 1 .4 . ; s `.1 FOR OFFICE'U ONLY : N ;,
�{ y
a �'C "I % t k ' Received r
City of Tigard i_ t l;� DateB ar "4" �l Permit No - / d as l 3
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 B 200 -. ," �m'I't� Date/By: t.
Other Perm
Inspection Line: 503 639.417 Date Ready /By. Suns 8 See Page 2 for
Internet: www.ci.tigard.or.us CITY Ur Til.iiiiRD Notified/Method. Supplemental Information
l � e i:1 P E 1 OV WORK. fr P LAN , REVIEW .
❑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
® I and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building ['System over 600 volts nominal units in one structure
❑Building over three stories ['Feeders, 400 amps or more
❑ Multi family ❑ Master builder ❑ Other:
❑Occupant load ['Manufactured structures or
over 99 persons
, . JOB I
STE.INF1 \ TION " :LOTICAON° ,' ` ❑E /li plan RV park
,�,_ a - _._. ,� „ 0 � �_ -,. , ��,.� ,,..._�� - - � -� .�� �.f ,aw ...
❑ Health -care facility ❑Other
Job no 07 -254 Job site address 9935 SW Johnson St. Submit 2 sets of plans with any of the above.
City /State /ZIP: Tigard, OR 97223 The above are not applicable to temporary construction service.
t^:,, :.. s -: l7i,, ;. i` , FWE* H
'SCEDULE'.-
Suite/bldg. /apt. no.: Project name: � _ ;, , , z . ..
N Description Qty. Fee. Toni
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'I 500 sq. ft. or portion 33 40 1
Limited energy, residential 75.00 2
Tax map /parcel no.: Limited energy, non - residential 75.00 2
,' DESCRIPTI O W OR & , : ` Each manufactured or modular
dwelling, service and /or feeder 90.90 2
Gas furnace reconnect. Services or feeders installation, alteration, and /or relocation
200 amps or less 80.30 2
�- ,,_ 201 amps to 400 amps 106 85 2
® PROPERTY OWNERS ❑TENANT;
- , ..... ,.. �.� .. .._. 401 amps to 600 amps 160.60 2
Name: Steve Borsch 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
9935 SW Johnson St . Reconnect only 66 85 I 2
City /State /ZIP: Tigard, OR 97223 Temporary services or feeders installation, alteration, and /or
relocation
Phone: ( 503 481- -4024 Fax: ( ) 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I 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
r
APPLICANT - . _ ❑ CONTCT A PERSON ; A. Fee for branch circuits with
service or feeder fee, each
6.65 2
Business name: branch circuit
B. Fee for branch circuits
Contact name: without service or feeder fee,
46.85 2
each branch circuit 1 46.85
Address: Each add'l branch circuit 1 6.65 6.65 2
City /State /ZIP: Miscellaneous (service or feeder not included)
Pump or irrigation circle 53.40 2
Phone: ( ) Fax: : ( )
Sign or outline lighting 53.40 2
E - mail: Signal circuit(s) or limited-
energy panel, alteration, or
._.� - _ CONTRA CTOR > . - �. r - . . gY p
° extension. Describe: Page 2 2
Business name: Bob's Action Electric
Address: tt tt Each additional inspection over allowable in any of the above
2700 NE Burton Rd. "A" Per inspection 62 50
City /State /ZIP: Investigation per hour (t hr nun) 62.50
Vancouver, WA 98662
Phone:( 360) 254 - 7200 [ 254 - 8219 Industrial plant per hour 73.75
1 ° V 0EI,ECTRIC APPE_R1VII`I'," *'=.
CCB Lie.: 53136 Electrical Lie.: 37 -4 c Suprv. Lic.: 4322S Subtotal 53.50
Suprv. Electrician signature, require /..� Plan review (25% of permit fee)
State surcharge (8% of permit fee) 4.28
Print name: Kevin Broselle Date: 2/LE/07
TOTAL PERMIT FEE 57.78
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Date: * Fee methodology set by Tn- County Building Industry Service Board
** Number of inspections per permit allowed.
CITY OF �7�������N�)
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BUILDING DIVISION
~°~°"~~~�""~~° ~~"~,~,.~~"~ PERMIT #: ELC2007'00113
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: N21/2007
Phone: (503) 639-4171 lir
Inspection Reque�s(24Hxej:(5O3)G3Q'4175 al ��
INSPECTION WORKSHEET FOR DATE: 2/28/2007 TIME: 7 PAGE: 77
SITE ADDRESS: O933,56w JOHNSON 8T CLASS OF WORK:
SUBDIVISION: NO. TIGARDYILLE ADDITION AMEND LOT #: 020 TYPE OF USE:
PROJECT NAME: BORSCH
DESCRIPTION: (2) branch circuits to naunnnoct gas furnace.
OWNER: BORSCH, JOE PHONE #: 503-4844O24
CONTRACTOR: BOBS ACTION ELECTRIC INC PHONE #: 360-254- 7200
Inspection Request Scheduled For: Date: 2/28/2007 Pour Time:
Code # Inspection Description e^ iffn-#` Contact # Message
199 Electrical final 043972'01 380'I51'7200
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Corrections/Comments/Instructions:
CA :1 (H )
A :ASS PARTIAL APPROVAL ri CANCEL NO ACCESS
| | FAIL | | CALL FOR INSPECTION | I ADDITIONAL FEES ASSESSED
_ u\ ��
Inspector: ~ »w ~^�� Date: 2 - '«a ~ `� � Phone #: (503) 718' 244